{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:10:50Z","timestamp":1792221050491,"version":"4.4.0"},"reference-count":26,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,19]]},"abstract":"<p><bold>Objective.<\/bold> To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru.<\/p>\n<p><bold>Methods.<\/bold> A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 \u2013 April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention.<\/p>\n<p><bold>Results.<\/bold> Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increased fruit and vegetable consumption, and stress control improved during the intervention (<italic>P<\/italic> &lt; 0.001). The EuroQol-Five Dimension Scale showed improvement (<italic>P<\/italic> &lt; 0.001) and body mass index, waist circumference, and systolic and diastolic BPs of the participants significantly decreased (<italic>P<\/italic> &lt; 0.001). Low-density lipoprotein cholesterol (LDL-C) and triglyceride decreased (<italic>P<\/italic> &lt; 0.01) and high-density lipoprotein cholesterol (HDL-C) increased. The estimated glomerular filtration rate (eGFR) increased after the program (<italic>P<\/italic> &lt; 0.001).<\/p>\n<p><bold>Conclusions.<\/bold> This comprehensive BP control program was effective in improving lifestyle indicators, BP levels, and laboratory results among people living in a low-income urban area of Peru. Increasing opportunities for BP measurement, systematic management of hypertensive patients, and community-based prevention and education programs are paramount to hypertension detection, prevention, and control.<\/p>","DOI":"10.26633\/rpsp.2020.18","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T14:54:40Z","timestamp":1589900080000},"page":"1","source":"Crossref","is-referenced-by-count":12,"title":["Effectiveness of a comprehensive blood pressure control program in primary health care in Peru"],"prefix":"10.26633","volume":"44","author":[{"given":"Jong Koo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye-yeon","family":"Jo","sequence":"additional","affiliation":[{"name":"Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Malo","sequence":"additional","affiliation":[{"name":"Pan American Health Organization\/World Health Organization, Country Office, Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Woo","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Health Administration, Yonsei University, Wonju, Republic of Korea."},{"name":"ewnam@yonsei.ac.kr"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","unstructured":"World Health Organization. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020. Geneva: WHO; 2013. Available from: https:\/\/www.who.int\/nmh\/events\/ncd_action_plan\/en Accessed 10 August 2019."},{"key":"ref2","unstructured":"Vinay K, Abul KA, Jon CA. Robbins and Cotran Pathologic Basis of Disease, 9th ed. London: Elsevier; 2014. Pp. 533-4."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287\u2013323.","DOI":"10.1016\/S0140-6736(15)00128-2"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, Haines A. Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet. 2008;372(9642):940\u20139.","DOI":"10.1016\/S0140-6736(08)61404-X"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Dennis SM, Zwar N, Griffiths R, Roland M, Hasan I, Powell Davies G, et al. Chronic disease management in primary care: from evidence to policy. Med J Aust. 2008;188:S53\u20136.","DOI":"10.5694\/j.1326-5377.2008.tb01745.x"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Pilleron S, Pasquier E, Boyoze-Nolasco I, Villafuerte JJ, Olchini D, Fontbonne A. Participative decentralization of diabetes care in Davao City (Philippines) according to the Chronic Care Model: A program evaluation. Diabetes Res Clin Pract. 2014;104(1):189\u201395.","DOI":"10.1016\/j.diabres.2014.01.026"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Jiang H, Vilma I, Katherine TM, Rosana P, Andrea B, Jacquelyn D, et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income patients in Argentina. JAMA. 2017;318(11):1016\u201325.","DOI":"10.1001\/jama.2017.11358"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Balc\u00e1zar H, Fern\u00e1ndez-Gaxiola AC,P\u00e9rez-Lizaur AB, Peyron RA, Ayala C. Improving heart healthy lifestyles among participants in a Salud para su Coraz\u00f3n promotores model: the Mexican pilot study, 2009-2012. Prev Chronic Dis. 2015;12:E34.140292.","DOI":"10.5888\/pcd12.140292"},{"key":"ref9","unstructured":"Ministry of Health of Peru. Carga de enfermedad en el Peru: estimacion de los a\u00f1os de vida saludable perdidos 2012. Lima: MOH; 2014."