Dietary habits and inadequate control of blood pressure in hypertensive adults assisted by a Brazilian Family Doctor Program

AbstractObjectiveTo estimate dietary habits and other factors associated with inadequate blood pressure (BP) control in hypertensive patients adherent to antihypertensive drug treatment assisted by a Brazilian Family Doctor Program (FDP).DesignA cross-sectional study.SettingFDP units, Niterói, Rio de Janeiro, Brazil.SubjectsWe included data from both male and female participants aged ≥20 years. Participants completed a standardized questionnaire containing questions related to demographics, socio-economic factors, comorbidities and lifestyle, as well as a validated FFQ and eleven additional qualitative questions to investigate dietary habits. Food items were divided into sixteen groups. Medical consultations were performed, BP measurements were taken, blood and urine samples were assessed and anthropometric and nutritional status was evaluated.ResultsIndividuals with inadequate BP control presented higher BMI values (prevalence ratio (PR) = 1·027, 95 % CI 1·009, 1·045) and also consumed more meat (PR = 1·091, 95 % CI 1·022, 1·165), which are potentially modifiable variables. Higher levels of serum creatinine (PR = 1·894, 95 % CI 1·241, 2·892) were also associated with inadequate BP control, as were skin colour (white). After inclusion of the Na excretion index, which is an indirect measure of salt intake, a slight decrease was observed in the PR for meat, which resulted in loss of statistical significance.ConclusionsThe results indicate that salt consumption, skin colour, BMI and serum creatinine are associated with inadequate BP control.

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Abstract P262: Spot Urine Sodium to Potassium Ratio Predicts Increasing Blood Pressure Levels in a General Population: The Nagahama Study

Hypertension ◽

10.1161/hyp.68.suppl_1.p262 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Yasuharu Tabara ◽

Yoshimitsu Takahashi ◽

Takeo Nakayama ◽

Fumihiko Matsuda

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Linear Regression Analysis ◽

Prognostic Significance ◽

Reverse Causality ◽

Cross Sectional ◽

Salt Loading ◽

Available N ◽

Spot Urine

Excessive salt intake is a risk factor for hypertension. The most reliable method for estimating daily salt intake is measurement of 24-h urinary sodium excretion, while it is inconvenient. Sodium-to-potassium ratio (Na/K) of a urine sample is another index of salt loading. We previously reported that a simple measure of spot urine Na/K might be a representative of salt loading in a cross-sectional setting. Here, we conducted a longitudinal study aiming to clarify a prognostic significance of spot urine Na/K for increasing blood pressure (BP) levels. Study subjects consists of 9,769 general individuals. Among them, individuals whose baseline Na/K was available (n=9,328), who were normotensive at baseline (n=6,392), and who participated in the follow-up measurement (n=5,209) were included in this analysis (51.8±12.9 years old, male: 29.2%). Mean follow-up duration was 5.0±0.5 years. Mean Na/K at baseline was 3.1±1.7, and showed step-wise increase with BP levels (optimal: 3.0±1.6, normal: 3.3±1.8, high normal: 3.4±1.8, P<0.001). Other major factors that were significantly associated with Na/K was fasting time (r=-0.220, P<0.001), and CKD (CKD (n=694): 2.7±1.6, control: 3.2±1.7, P<0.001). Mean SBP was significantly increased during follow-up period (baseline: 116±12, follow-up: 119±15 mmHg), and 805 individuals (15.5%) were newly diagnosed as hypertension (HT). These individuals were significantly older (HT: 60.3±9.9, NT: 50.3±12.8 years), were frequently male (36.4%, 27.9%), and had higher SBP (127±9, 115±11 mmHg) at baseline (P<0.001). In contrast, baseline spot urine Na/K was slightly lower in individuals who developed HT (3.0±1.6, 3.1±1.8, P=0.013), while that measured at follow-up investigation was oppositely higher in hypertensives (3.1±1.8, 2.8±1.5, P<0.001). Multiple linear regression analysis adjusted for the covariates identified baseline Na/K (β=0.108, P<0.001) and changes in Na/K during follow-up period (β=0.222, P<0.001) as independent determinants for future SBP levels. Higher spot urine Na/K, as well as increases in the Na/K levels, was significant determinant for future BP levels. The apparently lower baseline Na/K levels in individuals who developed HT might be due to reverse causality.

