title: [Community participation as a strategy of hypertension control in a health district of Ecuador].
abstract: The results of a program for the treatment and control of arterial hypertension in a rural community of the northern area of Ecuador are reported through the voices and the posters used for patients education, by nurses and health promoters (non professional representatives of the community, with a nursing role) of the district. The steps of the program, from the awareness of the problem because of its high impact on mortality; to the organization of the screening for hypertension of 4284 adults (half of the local adult population); to the systematic collection of data on mortality are described. One of the strategies adopted is the discussion of patients' stories with the local communities: the death of a young patient who refused the treatment and died had a strong influence in convincing at risk patients to enter the program. Treatments were available for 1 dollar a month. Nurses and community health promoters have a pivotal role in guaranteeing pressure control and in identifying at risk patients with the help of community adapted risk tables. From the analysis of data of the first 18 months of follow-up some improvements can be observed: grade II hypertensive patients shifted from 34% to 25%; grade III from 35% to 29%. Lack of compliance with the drug therapy is still one of the main problems.
authors.affiliation: Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona.
authors.forename: Mariella
authors.initials: M
authors.lastname: Anselmi
authors.forename: Feliza
authors.initials: F
authors.lastname: Caicedo
authors.forename: Oberliza
authors.initials: O
authors.lastname: Caicedo
authors.forename: Alba
authors.initials: A
authors.lastname: Chumo
authors.forename: Santo
authors.initials: S
authors.lastname: Mina
authors.forename: Pancho
authors.initials: P
authors.lastname: Peralta
authors.forename: Rosanna
authors.initials: R
authors.lastname: Prandi
authors.forename: Julio
authors.initials: J
authors.lastname: Valdez
authors.forename: Fausto
authors.initials: F
authors.lastname: Avanzini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D024802:Nurse's Role; D010349:Patient Compliance; D010353:Patient Education as Topic; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents