Life style of patient before and after diagnosis of hypertension in Kathmandu

doi:10.4236/health.2011.38081

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Vol.3, No.8, 490-497 (2011)

doi:10.4236/health.2011.38081

Health

Life style of patient before and after diagnosis of

hypertension in Kathmandu

Radha Achary a1, Hom Nath Chalise2*

1Department of Nursing, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre;

2Department of Public Health, Asian College for Advance Studies, Satdobato, Lalitpur; *Cor responding Author: [email protected]

Received 20 April 2011; revised 30 May 2011; accepted 18 June 2011.

ABSTRACT

Hypertension is an important public health-

challenge in the developing and the developed

world alike. However, hospital-based studies on

cardiovascular diseases including hypertension

in a developing country like Nepal have been

limited. Objective: The objective of the present

study w as to determine the life style of patients

before and after diagnosis of hypertension. Me-

thods: A total of 100 adult hypertensive pa-

tients over 30 years of age who were attending

in medical out patients department within 6

month to 2 years after first diagnosis of hyper-

tension in Shahid Gangalal National Heart Cen-

tre and Tribhuvan University Teaching Hospital,

in Kathmandu, Nepal, in April 2009, were in-

cluded using a descriptive research design. The

data was collected by interview using a ques-

tionnaire consisting of a combination of struc-

tured and semi- structured questions. The data

was analyzed by using SPSS 11.5 version. Re-

sults: This study found the respondents’

knowledge regarding hypertension was poor.

Regarding life style of hypertensive patients,

majorities (90%) of them were non-vegetarian

before diagnosis but after diagnosis of hyper-

tension the percentage of non-vegetarian was

reduced by 10%. Similarly, the reduction in

consumption of meat, eggs, ghee and oil (mus-

tard, sunflower) by hyperten- sive patients was

statistically significant dif- ference (p = 0.000)

after the diagnosis of hypertension. Regarding

soya- bean oil consumption, additional salty

food and amount of salt intake there was no

statistical significant difference before and after

the diagnosis of hypertension. Likewise,

physical exercise and str ess red ucti on a ctiv ities

performed by hypertensive patients and change

in drinking alcohol and smoking was found to

be statistically significant difference (p = 0.000)

after the diagnosis of hypertension. Conclusion:

The adverse consequences of hypertension can

be reduced by modifying the life sty le. Therefore

more focus should be given in increasing the

awareness about hypertension by developing

information, education and communication ma-

terials on hypertension and setting up hyper-

tensive counseling clinic in each hospitals.

Keywords: Hypertension; Lifestyle; Hypertensive

Patient; Nepal

1. INTRODUCTION

About a quarter of the world’s population have been

estimated to have hypertension at the turn of the millen-

nium. It has remained an important public health chal-

lenge in the developing and the developed world alike.

The burden of chronic conditions such as hypertension

has been likened to an iceberg phenomenon in which the

cases that we see are only a part of the whole problem.

Even within the ‘visible’ portion, there are different

strata of hypertension with or without controlled blood

pressure [1].

Hypertension has become one of the very common

diseases in the modern society. It is the result of the

mental tension and steeping into th e highly sophisticated

life style of the so-called modern society. Besides that

lack of knowledge of the people on their food habit or

diet intake has also played crucial role on the expansion

of the disease. Likewise, increasing pace of urbanization

and industrialization of the developing countries has

contributed significant impact on accelerating the dis-

ease. It can be assumed that there is highly positive cor-

relation between increased number of hypertension and

the pace of modernization [1].

Hypertension is a major health burden and the leading

cause of death in the world. Although hypertension is

more common in economically developed countries than

R. Acharya et al. / Health 3 (2011) 490-497

491

in economically developing ones, it is a greater popu-

lation burden in the latter because of the much larger

population. WHO estimated about 62% of cardiovascu-

lar disease and 49% of ischemic heart disease burden

worldwide. Hypertension is estimated to cause 7.1 mil-

lion deaths annually accounting for 13% of all deaths

globally. Overall 26.4% adult world population was esti-

mated to have hypertension in the year 2000, a number

that was projected to increase to 29.2% by 2025 [2].

Certain life style habits, including unhealthy dietary

habits, cigarette smoking and inactivity are risk factors

for cardiovascular disease that in part may be mediated

through effects on blood pressure and body weight.

These life style factors may also be established during

childhood and adolescence, however, their associations

with weight status and blood pressure in childhood and

adolescence are less clear than in adulthood [3].

