1. CLINICAL TRIALS
Readiness of Lifestyle Modification Among Hypertensive Patients in a Regional Community at Karachi Pakistan
Authors: Hina Murad, Shazeeena Virani, Abdul Rashid Khan, Muhammad Imran, Fazila Issani, Shahzeb Nazar Ali
Corresponding Authors: Sami Khokhar & Adeel Eliyas
(Published in International Journal of Scientific and Engineering Research Volume B, issue 3, March 2017)
Presented to
Dr. Shahbaz Ahamad Zakki
Prepared by
Muhammad Afzal
PhD Public Health UOH
2. DEFINITIONS OF DIFFERENT TERMINOLOGIES
• Lifestyle modification: life style modification involves altering of long term habits, typically eating or physical activity and main thing
the new behaviours for a month or year.
• Hypertension: Also known as high or raised blood pressure is a condition in which the blood vessels persistently raised pressure. Or
• A blood pressure of 140/90 or higher.
• Clinical trials: Clinical trials are research studies that test a medical, surgical or behavioural intervention in peoples.
ABSTRACT
• According to WHO it is estimated that HTN cause 7.5 million deaths of the total deaths which are about 12.8%
• In America about 70 million have HTN which is 1 of every 3 adulty.
• Present study was conducted in Shereen Jinnah colony in May 2016, to asses the readiness of lifestyle modification among hypertensive
patients.
• his study cross sectional study was conducted by using closed ended questionnaire consisting of 12 questions.
• A convenient sampling techniques is used for data collection (n=50) patients included in study having HTN for last 2 years
• Out of 50 respondent 30 were males and 20 were females having age between 20 to 60 years.
3. CONTINUED
• 84% respondents implement lifestyle modification to maintain their blood pressure.
• 40 have no proper diet and 38 percent used exercise for controlling of blood pressure
• HTN can be prevented by using healthy lifestyle modification.
INTRODUCTION
• Cardiovascular diseases is the most common cause of death in industrialised and developed countries.
• Hypertension is closely associated to a major incidences of stroke, myocardial infarction, heart failure, CKD.
• Blood pressure is a major of two pressures i.e systolic and diastolic pressure.
• HTN is grouped into two categories which are primary and secondary hypertension.
• When there is no cause of HTN it is called primary hypertension which affect 90% of the peoples and hypertension which occur due
to other medical condition is called secondary hypertension which is about 10 percent of the whole cases.
4. CONTINUED
• Factors such as age, high intake of salt, low potassium diet, sedentary lifestyle, stress as well genes have been found contributing to
hypertension.
• In 2000 it was estimated that 972 million peoples have HTN in which 65% were living developing world and it is predicated to increase 1.5
billion till to 2025. according to WHO it is estimated that HTN cause 7.5 million deaths in the world.
• According to Canadian Hypertension education programme recommends that healthy diet such as fruit, vegetable, whole grain and protein
from plant sources and that is reduced in saturated fat is important for HTN control.
• The prevalence of hypertension in general population is a 20 to 30%. High blood pressure is the most common health problem in developed
countries. Proper treatment and lifestyle modification reduced the risk of HTN complication.
• According to a study conducted in Finland the life style modification based on group sessions in a rehabilitation centre setting achieved
positive effect on BP of hypertensive persons.
• According to JNC 7 guidelines, all patients with HTN should adopt lifestyle modification rather they are using antihypertensive medication.
5. CONTINUED
• The component of lifestyle modification listed in JNC 7 guidelines are reducing weight, adopting the dietary approach to stop HTN (DASH)
eating plan, reducing dietary sodium intake, engaging in physical activities and moderating alcohol consumption.
• The adoption of adequate diet play a role in lowering blood pressure value. In a meta-analysis of 25 trials an average weight loss of 5.1 kg
was associated to reduction in mean 4.4 mmHg systolic and 3.6 mmHg diastolic pressure.
• Regular exercise could lead in some cases to reduce or to stop the use of antihypertensive drugs. It has been also reported that people who
are not involved in physical activities like exercise have greater chance of hypertension 35% to 70% as compared to those who are involved
in physical activities.
METHODOLOGY
• A quantatives cross sectional study design is used in this study and non probability convenient sampling technique is used for data collection.
• Sample size was 50 respondents having blood pressure for last 2 years and above 18 years of age. The study was conducted in Shereen
Jinnah colony Karachi
• The data collection tool was self developed, closed ended questionnaire consisting of 12 questions. The data was analysed by social package
for statistical sciences (SPSS) verson-20.
6. DISCUSSIONS
Did the lifestyle modification help you to maintain your blood pressure in normal ranges
• The table shows that out of 50 respondents 42 said that lifestyle modification has a role in hypertension which is 84 percent of total
population and 8 respondents out of total which are 16% said that lifestyle modification has no role in reduction of blood pressure. This
shows that most of the respondents do lifestyle modification to maintain their blood pressure.
• This study concluded that 82% of participant with known case of HTN do not smoke cigrate as compared to the study of East Nigeria that
44.6% do not smoke to control blood pressure.
• Moreover participants performed physical activity for different durations and the findings of study in Nigeria showed that 73% of
respondents performed exercise while in this study only 12% regularly do exercise.
• According to a study conducted in Rajvi Ghandhi institute of Medical Sciences, lifestyle modification and utilization of DASH diet on daily
Frequency Percentage
Yes
No
Total
42
8
50
84.0%
16%
100%
7. CONTINUED
• Basis had considerable effect on Blood pressure. Similarly results were obtained in our study 84% respondents said that lifestyle
modifications to maintain their blood pressure and consider it a best way to lower their blood pressure.
• This study shows that most of the participants 84% consider lifestyle modification as a best way to maintain their blood pressure and similar
results were present in a study conducted at South Ghana, according to which healthy lifestyle has a significant role to maintain the BP.
• Another similar results were obtained in a study conducted at Rehabilitation centre of Espoo Finland, according to which there was a
significant reduction in BP after implementation of lifestyle changes in intervention group.
• This study revealed that almost all the participants 96% do not use alcohol and they do not have any drug addiction which is contrary to the
study of Kofi, according to which most of the respondents 58% consume alcohol.
• A study conducted in USA in which various data sources were used states that lower sodium intake reduces blood pressure. A minimum
proportion of hypertensive patients in our study take low salt diet.
• The type of diet which respondent take after having HTN was asked from respondents. Where n=50, 10% respondents take low sugar diet,
26% take low salt diet, 24% take vegetarian diet and 40% respondents take no specific diet. This shows that most of the respondents, who
have hypertension, do not follow low salt diet.
8. CONCLUSIONS
• Hypertension can be managed by lifestyle modification. In current study most of the respondent said that life style modification has a role in
decreasing of blood pressure but they do not have sufficient knowledge how to adopt lifestyle modifications.
• Effective knowledge can bring change in human behaviours therefor knowledge should be provided to hypertensive patients so they can
modify their lifestyle to healthy one and maintain their blood pressure.
• Correct measures need to be taken from the point of diagnosis of hypertension by the health care team present in that community.
• The government and health policy makers need to assist the members of health care providers in implementing effective health strategies for
the prevention of hypertension so that hypertension ant its complication can be controlled effectively in our environment.
• Conflict of interest: There is no conflict of interest in this study.
• Source of funding: Self
