Eficacia clínica de la modificación del estilo de vida en el riesgo cardiovascular en prehipertensos: estudio PREHIPER I

El objetivo del estudio es determinar la eficacia de modificar el estilo de vida en el riesgo cardiovascular de los prehipertensos (pacientes con presión arterial sistólica entre 120 y 139 mmHg y diastólica entre 80 y 89 mmHg). Se realizó un ensayo clínico aleatorizado en prehipertensos sometidos a programa de dieta, actividad física y sesiones educativas, y se lo comparó con las recomendaciones habituales. El riesgo cardiovascular se evaluó con las tablas de Framingham y se utilizó las pruebas de la χ2, de la U de Mann-Whitney y de Friedman. La puntuación de Framingham disminuyó en el grupo experimental de 5 (rango de −10 a 12) a 3,5 (−11 a 10) (p < 0,05) y la probabilidad de eventos cardiovasculares a 10 años, de 5,29 ± 3,88 a 4,24 ± 2,86 (p < 0,05), RR = 0,3 (IC del 95%, 0,11-0,83), RRR = −69,8% (IC del 95%, −89% a −16,9%). En los controles no se modificó. La modificación del estilo de vida disminuyó el riesgo cardiovascular en prehipertensos.

The objective was to determine the effect of lifestyle modification on cardiovascular risk in individuals with prehypertension, which is defined as a systolic blood pressure between 120 mmHg and 139 mmHg and a diastolic pressure between 80 mmHg and 89 mmHg. A randomized clinical trial was carried out in prehypertensives to compare those who took part in a program involving dietary modification, physical activity and educational sessions with those who followed normal recommendations. Cardiovascular risk was evaluated using the Framingham risk score and the chi-squared test, the Mann-Whitney U-test and the Friedman test. The mean Framingham score in the intervention group decreased from 5 (rank, −10 to 12) to 3.5 (rank, −11 to 10; P<.05) and the probability of a cardiovascular event at 10 years decreased from 5.29±3.88 to 4.24±2.86 (P<.05). This improvement was associated with a relative risk of 0.30 (95% confidence interval, 0.11 to 0.83) and a relative risk reduction of −69.8% (95% confidence interval −89% to −16.9%). There was no change in control subjects. Lifestyle modification decreased cardiovascular risk in individuals with prehypertension.