ABC | Volume 113, Nº3, September 2019

Original Article Stress and Food Consumption Relationship in Hypertensive Patients Aline Lopes Dalmazo, 1 Claudia Fetter, 1 Silvia Goldmeier, 1 Maria Claudia Irigoyen, 1 Lucia Campos Pellanda, 2 Eduardo Costa Duarte Barbosa, 1 Thais Rodrigues Moreira, 2 Denise Ruttke Dillenburg Osório 3 Instituto de Cardiologia do Rio Grande do Sul - Laboratório de Investigação Clínica (LIC), 1 Porto Alegre, RS – Brazil Universidade Federal de Ciências da Saúde de Porto Alegre, 2 Porto Alegre, RS – Brazil Universidade FEEVALE, 3 Novo Hamburgo, RS – Brazil Mailing Address: Aline Lopes Dalmazo • Instituto de Cardiologia do Rio Grande do Sul - Laboratório de Investigação Clínica (LIC) - Rua Santana, 1237, segundo andar. Postal Code 90620-000, Santana, Porto Alegre, RS – Brazil E-mail: aline@dalmazo.com Manuscript received June 22, 2018, revised manuscript November 14, 2018, accepted December 19, 2018 DOI: 10.5935/abc.20190175 Abstract Background: Stress is a state of threat to the balance of the organism, which can cause biological and psychological changes. In hypertensive patients, stress can interfere with blood pressure levels, influence on food choices and neglect of the diet. Objective: This study aims to describe the relationship between stress and dietary intake of hypertensive patients. Methods: A transversal study was carried out at the Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil. The participants were aged ≥ 18 years and hypertensive. Blood pressure, food consumption and anthropometric measurements were collected. The variables related to stress were evaluated by the Lipp’s Stress Symptoms Inventory (LSSI) for adults. Significance level of 5% has been considered for all analyzed data. Results: The number of participants was 100. There was a higher prevalence of the female sex (67%), the mean age of the study population was 55.87 ± 12.55 years. Among the participants, 86% were classified in some of the stress phases, on which 57% were in the resistance phase. It was observed that there was no correlation between the presence of stress (as well as their actions), pressure levels and food consumption. The consumption of foods rich in lipids and individuals with a prevalence of psychological symptoms of stress displayed a significant association. Conclusions: Rich in fat dietary has been the first choice in patients with psychological symptoms of stress. Further studies regarding remodeled dietary intake and blood pressure levels in relation to the stress phases are suggested. These findings are important to contribute to the development of prevention and treatment strategies for cardiovascular diseases. (Arq Bras Cardiol. 2019; 113(3):374-380) Keywords: Hypertension; Food Consumption; Stress, Physiological; Dietary Fats/metabolismo; Body Weights and Measures; Metabolism. Introduction Stress is considered any force or experience that breaks the psychological homeostatic balance of an organism by activating a chain reactions cascade that increases blood flow through adrenaline release by adrenal glands and stimulates tachycardia, dilation of muscles and brain blood vessels and constricts blood vessels that supply the organs of digestion. 1 According to the World Health Organization, stress affects more than 90% of the world's population and about 70% of Brazilians. Stress is a special situation where the development of considerable blood pressure changes may occur. 2,3 Exposure to stress can lead to qualitative and quantitative changes in food consumption pattern, 4 with higher and easier consumption of hyperpalatable foods. They have high-calorie density and are rich in fats and sugars, providing not only weight gain, but also contributing to the increase of chronic non-communicable diseases. Most of the time, stress promotes an increase in the consumption of this type of food, consequently decreasing the intake of fruits and vegetables. 5 Emotional feeding may be related to behavioral and metabolic changes in the stress response. 4,6 The effect of stress on a diet seems tomodify themetabolism of various nutrients, such as B complex vitamins, C vitamin, calcium, magnesium, iron and zinc. 7,8 Furthermore, when stress affects the patient, there is a tendency of neglecting the diet, aggravating pathological conditions by inadequate intake of nutrients. Among nutritional deficiencies, it stands out that mineral deficiencies are connected to a wide variety of metabolic dysfunctions. 8 If the stress is continuous and intense, besides causing damage to the endocrine and immune system, 9 it may lead to changes in lipid metabolism, blood pressure, heart rate, increased myocardial oxygen consumption and, as a consequence, reduction in peripheral vascular resistance. 6 Progressively these problems lead to an increase in cardiovascular diseases. 10,11 There is evidence that the major 374