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Blood Pressure Changes After a Health Promotion Program Among Mexican Workers

Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determine...

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Autores principales: Garcia-Rojas, Isabel J., Omidakhsh, Negar, Arah, Onyebuchi A., Krause, Niklas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261043/
https://www.ncbi.nlm.nih.gov/pubmed/34249846
http://dx.doi.org/10.3389/fpubh.2021.683655
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author Garcia-Rojas, Isabel J.
Omidakhsh, Negar
Arah, Onyebuchi A.
Krause, Niklas
author_facet Garcia-Rojas, Isabel J.
Omidakhsh, Negar
Arah, Onyebuchi A.
Krause, Niklas
author_sort Garcia-Rojas, Isabel J.
collection PubMed
description Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined. Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting. Results: ITT analyses revealed mean BP change differences of −1.1 mmHg at 12 months (95% CI: −2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic −6.1 mmHg, (95% CI: −11.2; −1.2) to systolic −13.0 mmHg (95% CI: −16.0; −10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies. Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers.
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spelling pubmed-82610432021-07-08 Blood Pressure Changes After a Health Promotion Program Among Mexican Workers Garcia-Rojas, Isabel J. Omidakhsh, Negar Arah, Onyebuchi A. Krause, Niklas Front Public Health Public Health Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined. Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting. Results: ITT analyses revealed mean BP change differences of −1.1 mmHg at 12 months (95% CI: −2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic −6.1 mmHg, (95% CI: −11.2; −1.2) to systolic −13.0 mmHg (95% CI: −16.0; −10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies. Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers. Frontiers Media S.A. 2021-06-23 /pmc/articles/PMC8261043/ /pubmed/34249846 http://dx.doi.org/10.3389/fpubh.2021.683655 Text en Copyright © 2021 Garcia-Rojas, Omidakhsh, Arah and Krause. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Garcia-Rojas, Isabel J.
Omidakhsh, Negar
Arah, Onyebuchi A.
Krause, Niklas
Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title_full Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title_fullStr Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title_full_unstemmed Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title_short Blood Pressure Changes After a Health Promotion Program Among Mexican Workers
title_sort blood pressure changes after a health promotion program among mexican workers
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261043/
https://www.ncbi.nlm.nih.gov/pubmed/34249846
http://dx.doi.org/10.3389/fpubh.2021.683655
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