ABC | Volume 113, Nº3, September 2019

Original Article Dalmazo e al. Stress in hypertension Arq Bras Cardiol. 2019; 113(3):374-380 triggering factor for hypertension is precisely the stress exerted in moments of stress and anxiety that alter the entire hormonal and systemic configuration of the organism. 7 Therefore, this study aims to evaluate the relationship between stress, food choices and food consumption in hypertensive patients. Methods A cross-sectional study took place at Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil, between 2013 and 2015. Hypertensive patients of both genders, older than 18 years old, from Basic Health Units, with uncontrolled hypertension, in current use of antihypertensive medication and with an average diagnosis of hypertension of five years. Exclusion criteria were patients with secondary hypertension, congenital heart disease, surgical and acute myocardial infarction, as evidenced by the clinical file. The flowchart of patients invited to participate in the study is described in Figure 1. In order to obtain the sample number to perform the study, the calculation was performed with 80% power, 95% confidence level and an expected correlation of r = 0.25 between the phases of stress and food consumption, totalizing a sample composed of 97 patients. 12 Patients were invited to participate in the study after explaining the objectives, justification and methods that would be used in the data collection. After the acceptance, the patients signed two copies of the Free and Informed Consent Form, which was approved by the IC / FUC Research Ethics Committee, under No. 4843/13. It is important noticing that the study protocol complied with all ethical guidelines recommended by the National Health Council. The data collection was conducted by training professionals in the Cardiology Institute settings during a single scheduled consultation in the multidisciplinary outpatient clinic of Systemic Arterial Hypertension. Variables of age, gender, blood pressure, anthropometry, food consumption and stress symptoms were collected. The nurse team performed measures of blood pressure in accordance with the VII Brazilian Guidelines for Hypertension. 2 Anthropometric measurements were taken by the nutritionist. Weight and height variables were collected using an anthropometric scale (Welmy®), with a capacity of 200 kg and with anthropometric ruler coupled up to 2 meters. For weighing, all patients were instructed to be barefoot to remove objects from their pockets, watches and excess clothing. The patient was placed in the center of the platform, with arms extended along the body. For height measurement, the patient remained barefoot and standing upright, with his head held high, arms hanging at his side, heels and back against the vertical plane of the rod. In sequence, the patient was instructed not to shrink when the stem was placed on the head, the support of which remained Figure 1 – Flowchart of Participants. LSSI: Lipp stress symptoms inventory. Excluded patients: Recent surgery (n = 7) Coronary Artery Disease (n = 9) Kidneys disease (n = 4) Congenital heart disease (n = 2) Patients screened at Hypertension Ambulatory (n = 146) (n = 124) Not fullfilled LSSI (n = 24) Analyzed (n = 100) 375