RESUMO
OBJECTIVES: To describe the characteristics of uncontrolled hypertensive clients attending the specialist hypertension clinic at the University Hospital of the West Indies. To evaluate the effect of a six-month structured education programme on blood pressure (BP) control in these clients. METHOD: All clients attending the clinic between January 4 and March 29, 1999, with blood pressure >140/90 mmHg (n=80), were divided into Group 1, cases (n=42) and Group 2, controls (n=38). Blood pressure (BP), weight (wt), height (ht), waist (W) and hip (H) circumferences were measured and Body Mass Index (BMI) and W/H ratio calculated. Group 1 attended monthly structured interventions: BP and wt monitoring, videos, group and individual counselling for six months. A 40 item pretested questionnaire, administered to both groups, collected demographic, lifestyle, knowedge and medication data at baseline and at the end of six months. RESULTS: Mean BMI for men was 27.2 (95 percent CI, 25.7-29.6); mean BMI for women was 30.9 (95 percent CI, 26.1-35.7). Although the majority of both men and women recognized diet, inactivity and overweight as contributing to high blood pressure. Reported medication compliance was good with a mean of only 4 days missed per month. In men, there were associations between BMI and WWHR, p<0.05, BMI and diastolic BP and a negative association between BMI and activity level, p<0.05. Following the intervention, BP was reduced overall, p<0.01, except for diastolic BP in male controls. Knowledge improved among the male cases p<0.01. In the female cases activity scores were higher, p<0.001; Wt and BMI, were lower than at baseline, p<0.05. There was no difference in these variables among the controls. CONCLUSION: Structured education and monitoring interventions with personalised counselling in life style management and weight reduction may be an important part of therapy for clients.(Au)
