Effect of lifestyle on blood pressure in patients under antihypertensive medication: an analysis from the Portuguese Health Examination Survey

Introduction and Objectives: Hypertension is one of the main risk factors for disability and death from cardiovascular disease. Current guidelines include initiatives to control blood pressure in hypertensive patients that focus on lifestyle changes. The main objective of this study was to analyze t...

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Bibliographic Details
Published in:Revista Portuguesa de Cardiologia
Main Authors: Salvador, Mário Rui, Gonçalves, Susana Cunha, Romana, Guilherme Quinaz, Nunes, Baltazar, Kislaya, Irina, Matias Dias, Carlos, Rodrigues, Ana Paula
Format: Article in Journal/Newspaper
Language:English
Published: Elsevier España/ociedade Portuguesa de Cardiologia 2020
Subjects:
Online Access:http://hdl.handle.net/10400.18/7109
https://doi.org/10.1016/j.repc.2018.12.006
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Summary:Introduction and Objectives: Hypertension is one of the main risk factors for disability and death from cardiovascular disease. Current guidelines include initiatives to control blood pressure in hypertensive patients that focus on lifestyle changes. The main objective of this study was to analyze the association between lifestyle and blood pressure in patients under antihypertensive medication. Methods: Data collected in the Portuguese National Health Examination Survey (INSEF) were analyzed. Individuals who met INSEF inclusion criteria and reported being under antihypertensive medication in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, added salt intake, fruit and vegetable consumption, and physical activity) were assessed by questionnaire, and systolic and diastolic blood pressure were measured by physical examination. Associations between lifestyle factors and blood pressure, stratified by gender and adjusted for sociodemographic variables and obesity, were estimated through a multiple linear regression model. Results: Alcohol consumption (beta=6.31, p=0.007) and smoking (beta=4.72, p=0.018) were positively associated with systolic blood pressure in men. Added salt intake, fruit and vegetable consumption, and physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioral variable. Conclusions: These conclusions highlight the need in the population under antihypertensive medication, particularly in men, to focus on the fight against high systolic blood pressure in the two modifiable and preventable behaviors of smoking and alcohol consumption. Introdução e objetivos: A hipertensão arterial é um dos principais fatores de risco para incapacidade e morte por doenças cardiovasculares. Orientações atuais de controlo da pressão arterial em indivíduos hipertensos focam-se em alterações do estilo de vida. O principal objetivo deste estudo foi estimar a associação entre o estilo de vida e a pressão arterial em indivíduos sob medicação anti-hipertensiva. Métodos: Procedeu-se a uma análise dos dados colhidos no Inquérito Nacional de Saúde com Exame Físico. Indivíduos que cumpriram os critérios de inclusão e que referiram encontrar-se sob medicação anti-hipertensiva foram estudados. Variáveis de estilo de vida (consumo de álcool, hábito tabágico, consumo adicional de sal, consumo de fruta e vegetais, prática de atividade física) foram medidas por questionário e os valores de pressão arterial foram obtidos por exame físico. Associações entre fatores do estilo de vida e pressão arterial, estratificadas para o sexo e ajustadas a variáveis sociodemográficas e obesidade, foram estimadas através de um modelo de regressão lineal múltipla. Resultados: Consumo de álcool (b=6,31, p=0,007) e hábito tabágico (b=4,72, p=0,018) foram positivamente associadas à pressão arterial sistólica em homens. Consumo adicional de sal, consumo de fruta e vegetais e prática de atividade física não se encontraram associados à pressão arterial em homens. Em mulheres, nenhuma associação foi identificada para qualquer variável comportamental. Conclusões: Estas conclusões reforçam a necessidade, também na população sob medicação anti-hipertensiva, particularmente no sexo masculino, de centrar o combate à pressão arterial sistólica nestes dois comportamentos modificáveis e preveníveis: hábito tabágico e consumo de álcool. The Portuguese National Health Examination Survey is developed as a part of the project “Improvement of epidemiological health information to support public health decision and management in Portugal. Towards reduced inequalities, improved health, and bilateral cooperation”, that benefits from a 1.500.000€ Grant from Iceland, Liechtenstein and Norway through the EEA Grants. info:eu-repo/semantics/publishedVersion