Comparison of the Effect of Structured Lifestyle Changes Versus Verbal Advice Only on Blood Pressure Control Among Hypertensive Adults 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 blood pressure. The study compared the effect of structured lifestyle modification versus verbal advice only on blood pressure control among hypertensive adults presenting in the GOPD of JUTH. Study Design/Setting: The study was a randomized study involving hypertensive 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 counseling while routine advice only was offered to group B. Data was 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 was 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 was 17 mmHg (8.7, 25.3; 95% CI) after 12 weeks versus 6.67 mmHg (0.47, 12.87, 95% CI) in group B. The mean diastolic pressure reduction after the same period was 8 mmHg (3.5, 12.5; 95% CI) in group A and 5.33 mmHg (1.5, 9.1; 95% CI) in group B. Paired t-test analyses revealed that these reductions were statistically significant in both groups. Conclusion: Findings from the study show that individuals with hypertension can make and sustain, during a period of 12 weeks, multiple lifestyle modifications which can control or reduce 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 Keywords: Lifestyle modification, Hypertension, Blood pressure