Comparison of the Effect of Structured Lifestyle Changes Versus Verbal Advice Only on Weight and Body Mass Index Among Adult Pre-Hypertensive Patients in a Tertiary Hospital in North Central Nigeria

Background: Results from several clinical trials show that comprehensive behavioral intervention programs improve lifestyle behaviors and lower weight and BMI. The study was undertaken to determine to compare structured changes in lifestyle measures on weight and BMI with routine verbal advice only among pre-hypertensive adults presenting it the GOPC of JUTH. Study Design/Setting: The study was a randomized controlled experimental study involving pre-hypertensive adults aged 18 years and above presenting in GOPC of JUTH. Methods: Participants were consecutively selected and randomized to a control and an intervention group. The intervention group was offered a structured lifestyle modification counseling while routine advice only was offered to the control group. Data was collected about patients’ socio-demographic, medical and lifestyle habits that included dietary and exercise history. Physical examination was done to include height, weight and BMI. Participants were followed up monthly for twelve weeks during which physical examination was routinely carried out and changes in their lifestyle habits reported. The outcome measures were reduction in weight and BMI. The difference in the means of the outcome measures at pre- and post-intervention were determined using paired student t-tests at 95% confidence interval. Data were analyzed on an intention to treat basis. A p-value of ≤ 0.05 was considered statistically significant in all analyses. Results: On completing the study, paired t-test analysis revealed that the mean reductions in weight {t(29)4.36, p=0.00} and {t(29)12.34, p=0.00} within the control and intervention groups respectively were statistically significant. Similarly, the mean reductions in BMI {t(29)2.18, p=0.04} and {t(29)6.90, p=0.00} within the control and intervention groups respectively, were statistically significant. However, significant improvement in healthy lifestyle habits were notably more in the intervention group and desirable changes in the mean weight and BMI were more evident among participants of the intervention group after 12 weeks. Conclusion: Findings from the study showed that individuals with pre-hypertension in either group can make and sustain, during a period of 12 weeks, multiple lifestyle modifications which can significantly control or reduce weight and BMI. Structured changes on lifestyle measures were comparable with verbal advice only among pre-hypertensives in the study setting. Key words: Structured Lifestyle Changes, Verbal Advice, Weight, Body Mass Index, BMI, Pre-Hypertensive.