Behavioral and life style risk factor analysis for pre-hypertensive and hypertensive population in urban Dhaka

Abstract

Background: Prevalence of hypertension is on rise silently and slowly in Bangladesh. This quasi experimental type of interventional study was conducted aiming at evaluating reversible of blood pressure through reduction of body weight in overweight or obese, individual avoidance of table salt intake, increment of physical activity and cessation of smoking, changing of food habit in an urban committee. The study also aimed at finding out the socioeconomic and demographic profile for pre hypertension and stage-I hypertensions and evaluating outcome of behavioral risk reduction contributing to maintenance of reversal of hypertension. Objective: The study was conducted to analyze if modification of life style and behavioral risk factor can reduce pre-hypertension and stage-I hypertension. Material and method: This intervention study was conducted during the period August 2013 to October 2015 on respondents aged 18 years or above in Sutrapur thana of Dhaka city including an intervention period of 6 Months. Non-probability type of judgement sampling was used to collect 150 respondents with pre-hypertension and stage-I hypertension. The respondent had neither any complications nor any Co-morbidity. The Intervention was given person-to-person. Intervention included physical activity enhancement, dietary advice, avoidance of extra table salt intake and smoking cessation. Global standard tools were used to collect data through person-to-person interview and clinical assessment. Data analysis and interpretation done through SPSS. Result: Mean systolic blood pressure of the respondents was 130± 7.09 mm Hg and mean diastolic blood pressure was 83.51±7.39 mm Hg. Normal blood pressure was found only 45% cases. While 30% had pre-hypertension, 19% had stage-I hypertension and 6% had stage-II hypertension according to the JNC-7 criteria. Among the study group, after 6 months mean change of systolic blood pressure was -9.35± 1.75 mmHg and mean change of diastolic blood pressure was -4.20±1.94 mmHg. Both systolic and diastolic blood pressure was significantly reduced from baseline, after 6 months of behavioral risk reduction intervention. For sBP (p<.05) and for dBP (p<.001). At beginning, 58.7% took extra salt. After 6 months intervention it was 1.4%. Avoidance of extra salt intake was significantly related to change of both systolic blood pressure and diastolic blood pressure (p<0.001). There was no significant xii changes of smokers with blood pressure. Mean BMI reduction -1.62±1.8 kg/m2 (p<0.05). At the baseline of the study mean physical activities were 230.80±224.40 minutes/week and 518±275.70 minutes/weeks respectively after 6 months. Significant correlation of both systolic and diastolic blood pressure increment of physical activities (p<0.001). Conclusion: Reversal of pre- hypertension and stage-I hypertension was possible by structural behavior risk reduction meaning intake of balance diet with exclusion of extra salt intake, increment of physical activity along with reduction of body weight. Combination of all these parameter recommending to be used by the physicians while treating and caring patients with pre-hypertension and stage I hypertension.