Effect of Lifestyle Modification to Control the Blood Pressure in Hypertensive Individuals of Morang District, Nepal
Keywords:
Blood pressure, Effectiveness, LifestyleAbstract
Background: Hypertension is a strong, independent and etiologically relevant risk factor for cardiovascular diseases and therefore, the leading cause of preventable death worldwide. The purpose of this study was to determine the effect of multifaceted lifestyle modification intervention on blood pressure among hypertensive patients.
Objectives: The aim of the study was to assess the effectiveness of lifestyle modification to control blood pressure in hypertensive individuals in Morang district.
Methods: A quasi-experimental study was conducted among 67 participants in the medical Out Patient Department (OPD) of Purbanchal University Teaching Hospital. Participants were recruited through simple random sampling. The multifaceted intervention under investigation includes motivational interviews and 60-minute training sessions on dietary patterns and exercise, followed by 4 phone call follow-ups. Blood Pressure (BP) was measured both before and after the intervention, and the changes in BP were compared.
Results: The study population comprised 67 adults with a mean age of 59.17 ± 12.63 years, where 61.2% were male. Following the intervention, a statistically significant reduction in blood pressure was observed. The mean systolic blood pressure decreased by 7.65 ± 4.45 mmHg, and the mean diastolic blood pressure decreased by 5.74 ± 4.45 mmHg (p < 0.05).
Conclusion: The multifaceted lifestyle intervention resulted in a significant decrease in systolic and diastolic blood pressure. Thus, the use of this method as a supplementary treatment is recommended during visit to medical OPD.
References
Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. European Heart Journal. 2016 Aug 14;37(42):3232–45. DOI: https://doi.org/10.1093/eurheartj/ehw334
Neupane D, McLachlan CS, Sharma R, Gyawali B, Khanal V, Mishra SR, et al. Prevalence of hypertension in member countries of South Asian Association for Regional Cooperation (SAARC): systematic review and meta-analysis. 2014; Medicine vol. 93(13): e74. DOI:10.1097/MD.0000000000000074
Huang Y, Guo P, Karmacharya BM, Seeruttun SR, Xu DR, Hao Y. Prevalence of hypertension and prehypertension in Nepal: a systematic review and meta-analysis. glob health res policy. 2019; 4(11).DOI:10.1186/s41256-019-0102-6
Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388 (1005): 1659-1724. DOI:10.1016/S0140-6736(16)31679-8
Treciokiene I, Postma M, Nguyen T, Fens T, Petkevicius J, Kubilius R, et al. Healthcare professional-led interventions on lifestyle modifications for hypertensive patients - a systematic review and meta-analysis. BMC family practice. 2021 April; vol. 22,1 (63). DOI:10.1186/s12875-021-01421-z
Adam Timmis, Panos Vardas, Nick Townsend, Aleksandra Torbica, Hugo Katus, Delphine De Smedt, et al. European Society of Cardiology: cardiovascular disease statistics 2021. European heart journal. 2022; 43 (8): 716-799. DOI:10.1093/eurheartj/ehab892
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. European heart journal vol. 2018; 39 (34) : 3165-3241. DOI:10.1093/eurheartj/ehy340
Valenzuela PL, Carrera-Bastos P, Gálvez BG, Ruiz-Hurtado G, Ordovas JM, Ruilope LM, et al. Lifestyle interventions for the prevention and treatment of hypertension. Nature reviews. Cardiology vol. 18,4 (2021): 251-275. DOI:10.1038/s41569-020-00437-9
Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European heart journal. 2016; 37 (29) : 2315-2381. DOI:10.1093/eurheartj/ehw106
Zhou B, Bentham J, Di Cesare M, Bixby H, Danaei G, Cowan MJ, et al. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet (London, England). 2017; vol. 389 (10064): 37-55. DOI:10.1016/S0140-6736(16)31919-5
Hardy ST, Loehr LR, Butler KR, Chakladar S, Chang PP, Folsom AR, et al. Reducing the Blood Pressure-Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control. Journal of the American Heart Association vol. 2015;4 (10): e002276. DOI:10.1161/JAHA.115.002276
Whelton, P. K., He, J., Appel, L. J, et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002; 288 (15): 1882-8. DOI:10.1001/jama.288.15.1882
Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet (London, England). 2016; 387(10022): 957-967. DOI:10.1016/S0140-6736(15)01225-8
Andualem A, Gelaye H, Damtie Y. Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020. Integrated blood pressure control. 2020; 13: 145-156. DOI:10.2147/IBPC.S275575
Mirniam AA, Habibi Z, Khosravi A, Sadeghi M, Eghbali-Babadi M. A clinical trial on the effect of a multifaceted intervention on blood pressure control and medication adherence in patients with uncontrolled hypertension. ARYA atherosclerosis. 2019; 15(6): 267-274. DOI:10.22122/arya.v15i6.1904
Hanus KM, Prejbisz A, Gąsowski J, Klocek M, Topór-Mądry R, Leśniak W, et al. Relationship between gender and clinical characteristics, associated factors, and hypertension treatment in patients with resistant hypertension. Kardiologia polska. 2017; 75 (5) : 421-431. DOI:10.5603/KP.a2017.0020
Kabayama M, Akagi Y, Wada N, Higuchi A, Tamatani M, Tomita J, et al. A Randomized Trial of Home Blood-Pressure Reduction by Alcohol Guidance During Outpatient Visits: OSAKE Study. American journal of hypertension vol. 2021;34 (10): 1108-1115. DOI:10.1093/ajh/hpab082
Williams A, Manias E, Walker R, Gorelik A. A multifactorial intervention to improve blood pressure control in co-existing diabetes and kidney disease: a feasibility randomized controlled trial. Journal of advanced nursing. 2012; 8 (11): 2515-25. DOI:10.1111/j.1365-2648.2012.05950.x
Kim S, Symons M, Popkin BM. Contrasting socioeconomic profiles related to healthier lifestyles in China and the United States. American journal of epidemiology vol. 2004; 159(2 ): 184-91. DOI:10.1093/aje/kwh006
Onwuzo C, Olukorode J o, Omokore O, Odunaike OS, Omiko R, Osaghae O, et al. DASH Diet: A Review of Its Scientifically Proven Hypertension Reduction and Health Benefits. Cureus. 2023; 15 (9): e44692. DOI:10.7759/cureus.44692
Ghodeshwar GK, Dube A, Khobragade D. Impact of Lifestyle Modifications on Cardiovascular Health: A Narrative Review. Cureus. 2023; 15 (7 ):e42616. 28 Jul. 2023, DOI:10.7759/cureus.42616
Drageset J. Haugan G, Eriksson M. Health Promotion in Health Care – Vital Theories and Research, Springer, 12 March 2021.pp. 137–144. DOI:10.1007/978-3-030-63135-2_11
Bridges DR, Davidson RA, Soule Odegard P, Maki IV, Tomkowiak J. Interprofessional collaboration: three best practice models of interprofessional education. Medical education online. 2011; 16. 10.3402/meo.v16i0.6035. DOI:10.3402/meo.v16i0.6035
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Purbanchal University Health Journal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Purbanchal University Health Journal (PUHJ) allows to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. Copyright is retained by PUHJ. The PUHJ work is licensed under a Creative Commons Attribution-Non-commercial 4.0 International (CC BY-NC 4.0).
