Abstract:
Background: Results from several clinical trials show that comprehensive behavioural intervention
programs improve lifestyle behaviors and lower blood pressure. The study compared the effect of structured
lifestyle modification versus verbal advice only on blood pressure control among prehypertensive adults
presenting in the GOPD of JUTH.
Study Design/Setting: The study was a randomized study involving prehypertensive adults aged 20 years and
above presenting in GOPD of JUTH.
Methods: Participants were consecutively selected and randomized into two groups, a structured lifestyle
modification group (Group A) and a verbal advice only group (Group B). Group A was offered a structured
lifestyle modification counselling while routine verbal advice only was offered to group B. Data were collected
about patients' socio-demographic, medical and lifestyle habits that included dietary and exercise history.
Physical examination included blood pressure measurement. Participants were followed up monthly for
twelve weeks during which blood pressure measurement was routinely carried out and changes in their
lifestyle habits reported. The primary outcome was reduction in BP. The means at 95% confidence intervals of
the blood pressure values of the two groups were determined using paired t-test analysis. Data were analyzed
on an intention to treat basis. A p-value of <0.05 was considered significant in all analyses.
Results:
The mean systolic blood pressure reduction in group A after 12 weeks was 3.61 mmHg (1.52, 5.26; 95% CI)
while the mean diastolic pressure reduction after the same duration was 0.44 (-2.25, 1.97, 95%). Paired t-test
analysis revealed a statistically significant difference in the mean reduction in SBP at the end of the
study,{t(31)2.23, p=0.02}. The mean reduction in diastolic blood pressure on completing the study was
however not significant, {t(31)0.9, p=0.17}.
The mean systolic blood pressure reduction in group B after 12 weeks was 2.75mmHg (-1.23, 5.23, 95% CI)
while the mean diastolic pressure reduction after the same period was 0.38 (-2.26, 1.98, 95% CI). Paired t-test
analysis revealed no statistical difference in the mean reduction in SBP and DBP at the end of the study -
{t(29)1.39, p=0.062}versus {t(29)0.92, p=0.14}
Conclusion: Findings from the study show that individuals with pre-hypertension can make and sustain,
during a period of 12 weeks, structured multiple lifestyle modifications which can significantly control or
reduce systolic blood pressure. There is therefore a need for improved lifestyle intervention programs,
including those appropriate for delivery in the clinical setting, that enable individuals with or at risk for
hypertension to adopt long-term healthier lifestyles
