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  • Online Edition Volume 5(3)has been added Last update March 18, 2010 -10:15 PM
    • Impact of Physical Activity on Hypertension Control 

    Objective: To determine the impact of physical activity (walking) on control of systolic and diastolic blood pressure in hypertensive patients of Islamabad.
    Patients and methods: This cross-sectional study was performed in the cardiology outpatient department of Pakistan Institute of Medical Sciences (PIMS), Federal Government Services Hospital, and Out Patient Department of Pakistan Atomic Energy Complex (PAEC) Islamabad, from April 2006 to September 2006. A total of 240 patients were selected. Information regarding the socio-demographic profile as well as their level of physical activity (30 minutes brisk walk 5 days /week) was gathered through a structured questionnaire.
    Results: Out of 240 patients, 123 were males (51.25%) and 117 (48.75%) were females. 80/123 (65%) males and 63/117 (54%) females replied that they did physical activity regularly. 99% of the group of patients who did physical activity (143/240 patients) had normal B.P values and 64% of the group of patients who did no physical activity (97/240 patients) had blood pressure towards the upper limits of normal. The systolic and diastolic B.P was significantly (P=0.000) different in patients with and with out physical activity who were on regular medication. Similarly B.P was also significantly (P=0.000) different in hypertensive patients with and without regular exercise who were not taking medication. Conclusion: Physical activity especially walking for 30 minutes at least 5 days per week has a significant role in reducing and controlling blood pressure in patients with and without medication.
    Key Words: Hypertension, Diastolic Blood Pressure, Systolic Blood Pressure, Physical Activity

    Introduction 

    Hypertension is defined as a blood pressure level ≥ 140 mm Hg systolic and/or 90 mm Hg diastolic and/or taking antihypertensive medication.1 Physical activity is a global term referring to any bodily movement produced by the skeletal muscles which results in energy expenditure, for example walking. Hypertension is estimated to cause 4.5% of current global disease burden and is as prevalent in many developing countries as it is in the developed world.2 According to NHSP (National Health Survey of Pakistan 1990-94), prevalence of hypertension over the age of 15 years was reported at 17.9 %, with a higher prevalence observed in urban areas (21% versus 16.2% in rural areas).1 Physical inactivity is a major risk factor for cardiovascular health, including Hypertension.3 Epidemiological studies suggest that physically active individuals have a 30-50% risk reduction for coronary heart disease and are associated with an increased incidence of stroke, coronary heart disease, heart failure, peripheral arterial disease, and renal insufficiency.4,5 All current treatment guidelines for hypertension emphasize the role of physical activity in the treatment of hypertension.6-9 Hypertension prevalence is increasing whereas awareness of the condition and control rates is below average.10 The positive relationship between cardiovascular disease risk and blood pressure occurs with a BP (blood pressure) as low as 115/75 mm Hg and doubles for each 20/10-mm Hg increase.11 It has been estimated that a 5 mmHg reduction of Systolic Blood Pressure in the population would result in a 14% overall reduction in mortality due to stroke and 9% reduction in mortality due to coronary heart disease and an overall 7% decrease in all cases mortality.12 Moderate intensity activity for most people is comparable to a brisk walking pace of 4.5 to 6 km per hour, and high intensity activity is comparable to jogging or running.13 There are also no indications of age or gender related differences in blood pressure response to exercise.12 Increasing the awareness and simple preventive measures such as promotion of physical activity, reducing body weight and reduction of salt intake, present the best hope for reducing the impact of hypertension on morbidity and mortality.13, 14
    There is a tremendous burden of disease regarding Hypertension and other co morbid diseases in our country due to an increasing sedentary lifestyle.
    		  

    Farwa Rizvi*

    Muhammad Afzal**

    M. Ashraf Chaudhry***

    Atif Baig****

    Zubair Hasan*****

     

    *Assistant Professor, Islamabad Medical and Dental College

    **Senior Research Officer, IMDC, Islamabad

    ***Prof. and HOD Community medicine, IMDC, Islamabad

    ****Consultant Physician, PAEC Hospital, Islamabad

    *****DG, PAEC, Islamabad


    Obesity is already on the rise and is becoming a pandemic, acting as a harbinger of a plethora of non communicable diseases like Hypertension, Diabetes, and Cardiac Diseases. Educating and motivating people to start physical activity (walking) can be a very cost effective way by inculcating life style changes. The present study was planned to see the effect of physical activity on control of blood pressure.


    Patients and Methods

    This multi-centre cross-sectional study was conducted in three centres, which were the Medical outpatient department of Pakistan Atomic Energy Complex (PAEC), Cardiology outpatient department of Pakistan Institute of Medical Sciences (PIMS) and Polyclinic hospital from April 2006 to September 2006. A total of 240 patients were selected by purposive sampling technique from the three public sector hospitals in Islamabad. According to the outpatient department turnover, 115 patients from Pakistan Institute of Medical Sciences (PIMS), 100 from Polyclinic, and 25 from Pakistan Atomic Energy Complex (PAEC) were selected. Informed written consent was taken. Permission from the respective Medical Superintendents of the hospitals was also taken to avoid any ethical issues. Patients (both gender) of essential hypertension, above 25 years, who were on regular antihypertensive medication and those who were on irregular medication/no medication, without any other co-morbid diseases and who were non-smokers were included in the study. A brief history regarding socio-demographic profile, level of physical activity (30 minutes brisk walk at least 5 days per week), and duration of hypertension since diagnosis was taken through a structured questionnaire having multiple choice questions. Brief clinical examination was done regarding BP measurement. Blood pressure measurement was taken by mercury sphygmomanometer with the cuff width of 14.5 cm and range 25.4 – 40.6 cm. The cuff of the B.P apparatus was tied not too tight or too loose. BP reading was taken from the left arm in the sitting position. Two readings were taken at 5 minutes interval at the same sitting. It was ensured that the cuff was at heart level by appropriately supporting the arm whatever the position of the patient and the patients had not taken any caffeine-containing beverages or smoked for at least two hours before blood pressure was measured.SPSS version 13.0 was used for statistical analysis. Independent sample t-test was used to compare systolic and diastolic B.P in patients with and with out physical activity who were taking medication regularly and who were not on medication. Chi-square test was used to find any association of physical activity with age, gender and education. ResultsOut of 240 patients, 123 were males (51.25%) and 117 (48.75%) were females. Among the male patients, 80 (65%) patients answered yes for physical activity and 33.33% said no. In the female patients 63 (54%) answered yes and 52 (44.4%) said no (no physical activity). Physical Activity meant brisk walk for at least 30 minutes 4 days per week.Our results showed that as the education level increased the proportion of physical activity also increased significantly (P= 0.000). Education played a significant (P=0.000) role in the general awareness in the patient population regarding the meaning and awareness of normal blood pressure.
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