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High urate concentration is associated with elevated blood pressure in schoolchildren

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0227 ◽

2018 ◽

Vol 31 (11) ◽

pp. 1207-1212 ◽

Cited By ~ 5

Author(s):

Luiza Naujorks Reis ◽

Cézane Priscila Reuter ◽

Jane Dagmar Pollo Renner ◽

Leandro Tibiriçá Burgos ◽

Silvia Isabel Rech Franke ◽

...

Keyword(s):

Blood Pressure ◽

Basic Education ◽

Prevalence Ratio ◽

Cross Sectional Study ◽

Blood Collection ◽

Descriptive Data ◽

Cross Sectional ◽

Borderline Hypertension ◽

Z Scores ◽

Altered Blood

Abstract Background Studies in adults have shown a relationship between high blood pressure and hyperuricemia, but few studies have investigated this association in children and adolescents. The aim of the present study was to associate urate concentration with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in schoolchildren. Methods This cross-sectional study used a sample of 2335 schoolchildren in basic education between 7 and 17 years old. Blood pressure was classified by percentile according to Brazilian parameters for sex and age, reclassified into two categories: normal and borderline/hypertension. Blood collection to obtain serum for urate concentration analysis was performed after a 12-h fast. Values above 5.5 mg/dL were considered hyperuricemia. Descriptive data were presented in frequency and percentage. Linear regression and Poisson regression (prevalence ratio [PR]) was used to test the association between urate concentration and blood pressure. Results Urate concentration was weakly associated with SBP (β: 0.05; 95% CI: 0.02–0.08) and DBP (β: 0.03; 95% CI: 0.01–0.05) z-scores. Schoolchildren with hyperuricemia had a higher prevalence of high SBP (PR: 1.12; p<0.001) and DBP (PR: 1.08; p<0.001). Conclusions Elevated urate concentration is associated with altered blood pressure in schoolchildren.

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Food Fortification: The Level of Awareness among Kenyan Consumers

Journal of Nutrition and Metabolism ◽

10.1155/2020/8486129 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Amaya Aura Linda ◽

Florence Kyallo ◽

Judith K. Okoth ◽

Peter Kahenya ◽

Anselimo Makokha ◽

...

Keyword(s):

Large Scale ◽

Dietary Habits ◽

Statistical Significance ◽

Cross Sectional Study ◽

Binary Logistic Regression Analysis ◽

Food Fortification ◽

Micronutrient Deficiencies ◽

Cross Sectional ◽

The Government ◽

Study Participants

More than half of the morbidity and mortality cases among children in Kenya are as a result of micronutrient deficiencies (MNDs). Food fortification is considered by the Government of Kenya as a feasible strategy for addressing MNDs. Worldwide, fortification has been proven to be effective since it does not require any change in dietary habits. Success of large-scale food fortification however may depend on consumer awareness of the fortification benefits. A cross-sectional study was conducted in 13 counties to collect information on fortification awareness using structured questionnaires. 1435 respondents were selected using the Lot Quality Assurance Sampling method. Data were analyzed using Stata version 14.0 and statistical significance p<0.05. The study participants were described using descriptive statistics. The association of sociodemographic characteristics and awareness of fortification was performed using binary logistic regression analysis. The median age of the study participants was 35 years. Only 28% of the respondents were aware of the term “fortification.” Of the respondents, about 27% heard of food fortification through radio. Vernacular radio emerged as the most preferred channel for communicating fortification information among 24.9% of the respondents. Although awareness of vitamins (32%) and minerals (1.5%) was limited, most (76%) respondents reported of existence of health risks for lacking micronutrients. Awareness of food fortification was significantly associated with respondents’ occupation (p< 0.001), household size (p=0.012), education levels (p<0.001), and age (p=0.025). There is need for a wider use of broadcast media sources to modify information and education materials to promote fortification awareness among Kenyan consumers.