The main objective of this study was to know what is

the awareness of hypertensive patient about their disease

and life style of patient before and after diagnosis of

hypertension.

2. METHODOLOGY

This is a cross-sectional study. A face to face inter-

view survey method using structured questionnaire was

adopted for this survey.

3. STUDY SITE AND STUDY

POPULATION

This study was co nducted in 2008 in 100 hyp erten sive

patients above 30 years of age in two hospitals namely

Shahid Gangalal National Heart Centre and Tribhuvan

University Teaching Hospital (TUTH) in Kathmandu.

Respondents for this study were patients who were hy-

pertensive since 6 month to 2 years (diagnosed cases of

hypertension) and they were under the treatment regi-

men and who were attended in medical outpatient de-

partment and follow up treatment of hypertension in the

above two hospitals. The patients were selected from

OPD card and according to Diagnosis (isolated hyper-

tension) by the Doctor.

Patients having associated disease like Heart disease,

Kidney disease, Diabetes etc. were excluded. The study

was conducted over a month period from first August to

first September, 200 8.

Purposively 100 respondents were taken as sample for

this study. Among 100 patients, 15 patients were taken

from those who attended TUTH (From 065/4/12 to

065/4/16 Bikram Sambat Nepali Calendar) and 85 from

SGNHC (From 065/4/17 to 065/5/6 Bikram Sambat

Nepali Calendar). Only few patients were taken from

TUTH due to lesser number of hypertensive patients

attending this hospital. For the selection of respondents,

Out Patient Department files of the hypertensive patients

were analyzed. And th e first hundred patients whose file

met the requirement were taken as the sample. All the

patients meeting the criteria were interviewed on first

come first basis till 100 samples were met.

3.1. Ethical Consideration

The study was conducted after receiving approval

from the Thesis Committee of Maharajgunj Nursing

Campus, Tribhuvan University. Before we started our

study a written permission was obtained from the con-

cerned authorities of the selected hospitals fo r this study.

The study respondents were adequately informed and

explained about the purposes of the study. They were

assured of the privacy and confidentiality of the infor-

mation. So, verbal informed consent was obtained before

a respondent was interviewed which is qu ite commo n in

previous stu dy t oo [ 4, 5] .

3.2. Data Analysis

SPSS 11.5 version soft ware was used to analyze the

data. First, distribution in the form of frequencies and

percentages, and measures of central tendency for all

independent and dependent variable were reviewed. Chi-

square test was done to compare the life style modi-

fication before and after diagnosis of hypertension and

p-value < 0.05 was considered as significant.

4. RESULTS

Table 1 shows the socio-demographic characteristics

of the study population. Age distribution of the respon-

dents shows that age ranged from 31 years to 76 years

with mean (SD) age 51.26 (0.78). Similarly, 57% were

male and 43% were female. According to the location of

the respondents, 64% were urban and 36% were from

rural area. Among the four religious groups, 80% re-

spondents were Hindus. Similarly in the ethnic composi-

tion of the respondents, 32% were Newars, 30% Brah-

mins, 15% Mongolian and 7% Terai cast. In the educa-

tional level, 31% were illiterate, 79% were literate among

them 35% had higher secondary and above education

status. As per the occupational distribution of the re-

spondents, 42% fr om house hold work secto r, 25% fro m

service sector, 17% from business and 16% were from

the agriculture sector. Economic status of respondents

was measured on the basis of food sufficiency to eat.

10% respondents do not have sufficient food for a year,

60% have sufficient for a year and 30% respondents

have some saving also. Duration of Hypertension shows

that majority of the respond ents were suffering from one

to two year and 20% were suffering from six to one year.

R. Acharya et al. / Health 3 (2011) 490-497

492

Table 1. Socio-demographic characteristics of the hypertensive

patients (n = 100).

Variables Number Percent

Age Group

31 - 40 18 18

41 - 50 34 34

51 - 60 25 25

Above 60 23 23

Mean age 51.26 (minimum 31 maximum 76)

