Impacto de orientações sobre ingestão adequada de água na constipação de pessoas com hipertensão acompanhadas na atenção primária

Abstract

Arterial hypertension is a chronic non-communicable disease that may be associated with alterations in the gut microbiota and the development of dysbiosis, a condition that can impair digestive function and contribute to constipation. Constipation is a common condition among individuals with hypertension and may be exacerbated by the use of certain antihypertensive medications. Adequate water intake may play an important role in gastrointestinal motility, helping to prevent and manage constipation. This study aimed to evaluate the impact of guidance on adequate water intake on intestinal function and stool consistency among adults with hypertension receiving care in Primary Health Care. A quasi-experimental before-and-after study was conducted in a Primary Health Care Unit (PHCU) in the municipality of Caucaia, Ceará, Brazil. Fifty-four adults with hypertension participated in the initial assessment, and 33 returned for follow-up after 15 days. Participants received individualized guidance on adequate water consumption, and their progress was monitored using the Bristol Stool Scale. Data were collected using a structured questionnaire covering identification data, sociodemographic, economic, and clinical characteristics, personal history, anthropometric and blood pressure measurements, health history, comorbidities, medication use, lifestyle habits, dietary habits, and water intake practices. Stool consistency was assessed using the Bristol Stool Scale. A pilot study involving four participants was conducted prior to data collection; these individuals were not included in the final study sample. The collected data were entered into an electronic database and analyzed using SPSS Statistics version 23.0. Descriptive analyses included measures of central tendency and dispersion for quantitative variables and absolute and relative frequencies for categorical variables. Associations between variables and study outcomes were assessed using appropriate statistical tests, adopting a significance level of p < 0.05. The study complied with ethical and legal requirements and was approved by a Research Ethics Committee under approval number 7,643,090. The sample was predominantly female, with low to middle income levels and educational attainment corresponding mainly to high school education. A high prevalence of overweight, obesity, anxiety, and dyslipidemia was observed, along with low levels of physical activity and inadequate dietary habits. Constipation emerged as the most frequent intestinal disorder identified among participants, exceeding the occurrence of diarrhea. Following the intervention, a trend toward improvement in bowel patterns was observed, with a reduction in constipation throughout the follow-up period. However, no statistically significant differences were found in the comparison of the assessed outcomes. Likewise, no statistically significant associations were identified between stool consistency and the sociodemographic, clinical, or dietary variables analyzed. In conclusion, constipation was highly prevalent among individuals with arterial hypertension, highlighting its relevance in Primary Health Care. Although the intervention did not produce statistically significant effects, a trend toward clinical improvement in bowel habits was observed. These findings suggest that simple, low- cost educational interventions may contribute to self-care and the promotion of intestinal health. Nevertheless, studies with larger sample sizes and longer follow-up periods are needed to confirm the effectiveness of this strategy.