},{"key":"ref10","unstructured":"Instituto Nacional de Estad\u00edstica e Inform\u00e1tica. Una mirada a Lima metropolitana. Lima: INEI; 2014."},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206\u201352.","DOI":"10.1161\/01.HYP.0000107251.49515.c2"},{"key":"ref12","unstructured":"The International Physical Activity Questionnaire Group. International Physical Activity Questionnaire. 2010. IPAQ_Spanish (Argentina) short last 7 days self-administered format; 2011. Available from: http:\/\/www.ipaq.ki.se Accessed 11 November 2019."},{"key":"ref13","unstructured":"EuroQol Research Foundation. EQ-5D. Rotterdam: EuroQol Research Foundation; 1990. Available from: https:\/\/euroqol.org\/eq-5d-instruments\/eq-5d-3l-about\/ Accessed 11 November 2019."},{"key":"ref14","unstructured":"Korea Center for Disease Control and Prevention. Standard Educational Materials of Hypertension. Osong, Republic of Korea: KCDC; 2012. Available from: http:\/\/www.cdc.go.kr\/board.es?mid=a20503050000&bid=0021&act=view&list_no=127690 Accessed 11 November 2019."},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"van de Vijver S, Oti S, Addo J, de Graft-Aikins A, Agyemang C. Review of community-based interventions for the prevention of cardiovascular diseases in low-and-middle-income countries. Ethn Health. 2012;17(6):651\u201376.","DOI":"10.1080\/13557858.2012.754409"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Jafar TH, Islam M, Hatcher J, Hashmi S, Bux R, Khan A, et al. Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial. BMJ. 2010;340:c2641.","DOI":"10.1136\/bmj.c2641"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Mills KT, Obst KM, Shen W, Molina S, Zhang H, He H, et al. Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients. Ann Intern Med. 2018; 168(2):110\u201320.","DOI":"10.7326\/M17-1805"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Neupane D, McLachlan CS, Mishra SR, Olsen MH, Perry HB, Karki A, et al. Effectiveness of a lifestyle intervention led by female community health volunteers versus usual care in blood pressure reduction (COBIN): an open-label, cluster-randomised trial. Lancet Glob Health. 2018;6(1):e66\u201373.","DOI":"10.1016\/S2214-109X(17)30411-4"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Huang S, Hu X, Chen H, Xie D, Gan X, Wu Y, et al. The positive effect of an intervention program on the hypertension knowledge and lifestyles of rural residents over the age of 35 years in an area of China. Hypertens Res. 2011;34(4):503\u20138.","DOI":"10.1038\/hr.2010.265"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Almeida-Pittito Bd, Hirai AT, Sartorelli DS, Gimeno SGA, Ferreira SRG. Impact of a 2-year intervention program on cardiometabolic profile according to the number of goals achieved. Braz J Med Biol Res. 2010;43(11):1088\u201394.","DOI":"10.1590\/S0100-879X2010007500110"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Calano BJD, Cacal MJB, Cal CB, Calletor KP, Guce FICC, Bongar MVV, Macindo JRB. Effectiveness of a community-based health programme on the blood pressure control, adherence and knowledge of adults with hypertension: A PRECEDE-PROCEED model approach. J Clin Nurs. 2019;28(9-10);1879\u201388.","DOI":"10.1111\/jocn.14787"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Dami\u00e3o R, Sartorelli DS, Hirai A, Massimino F, Poletto J, Bevilacqua MR, et al. Nutritional intervention programme among a Japanese-Brazilian community: procedures and results according to gender. Public Health Nutr. 2010;13(9):1453\u201361.","DOI":"10.1017\/S1368980010000935"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Krishnan A, Ekowati R, Baridalyne N, Kusumawardani N, Suhardi, Kapoor SK, et al. Evaluation of community-based interventions for non-communicable diseases: experiences from India and Indonesia. Health Promot Int. 2011;26(3):276\u201389.","DOI":"10.1093\/heapro\/daq067"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income patients in Argentina: a randomized clinical trial. JAMA. 2017;318:1016\u201325.","DOI":"10.1001\/jama.2017.11358"},{"key":"ref25","unstructured":"Baghianimoghadam MH, Rahaee Z, Morowatisharifabad MA, Sharifirad G, Andishmand A, Azadbakht L. Effects of education on self-monitoring of blood pressure based on BASNEF model in hypertensive patients. J Res Med Sci Off J Isfahan Univ Med Sci. 2010;15:70."},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison HC, et al. 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. 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