Sex

Male 57 57

Female 43 43

Marital Status

Unmarried 2 2

Married 91 91

Widow 7 7

Residence

VDC 36 36

Municipality 64 64

Religion

Hindu 80 80

Buddhist 14 14

Christian 4 4

Kirant 2 2

Ethnicity

Brahmin 30 31

Chhetri 16 16

Newar 32 32

Mongolian 15 15

Teraicastes(Shah, Gup-

ta, Chaudhary) 7 7

Educational Status

Illiterate 31 31

Literate(Non formal

education) 10 10

Primary 8 8

Secondary 16 16

Higher secondary and

above 35 35

Occupation

Agriculture 16 16

Business 17 17

Service 25 25

House hold work 42 42

Economic Status

Not sufficie nt to eat for

1 year 10 10

Sufficient to eat for 1

Year 60 60

Extra saving 30 30

Family Type

Nuclear 53 53

Joint 31 31

Extended 16 16

Duration of Hypertension

6 month - 1 years 20 20

1 year - 2 years 80 80

The respondents were asked about hypertension but

they have poor kno wledge regarding its causes, sign and

symptoms, control measure and complications. Among

the total respondents 31% answered excessive salt and

fat intake as the factors leading to disease occurrence

followed by stress/tension (24%), smoking/alcohol (10%)

and five percent answered over weight and heredity

(Table 2). Further 55% respondents answered main

symptoms of hypertension was dizziness (55%) followed

by Headache (47%), Fatigue (18%), Palpitation (8%),

Blurred vis io n ( 7%), and Flushing face (6% ).

Out of total respondents, majority (63%) of the re-

spondents reported that taking medicine can help the

control of blood pressure. Similarly, 49% respondents

reported taking low salt and low fat diet is to control

blood pressure. Few (3%) of them reported weight re-

duction can help to control the blood pressure (Table 3).

Regarding the complication related with hypertension

42% respondents reported heart attack followed by pa-

ralysis (26%), kidney disease (15%), stroke (10%) and

blindness (5%) (Table 3).

Regarding the food habit of respondents, majorities

(90%) of respondents were non-vegetarian and only 10%

were vegetarian before diagnosis, whereas after diagno-

sis of hypertension, vegetarian were found to have in-

creased from 10% to 20%, which is not shown here in

the table.

Table 4 shows the change in frequency of meat and

eggs consumed by non-vegetarian after diagnosis of hy-

pertension. Majority of respondents (81%) used to take

mutton before diagnosis and it reduced to 59% after di-

agnosis. After diagnosis of hypertension, daily consum-

ers reduced from 17% to 5% and weekly consumers

from 42 to 18 where as occasional consumers increased

from 22% to 30%. Similarly pork consumers declined

from 16 to 8%, chicken consumers declined from 76%

Table 2. Awareness on symptoms and factors that may lead to

hypertension (n = 100).

Symptoms/factors Number (%)

Symptoms

Dizziness 55 (55)

Headache 47 (47)

Fatigue 18 (18)

Epistaxis 2 (2)

Blurred vision 7 (7)

Palpitation 8 (8)

Flushing face 6 (6)

Disease causing factors

Over weight 5 (5)

Heredity 5 (5)

Smoking/alcohol 10 (10)

Excessive salt and fat intake 31 (31)

Stress/tension 24 (24)

R. Acharya et al. / Health 3 (2011) 490-497

493

Table 3. Awareness on complication and control measure of

hypertension, n = 100.

Complication and awareness Number (%)

Complications of Hypertension

Heart attack 42 (42)

Kidney disease 15 (15)

Blindness 5 (5)

Stroke 10 (10)

Other (paraly sis) 26 (26)

Control measures

Reducing weight 3 (3)

Low salt and low fat diet 49 (49)

Stop smoking 11 (11)

Regular exercise 27 (27)

Reducing stress 22 (22)

Taking medicine 63 (63)

Table 4. Type of meat and eggs consumed by respondents (n =

90).

Varia bles Frequency of consumption Chi-square

p-value

Type of

Meat Daily Weekly Occasionally Total

Mutton

Before

diagnosis 17

(19%) 42 (47%) 22 (24%) 81 (90%)

After

diagnosis 5 (6%) 18 (20%) 30 (33%) 53(59%) 0.000

Pork

Before

diagnosis 1 (1%) 5 (6%) 8 (9%) 14(16%)

After

diagnosis - 2 (3%) 5 (6%) 7(8%) 0.000

Chicken

Before

diagnosis 26

(29%) 38 (42%) 12 (13%) 76(84%)

After

diagnosis 15

(17%) 32 (36%) 21 (23%) 68(76%) 0.000

Fish

Before

diagnosis - 6 (7%) 16 (18%) 22(24%)

After

diagnosis - 5 (6%) 12 (13%) 17(19%) 0.000

Eggs

Before

diagnosis 35

(39%) 24 (27%) 26 (29%) 85(94%)

After

diagnosis 14

(16%) 25 (28%) 25 (28%) 64(71%) 0.000

to 68%, fish consumption from 22% to 17% and egg

from 94% to 71%. The table also shows the frequency

item consumption also declined after the diagnosis of

hypertension. The change in food pattern after the diag-

nosis of hypertension was statistically significant (P-

value = 0.000).