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Barriers of dietary salt reduction among hypertensive patients: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203907 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3459

Author(s):

Mariyam Khwaja

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Lifestyle Modification ◽

Cross Sectional Study ◽

Sectional Study ◽

Dietary Salt ◽

Cross Sectional ◽

Salt Reduction ◽

Hypertensive Patients ◽

Dietary Salt Intake

Background: Healthy dietary practice is an important lifestyle modification and one of the key adjuncts to pharmacotherapy in management of hypertension. A modest reduction in salt intake of 5 gm/day lowered blood pressure by 7/4 mmHg diastolic in hypertensive patients. Despite knowledge about the ill consequences, many people continue to consume high levels of salt in their diet. To motivate people to reduce salt in their diet, a solid understanding of barriers encountered by those under salt reduction recommendation is necessary. Hence, this study was conducted with the aim of identifying the barriers to dietary salt reduction among hypertensive patients.Methods: A community based cross sectional study was conducted on a sample of 356 hypertensive patients in field practice areas (urban and rural) in Department of Community Medicine, JNMC, AMU, Aligarh. A pretested semi-structured questionnaire was used for the study. Compliance to dietary salt intake was assessed by calculating average salt intake per person per day. The tenets of health belief model were used to examine the key determinants of human behavior. Analysis was done by using correlation, proportions, chi-square and multiple linear regression.Results: 31.4% of the participants took salt <5 gm per day. A significant association was noticed with area, religion, social class, family size, perceived benefits and perceived susceptibility. A significant positive correlation was seen with total adherence score and family size.Conclusions: A lot of barriers hinder the compliance to dietary salt reduction. Health Education stressing the role of salt reduction in control of blood pressure is recommended.

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Knowledge, attitude and behaviour on salt intake and its association with hypertension in the Malaysian population: findings from MyCoSS (Malaysian Community Salt Survey)

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00235-0 ◽

2021 ◽

Vol 40 (S1) ◽

Author(s):

Azli Baharudin ◽

Rashidah Ambak ◽

Fatimah Othman ◽

Viola Michael ◽

Siew Man Cheong ◽

...

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

High Salt ◽

Cross Sectional ◽

Face To Face ◽

Salt Consumption ◽

Malaysian Population ◽

High Salt Intake ◽

Nationally Representative ◽

Research Assistants

Abstract Background High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population. Methods Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure. Results Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension. Conclusion Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.

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Parameters Associated with Elevated Systolic Blood Pressure Levels in Greek Military Pilots

The Open Hypertension Journal ◽

10.2174/1876526201406010027 ◽

2014 ◽

Vol 6 (1) ◽

pp. 27-31

Author(s):

G. Platsas ◽

G. Kourianidis ◽

P. Toutouzas ◽

C. Stefanadis ◽

G. Vyssoulis

Keyword(s):

Blood Pressure ◽

Dietary Habits ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Multivariate Linear Regression Analysis ◽

Medical Monitoring ◽

Cross Sectional ◽

Elevated Systolic Blood Pressure ◽

Life Style Changes ◽

Military Pilots

Background: Elevated blood pressure levels (BP) continue to comprise one of the most important public health problems worldwide. Hypertension is among the most serious risk factors that relates to myocardial infarction, stroke and kidney failure. The purpose of the study was to examine factors that may contribute to presentation of hypertension in military jet pilots. Methods: This is a cross-sectional study of 300 jet pilots of Greek Air-Force. Several data were retrieved from medical files. Participants filled in a questionnaire about demographics, dietary habits and lifestyle factors. Arterial BP was also measured. Spearman’s r was used for correlations. Also, multivariate linear regression analysis was performed. Results: All pilots presented systolic and diastolic BP within normal range (mean: 117.5 mmHg and 77.0 mmHg, respectively). 200 pilots presented optimal BP, 80 normal BP and 20 had marginally normal BP. Most pilots were exercising up to two times weekly (66.9%), however, some reported they didn’t exercise at all (12%) and mentioned exercising for a mean period of 12.0 (±7.6) years, mainly (62.1%) outdoors with aerobic (52.4%), anaerobic exercises (5.6%) or both (42%). Factors that influenced systolic BP levels were body mass index, flight hours, HDL values and exercise intensity. Conclusion: Pilots’ medical monitoring seems adequate since there weren’t any abnormal BP values. Emphasis should be placed on the continuation of programs already in place with further refinement according to specific needs. Smoking cessation interventions are needed as well as promotion of measures that can effectively lead to long standing life-style changes and dietary modifications.

