4. Discussion
hypertensive
The aim of this randomized controlled trial was to compare the effectiveness of an educational intervention that used DSRQ with usual care provided by registered dietitians. After six months, the estimated sodium urinary excretion was similarly reduced in both groups. However, no statistically significant reduction was observed in 24-h ABPM measurements after six months.For the initial time, the validated edition of the DSRQ was employed in a randomized clinical trial, specifically for hypertensive patients located in southern Brazil. At the follow-up, the DSRQ score for the attitude and subjective norm scale showed that participants in the intervention group identified more benefits of following a low-sodium diet compared to the control group. They also reported fewer barriers related to reducing sodium intake, which improved their perceived behavioral control subscale. Furthermore, the participants were incentivized to modify their conduct and acquire abilities for creating meals with reduced sodium content. In addition, the individuals expressed that they had adjusted to the flavor of low-sodium foods. However, on the subscale that measures dependent behavior, the choice of a bistro or restaurant did not affect the participants’ commitment to maintaining a low-sodium diet. On the other hand, subjects stated that they became accustomed to the taste of low-sodium foods and changed their meal preparation habits, reducing sodium and abstaining from sodium-based condiments. Participants also expressed a preference for homemade meals and buying unprocessed foods such as meats, cereals, fruits and vegetables, avoiding ultra-processed foods.After a 6-week intervention, the results of a study [Our results agree with a study performed on hypertensive adults and the elderly, who had an intake above the recommended, primarily based on sodium added during cooking and at the table [It is worth mentioning that a few participants in our study had also taken part in a prior study and had received extensive guidance on diet, sodium restriction, and lifestyle changes from different healthcare teams for a considerable length of time. As a result, the residual impact of their previous experiences may have played a role in the reduction in sodium intake observed in both groups.Shamsi et al. reported that a lifestyle intervention in the form of a continuous care model decreased the mean dietary sodium intake and systolic and diastolic BP in hypertensive patients compared with usual care [Our findings corroborate previous interventions based on the Theory of Planned Behavior in Brazilian hypertensive patients to promote low-sodium intake [This study presented some limitations that deserve consideration. The collection of urine spots can be utilized to estimate sodium intake; however, its accuracy remains a topic of controversy [Nevertheless, predictive equations for estimating an individual’s mean 24-h sodium excretion may have some value in monitoring sodium intake progress, despite the limitations [