Table 5 shows the changing pattern of oil and ghee

consumed by the respondents after diagnosis of hyper-

tension. Majority (79%) of respondents used animal

ghee before diagnosis. After diagnosis of hypertension

daily users were found to have shifted occasional and

non users. Hence, non users found increased from 21%

to 67% after diagnosis. Similarly vegetable ghee users

also changed from occasion to non-users after the diag-

nosis of hypertension.

Most of the respondents used mustard oil before di-

agnosis of hypertension. After the diagnosis of hyperten-

sion the daily users reduced from 76% to 41% and

weekly and occasional users shifted to non users. After

the diagnosis of hypertension 59% discontinued the

mustard oil.

The number of soybean oil consumers before diagno-

ses were 18% and after diagnosis increased from 18% to

26% in daily users. Very few respondents were occa-

sional users. The use of soybean oil shows insignificant

association (p-value = 0.281) with change in oil consum-

ption after the diagnosis of hypertension.

Out of total respondents, only 5% respondents used

sunflower oil daily and the number of daily user sharply

increased from 5% to 29% after diagnosis of hyperten-

sion. There was statistically significant increase in the

consumption of sunflower oil after the diagnosis of hy-

pertension.

Out of total respondents, majority (54%) had taken

normal (as usual) salt, 41% were found taking additional

or above normal and only 5% were taking low salt be-

fore diagnosis. But after diagnosis, majority (65%) had

taken low salt, 33% usual and 2% had taken additional

salt. The change in the amount of consumption of salt

after the diagnosis was not statistically significant (p =

0.431) (Table 6).

Additional salty food comprises papad, bottle pickle

and potatochips/dalmoth etc. Out of total respondents,

76% were found to be using additional salty food before

diagnosis and 60% still used it after the d iagnosis. There

was no statistically significant difference in consumption

of additional salty food after the diagnosis.

Ta b l e 7 shows the smoking and alcohol consumption

of respondents before and after diagnosis of hyperten-

sion. Out of total respondents 44% smoked before diag-

nosis and it reduced to 35% after diagnosis of hyperten-

sion. There was statistically significant difference (p =

0.000) in smoking habit after the diagnosis of hyperten-

sion. After diagnosis of hypertension many respondents

decreased the frequency of smoking. Similarly 60% re-

spondents consumed alcohol before diagnosis. Among

them daily users were 33%, weekly 3% and occasional

users were 24%. However, 70% respondents did not

consume alcohol after the diagnosis of hypertension.

Only 12% responden ts consumed alcohol daily, 4% weekly

R. Acharya et al. / Health 3 (2011) 490-497

494

Table 5. Type of ghee and oil consumed by respondents, (n = 100).

Frequency of consumption

Type of Ghee/Oil Daily Weekly Occasionally Non-user Chi-square p-value

Ghee (animals)

Before diagnosis 57 (57%) - 22 (22%) 21 (21%)

After diagnosis 15 (15%) - 18 ( 18%) 67 (67%) 0.008**

Ghee (vegetables)

Before diagnosis 1 (1%) - 14 (14%) 85 (85%)

After diagnosis - - 3 (3%) 97 (97%)

0.028*

Mustard Oil

Before diagnosis 76 (76%) 2 (2%) 22 (22%) 100%

After diagnosis 41 (41%) - - 59 (59%)

0.013**

Soyabean Oil

Before diagnosis 18 (18%) - 3 (3%) 79 (79%)

After diagnosis 26 (26%) - 2 (2%) 72 (72%)

0.281

Sunflower Oil

Before diagnosis 5 (5%) - 1 (1%) 94 (94%)

After diagnosis 29 (29%) 2 (2%) 3 (3%) 66 (66%)

0.038*

Butter

Before diagnosis 1 (1%) 1 (1%) 10 (10%) 88 (88%) 0.000**

After diagnosis - - 3 (3%) 97 (97%)

** Significant at 0.01 level *Significant at 0.05 level.

Table 6. Amount of salt taken by hypertensive respondents (n = 100).