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Hypertension knowledge, heart healthy lifestyle practices and medication adherence among adults with hypertension

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v6i1.1416 ◽

2018 ◽

Vol 6 (1) ◽

pp. 108 ◽

Cited By ~ 1

Author(s):

Hawa Ozien Abu ◽

Hanan Aboumatar ◽

Kathryn Carson ◽

Robert Goldberg ◽

Lisa Cooper

Keyword(s):

Blood Pressure ◽

Medication Adherence ◽

Salt Intake ◽

Healthy Lifestyle ◽

Pressure Control ◽

Dietary Salt ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Lifestyle Practices ◽

Hypertension Knowledge

Objective: To assess patients’ knowledge about hypertension and its association with heart healthy lifestyle practices and medication adherence.Methods: We conducted a cross sectional survey of 385 adults with hypertension treated at 2 primary care clinics in Baltimore, Maryland, USA. We used an 11-item measure to assess hypertension knowledge and obtained self-reports on dietary changes, engagement in aerobic exercise and medication adherence. Results: Approximately 85% of patients properly identified high blood pressure, but more than two-thirds were unaware that hypertension lasts a lifetime once diagnosed; one-third were unaware that hypertension could lead to renal disease. Patients with low hypertension knowledge were less likely to reduce their salt intake (OR=0.44 [95% CI: 0.24-0.72]) and eat less to lose weight (OR=0.48 [95% CI: 0.26-0.87]) than patients with high hypertension knowledge.Conclusion: In general, patients were knowledgeable about hypertension, but most were unaware that hypertension is a lifelong condition and could lead to kidney disease. High knowledge of hypertension was associated with healthy lifestyle practices including eating less to lose weight and dietary salt reduction.Practice Implications: Intensifying education strategies to improve patients’ knowledge of hypertension may enhance their engagement in heart healthy lifestyle practices for optimal blood pressure control.

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Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023995 ◽

2019 ◽

Vol 9 (1) ◽

pp. e023995 ◽

Cited By ~ 2

Author(s):

Samuel Kimani ◽

Waithira Mirie ◽

Margaret Chege ◽

Okubatsion Tekeste Okube ◽

Samuel Muniu

Keyword(s):

Blood Pressure ◽

Fast Food ◽

Antihypertensive Medication ◽

Dietary Habits ◽

Lifestyle Modification ◽

Referral Hospital ◽

Cross Sectional ◽

Highly Educated ◽

Vegetables And Fruits ◽

National Referral Hospital

ObjectiveAssociation of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya.DesignDescriptive, cross-sectional.SettingMedical wards and outpatient clinic of a national referral hospital.ParticipantsPatients (n=229) diagnosed with primary hypertension for at least 6 months.Primary outcomesClinical makers, cholesterol levels, anthropometrics, lifestyle/dietary habits adjusted for age, gender and education; antihypertensive adherence; views on prevention of hypertension and adequacy of hypertension information.ResultsAgeing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. Females had higher body mass index (BMI). More males reported drinking alcohol and smoking (p<0.001), especially the highly educated. Higher BPs were observed in smokers and drinkers (p<0.05). Daily vegetables and fruits intake were linked to lower BP, HR and BMI (p<0.05). Intake of foods high in saturated fat and cholesterol were associated with raised HR (p<0.05). Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90). Few respondents (30.8%) considered hypertension as preventable, mainly the single and highly educated (p<0.05). Respondents (53.6%) believed they should stop taking their antihypertensive medication once hypertension is controlled.ConclusionMissed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. Alcohol and smoking is common in males associated with poor BP control. Daily vegetables and fruits intake are associated with better BP control and overall hypertension risk reduction. Observed suboptimal BP control despite pharmacological adherence suggests lifestyle modification is needed besides antihypertensive medication. Interventions should address modifiable risk factors aggravated by age and adverse lifestyles through adopting combined lifestyle modification, pharmacological adherence and tailored expert delivered hypertension-related information.

