title: Evaluation of a pilot hypertension management programme for Guatemalan adults.
abstract: Corazón Sano y Feliz is a hypertension management intervention developed to address deficiencies in the management of hypertensive patients in Guatemala. From 2007 to 2009, Corazón Sano y Feliz was pilot-tested in the community of Mixco. Corazón Sano y Feliz comprises a clinical risk assessment and treatment component implemented primarily by nurses, and a health education component implemented by community health workers. To accomplish our secondary objective of determining Corazon Sano y Feliz's potential for change at the patient level, we implemented a one-group pretest-posttest study design to examine changes in clinical measures, knowledge and practices between baseline and the end of the 6-month intervention. Two nurses and one physician set up a hypertension clinic to manage patients according to risk level. Twenty-nine community health workers were trained in CVD risk reduction and health promotion and in turn led six educational sessions for patients. Comparing baseline and 6-month measures, the intervention achieved significant improvements in mean knowledge and behaviour (increase from 54.6 to 59.1 out of a possible 70 points) and significant reductions of mean systolic and diastolic blood pressure (27.2 and 7.7 mmHg), body mass index (from 26.5 to 26.2 kg/m(2)) and waist circumference (89.6-88.9 cm). In this pilot study we obtained preliminary evidence that this community-oriented hypertension management and health promotion intervention model was feasible and achieved significant reduction in risk factors. If scaled up, this intervention has the potential to substantially reduce CVD burden.
authors.affiliation: Institute of Nutrition of Central America and Panama-INCAP, Guatemala City, Guatemala cmendoza@incap.int.
authors.forename: Carlos
authors.initials: C
authors.lastname: Mendoza Montano
authors.affiliation: Institute of Nutrition of Central America and Panama-INCAP, Guatemala City, Guatemala.
authors.forename: Meredith
authors.initials: M
authors.lastname: Fort
authors.affiliation: Programme of Chronic Diseases, Ministry of Health of Guatemala, Guatemala City, Guatemala.
authors.forename: Miriam
authors.initials: M
authors.lastname: deRamirez
authors.affiliation: Programme of Chronic Diseases, Ministry of Health of Guatemala, Guatemala City, Guatemala.
authors.forename: Judith
authors.initials: J
authors.lastname: Cruz
authors.affiliation: Institute of Nutrition of Central America and Panama-INCAP, Guatemala City, Guatemala.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramirez-Zea
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004502:Education, Medical, Continuing; D005260:Female; D006166:Guatemala; D006293:Health Promotion / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015397:Program Evaluation; D018570:Risk Assessment
keywords: cardiovascular health promotion; community-based intervention; diabetes; hypertension control