Amount of sal t intake Lo w Normal Additional

Before diagnosis 5 (5%) 54 (54%) 41 (41%)

After diagnosis 65 (65%) 33 (33%) 2 (2%)

P-Value

0.431

Table 7. Smoking and alcohol consumption habit of respondents.

Smoking and drinking Yes No P-Value

Smoking

Before diagnosis 44 (44%) 56 (56%)

After diagnosis 35 (35%) 65 (65%) 0.000

Drinking

Before diagnosis 60 (60%) 40 (40%)

After diagnosis 30 (30%) 70 (70%) 0.000

and 14% were taking it occasionally. The overall trend

of the alcohol intake seems notably declining over the

incidence in terms of both amount and frequency of in-

take although it is not shown here in detail. There was

statistically significant (p = 0.000) reduction in consum-

ption of alcohol before and after diagnosis of hyperten-

sion.

Physical exercise and stress reduction activities are

important to control the hypertension. Out of total re-

spondents, 23 h ad done physical exercise b efore diagno-

sis of hypertension. But after diagnosis; the number in-

creased from 23% to 47%. Similarly, very few 11 re-

spondents had stress reduction activities before the di-

agnosis of hypertension and their number increased re-

markably from 11% to 39% after diagnosis of hyperten-

sion. There was statistically significant (p = 0.000) in-

crease in performance of physical exercises and stress

reduction activities after the diagnosis of hypertension

(Table 8).

5. DISCUSSION

Hypertension is one of the most common disease af-

fecting humans worldwide. Hypertension is the risk fac-

tor for coronary heart disease, stroke, congestive heart

failure, end-stage renal disease, and peripheral vascular

disease. Thus it has become a challenge for the health

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495

Table 8. Physical exercises and stress reduction activity per-

formed by respondents.

Control measures Yes No P-Value

Physical exercise

Before diagnosis 23 (23%) 77 (77%)

After diagnosis 47 (47%) 53 (53%) 0.000

Stress reduction activity

Before diagnosis 11 (11%) 8 9 (89%)

After diagnosis 39 (39%) 61 (61%) 0.015

care professionals to identify and treat this disease.

This study used adult hypertensive patients above

30 yrs of age from two hospital of Kathmandu. Mean

age of the respondents was 51.26 (±0.78) years. Male

patients (57%) exceeded female patients. Similarly, ma-

jority patients belonged to nuclear family and had suffi-

cient resources to eat for a year, but majority of them

had no savings.

Men tend to display higher blood pressure than women,

more evident in young and middle-age. This corresponds

to the incidence and prevalence of hypertension in Nepal,

as majority of hypertension is found to affect middle

adult population. The prevalence of hypertension and the

blood pressure levels increased with age in both men and

women [6].

According to the location of the case, urban residents

(64%) were more vulnerable to hypertension than rural

residents (36%). An epidemiological study by Gupta and

Sharma (2007), showed similar result with 25% urban

and 10% rural subjects in India had hypertension. In

developed countries prevalence of hypertension has been

noted high in lower socio-economic groups whereas in

societies with transitional state of economy high preva-

lence of hypertension has been noted [7].

The findings of the present study also suggest that

hypertensive patients are not sufficiently aware about

hypertension regarding its causes, signs and symptoms,

control measures and complications. Familoni (2005)

studied on knowledge and awareness of hypertension

among patients with systemic hypertension in Nigeria

which showed inadequate knowledge of hypertension in

patients with hypertension in Nigeria. Among 254 pa-

tients, only one third knew that hypertension should be

treated for life while 58.3% believed that antihyperten-

sive drugs should b e used only when there is a symptom

[8].

Sharma et al. (2006) studi ed of prevalence, awareness,

and control of hypertension in a suburban area of Kath-

mandu, Nepal. This study showed prevalence of hyper-

tension is significant in Nepal and awareness, treatment

and control rates are poor [9]. Another study carried out

by Dong et al. (2007) in China also showed high preva-

lence of hypertension in rural adults in north east China

with low rate of awareness and control [10].

The result of this study shows majority (90%) of re-

spondents were non-vegetarian before diagnosis, whereas

after the diagnosis of hypertension vegetarian were fou-

nd to have increased from 10% to 20%. The change in

food pattern after the diagnosis was statistically sig- ni-

ficant (p = 0.000). Many literatures have been pub-

lished supporting the usefulness of vegetarian diet for

the hypertensive patients. A research study done by Lin-

dhal (2006) found that vegetarian diet was extremely

beneficial for h yp er t en sive patients [11].