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Salt reduction in bread: Is it enough? Preliminary results of a HIA in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz187.027 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Santos ◽

P Braz ◽

A Costa ◽

L Costa ◽

M Santos ◽

...

Keyword(s):

Blood Pressure ◽

Statistical Difference ◽

Salt Intake ◽

Statistical Significance ◽

Systolic Pressure ◽

Health Impact ◽

World Health ◽

Salt Reduction ◽

Aggregated Data ◽

The Impact

Abstract Issue Health Impact Assessment (HIA) is a methodology that aims at assessing the impact of policies in health. A pilot HIA is in progress to kick off the implementation of this methodology in Portugal with the support of the World Health Organization (WHO). In this context, the impact of a nation-wide policy that intends to achieve a maximum of 1 g of salt/100 gr in bread is under assessment. Description of the issue In 2017, Portugal approved a protocol between the industry and other stakeholders to gradually decrease the amount of salt in bread, as this is the main source of salt intake. The purpose of this study was to assess the impact in blood pressure from current (1.4 gr) to 1 g (29% reduction) of salt in bread. Data from two different surveys regarding blood pressure and salt intake was gathered. We estimated the decrease in blood pressure with respect to current average values according to sex, age, education and region. Results It is expected that a reduction of 29% in salt intake through bread contributes to a general decrease in systolic pressure for normotensive people (from 120.4mmHg to 120.0mmHg, p = 0.85) and hypertensive people (from 151.0mmHg to 150.1mmHg, p = 0.68), although not statistically significant. Older hypertensive individuals (65 to 75 years) are the group with the largest benefit (152.8mmHg to 152.0mmHg) but no statistical difference was found. Disaggregation by sex, region and education also didn’t show any statistical difference. Lessons The impact in blood pressure from a 29% reduction in salt intake from bread seems very small. We found no statistical significance between the current and expected values in blood pressure either for total or group stratification. The absence of statistical effect might be due to sample size as our sources only allowed us to work with aggregated data. Key messages Quality and access to data is needed to assess impact of policies. to increase effects in blood pressure either salt reduction from bread must be larger or a wider range of products should be considered.

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The Contribution of Preschool Meals to the Diet of Finnish Preschoolers

Nutrients ◽

10.3390/nu11071531 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1531 ◽

Cited By ~ 3

Author(s):

Liisa Korkalo ◽

Kaija Nissinen ◽

Essi Skaffari ◽

Henna Vepsäläinen ◽

Reetta Lehto ◽

...

Keyword(s):

Dietary Habits ◽

Salt Intake ◽

Age Groups ◽

Food Services ◽

Food Record ◽

Cross Sectional ◽

Added Sugar ◽

High Salt Intake ◽

Education And Care ◽

The Mean

Preschool meals may influence the formation of children’s dietary habits and health. We assessed the contribution of preschool meals to the diet of Finnish children. We used food record data from the cross-sectional DAGIS survey and selected recording days which included all three meals (breakfast, lunch, afternoon snack) at preschool. We analyzed the diet of three- to four-year-olds (n = 324) and five- to six-year-olds (n = 233). Preschool meals accounted for 54% of the weekday’s energy intake in both age groups, and provided ≥60% of total fiber, polyunsaturated fatty acids, and vitamins D and E. More than 60% of fish dishes but only one third of total daily fresh fruit were consumed at preschool. The mean (SD) percentages of energy from protein and fat at preschool were 17% (3%) and 30% (7%) in the younger and 17% (3%) and 31% (6%) in the older age group, respectively. The mean proportions of energy from added sugar at preschool were below 5% in both age groups. On average, salt intake exceeded recommendations and 60% of salt came from preschool food. Tackling high salt intake should be a future goal of guidance for early childhood education and care food services.

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