El control de la presión arterial (PA) es fundamental en reducir la morbi-mortalidad en hipertensos, pero con resultados hasta la fecha insatisfactorios en Chile y en países de alto desarrollo socioeconómico. En Chile se inició en 2002 el Programa de Salud Cardiovascular (PSCV) intentando mejorar el manejo de estos pacientes. Objetivos: Evaluar características sociodemográficas, clínicas, antropométricas, psicosociales y de estilos de vida de un grupo de pacientes participantes en el PSCV, y la influencia de estos factores en el control de la PA. Métodos: Se obtuvo una muestra aleatoria de 525 pacientes (380 mujeres) de un universo de 1.533 hipertensos entre 30 y 68 años bajo seguimiento en el PSCV. Se registraron datos sociodemográficos, clínicos, antropométricos, psicosociales y de estilos de vida a través de evaluación clínica y cuestionarios validados. La PA fue medida utilizando un protocolo estándar por personal entrenado. El análisis estadístico incluyó la predicción del riesgo (Odds RATIO) de PA no controlada por las diversas características estudiadas. Resultados: El 47% de los pacientes logró una PA controlada (<140/90 mmHg). La presencia de diabetes mellitus (DM) fue documentada en el 38,5%. Factores predictores significativos de PA no controlada fueron DM, baja educación, inadecuada relación médico paciente y alto nivel de estrés emocional/depresión. Conclusiones: El PSCV ha logrado un avance importante en el control de la PA resaltando la influencia significativa de factores psicosociales. Sin embargo es preocupante la alta proporción de hipertensos diabéticos, su inferior control de PA, y la limitada captación de hombres al programa. Palabras Claves: Hipertensión arterial, control de la presión arterial, atención primaria, factores psicosociales.
Background: There is consensus in the value of assessing and counseling hypertensive patients in reference to their physical activities (PA). The International Physical Activity Questionnaire (IPAQ) is a commonly used instrument to asses the energy expenditure (EE) through different domains of daily activity. Objectives: The main purpose of this study was to assess the relation of self-reported PA through the IPAQ and the aerobic capacity using oxygen consumption (VO 2 ) measured directly in hypertensive sedentary women. Methods: Cross-sectional study in a simple random sub-sample of 64 hypertensive women between 35 and 55 years old, without physical limitation or coronary event. PA was evaluated using the Spanish version of the IPAQ to assess the energy expenditure (EE) and PA intensity (moderate or vigorous) in different domains (work, transport, domestic, leisure). VO 2 peak was measured directly, breath to breath (Fitmate Pro®), at a submaximal (85% [85 of 100] maximal heart rate) exercise test with 25 watt/3 min load increments in a bicycle ergometer. Results: Mean age was 48.4±5.2 years. Measured peak VO 2 was 16.5±2.6 mL/Kg/min with a predicted VO 2 max of 23±3.7 mL/Kg/min, both corresponding to a sedentary level. The greater proportion of EE was observed in work and domestic domains in contrast to leisure activities that had the lowest. Over 50% (1 of 2) of the PA was done at moderate intensity. Peak VO 2 showed a direct correlation with total EE, work and domestic, and finally, with the cost in PA done at moderate intensity. Table. Relationship between self-reported PA (IPAQ) and direct measurements of VO 2 Domain or PA type IPAQ EE (MET-min/week) * EE(%) † Pearson's Correlation coefficient VO 2 peak (ml/Kg/min) p-value IPAQ total 3,613 (1,976 - 5,589) − 0.539 0.001 Work 358 (0 - 2,230) 25.4 0.577 0.001 Transport 396 (89 - 795) 15.5 −0.103 0.542 Domestic 1,465 (893 - 2,520) 47.1 0.385 0.018 Leisure 153 (0 - 664) 13.1 −0.011 0.950 Moderate 1,672 (978 - 3,275) 57.4 0.560 0.001 Vigorous 0 (0 - 1,216) 12.8 0.249 0.136 * Data expressed as median (percentiles 25 and 75) † Percentage of mean EE of the domain or PA type according to total EE. Conclusion: In sedentary hypertensive women self reported PA using IPAQ is predominantly related to domestic and work activities at moderate intensity. Work, and domestic EE or moderate intensity global PA correlated well with the peak VO 2 directly measured during a sub maximal exercise test. Thus, IPAQ appears as an adequate instrument to assess the EE of hypertensive patients and its impact on their aerobic capacity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.