The consumption habit of non vegetarian items such

as mutton, buff, pork, chicken, fish and eggs were taken

into account while co llecting the data. Th ere was a sharp

reduction in the consumption of meat items after diag-

nosis of hypertension. There was statistically significant

decline in consumption of meat and eggs after the diag-

nosis of hypertension.

The study by Guba& Lincoln, 2008, The Dietary Ap-

proaches to Stop Hypertension (DASH) diet is a diet rich

in fish, chicken, lean meat, low-fat dairy, fruits, vegeta-

bles, whole grains, legumes, nuts, and seeds. In a high-

quality randomize control trials the DASH diet lowered

SBP for hypertensive patients by an average of 11 mm

Hg and DBP by an average of 5.5 mm Hg compared

with the control group [12].

According to study by MacGregor (2003) it was esti-

mated that a reduction of 3 g/d in salt intake would

lower blood pressure by 2.5/1.4 mmHg, which would

reduce strokes by 12 to 14% and ischaemic heart disease

by 9% to 10% and could prevent about 7,300 to 8,300

stroke deaths and 10,600 to 12,400 ischemic heart di-

sease deaths in the UK per year [13].

The number of respondents drinking alcohol declined

to 30% from 60%. The trend of the alcohol intake nota-

bly declined over the period both in terms of amount and

frequency of intake. A study (WHO, 2006) observed a

consistent association between alcohol intake and high

blood pressure. There was statistically significant dif-

ference in consumption of alcohol before and after di-

agnosis of hypertension. Out of total respondents, 44%

had a habit of smoking before diagnosis. But after diag-

nosis of hypertension 9% of them changed their habit.

As a result the number of smokers declined to 35%.

There was no statistically significant difference in num-

ber of sticks used by the smoker after the diagnosis of

hypertension.

Physical factors have been taken as one of the associ-

ated factors for the hypertension. After the diagnosis of

hypertension, the number of respondents doing physical

R. Acharya et al. / Health 3 (2011) 490-497

496

exercise increased to 47% from 23%. Similar findings

were also reported by Regmi (2008). He found that

walking an hour per day at the rate of 4km/hour to be an

effective exercise for reducing hypertension [14].

Another study (WHO, 200 6) also showed that there is

an inverse relationship between an aerobic physical ac-

tivities and blood pressure. Regular aerobic physical

activity has been demonstrated to be beneficial both for

prevention and treatment of hypertension [15]. In this

study very few respondents had gone through stress re-

duction activities before diagnosis but after that number

increased to 39%.There was statistically significant dif-

ference between change in performance of physical ex-

ercises and stress reduction activities after the diagnosis

of hypertension.

6. THE LIMITATIONS OF THE STUDY

The result of the study does not represent the whole

population because it is a small scale hospital based

study limited to the patients coming to TUTH and Sha-

hid Gangalal National Heart Centre during the short pe-

riod of data collection. The sample size also not esti-

mates by calculating formula. Hence the results may not

be generalized. This study was not designed randomly;

hence this might possibly affect the results. There might

be recall bias for questions asking about past life style

(especially if diagnosed quite earlier). Regarding meat,

oil/ghee and salt consumption, amount was not included

in the questionnaire. Similarly time was not specified for

physical exercise.

7. CONCLUSIONS

From this study, the awareness of hypertensive pa-

tients about their disease wa s found to be very poor. Re-

garding the change in life style, there was statistically

significant difference on the type of food consumption

including meat, eggs, ghee and oil. However there was

no significant difference in soyabean oil consumption,

additional salty food and amount of salt intake after the

diagnosis of hypertension. There was statistically sig-

nificant difference in certain types of physical exercises

as swimming/cycling and yoga but not in walking, jog-

ging/jumping and meditation. Similarly, there was statis-

tically significant difference in consumption of alcohol

and smoking habit.

Hence, it can be concluded that the awareness level of

hypertensive patients is still low. The modification of life

style is satisfactory for most risk factors, except for few

like salt intake, additional salty food and number of

sticks of cigarettes smoking. So Focus should also be

given on modification of lifestyle for reducing the ad-

verse consequences of hypertension. This can be done

by: Mobilizing the key informants’ e.g. political leader,

social workers for public awareness, Broadcasting pro-

gram and information regarding hypertension, Develop-

ing IEC (Information, Education and Communication)

material (e.g. pamphlet, poster) which helps in prevent

and control of hypertension and Setting up a hyperten-

sion-counseling clinic in each hosp ital to be launched by

the trained nurses.

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