@2024 Afarand., IRAN

---

ISSN: 2383-2150    Journal of Education and Community Health 2020;7(1):59-64

Background
Hypertension is one of the chronic problems and the first risk factor leading to mortality and disability worldwide, which is most prevalent in developed and developing countries [1].
Previous Studies
... [2]. Various global studies have reported different incidence of hypertension in diabetic patients [3–5]. The prevalence of hypertension in diabetic individuals in Iran varies from 11% in major cities, 13.9% in Zabol, 21% in Semnan, and 38% in Tehran [6]. Its prevalence in diabetic subjects aged 15 to 60 years has been reported to be 26.6% [7]. Lifestyle can be effective in causing stress, anxiety and tensions, and subsequently elevating blood pressure [8]. Lifestyle modification has been emphasized for the prevention and control of blood pressure on [9]. ... [10-14].
Aim(s)
The purpose of this study was to investigate the effect of lifestyle intervention on blood pressure in diabetic patients with hypertension.
Research type
The present study was an experimental interventional study.
Research society, place and time
This study was performed in 2017 among patients with diabetes and hypertension referred to the Urmia Diabetes Association.
Sampling method and number
The sample size was 80 persons according to Rezai et al. [15] and considering the possible attrition and obtaining more accurate results. The samples were randomly divided into the intervention and control groups.
Used devices&materials
Study data, such as demographic characteristics and systolic and diastolic blood pressure were obtained from patients at the beginning of the study. Subsequently, the intervention group was again contacted once and invited to participate in training sessions. Based on previous studies, they were given six hours of training in four 1.5-hour sessions over two weeks [17-17] by the researcher along with PowerPoint presentations. In order to better educate and monitor each case, and to avoid the lack of coordination to attend all subjects at a specific time in the class, the subjects were divided into two groups of 20 cases and the educational contents were presented at different times. At the end of the classes, the intervention group was asked to do the provided trainings consistently. According to the study by Shams et al. [17], subjects were followed for 12 weeks. All subjects (control and intervention) were invited once every two weeks to measure blood pressure and also to encourage them to continue the study. Blood glucose levels were also measured every month at the referrals to measure blood pressure to encourage them to continue the study. Then, after 12 weeks, blood pressure was controlled six times in total, and its mean was considered as post-study blood pressure. Physical activity was also self-reported by the subjects, including 210 min per week of intermittent exercise or 125 min per week of vigorous-intensity exercise or 150 min per week of moderate physical activity [18]. Overall, the study was completed after 16 weeks. Also, after the samples’ withdrawal due to unwillingness to continue the study (3 cases in each group), the number of samples in each group was 37 subjects. Data were analyzed by SPSS 16 software using Chi-square, independent t-test and paired t-test.
Findings by Text
The mean age in the control group was 47.30±10.80 years and in the intervention group was 49.38 ± 7.90 years and also the mean duration of the disease in the control group was 16.89 ± 5.40 years and in the intervention group was 19.00±4.60 years. There was no significant difference between the intervention and control groups in terms of the theses variables as well as gender, marital status, type of diabetes, income level, job and education level (p> 0.05; Table 1).Before intervention, there was no significant difference between the two groups in mean systolic and diastolic blood pressure, but after intervention, the mean systolic and diastolic blood pressure were significantly different between the two groups. In the control group, systolic blood pressure decreased slightly after a while and this decrease was statistically significant, but diastolic blood pressure did not change significantly. In the intervention group, systolic blood pressure decreased approximately 20 mmHg and diastolic blood pressure approximately 18 mmHg after the intervention, which was statistically significant (Table 2).
Main comparison to the similar studies
In a study of Ghavami et al. [19], systolic blood pressure did not differ significantly between the two groups after the intervention, but there was a significant difference in diastolic blood pressure. Bahrami Nejad et al. compared the effect of person- and family-centered education on blood pressure control and lifestyle of clients and their results showed a significant decrease in patients' blood pressure [20]. Bayat et al. in their study also showed that diabetic patients had a significant decrease of 6.98% in systolic blood pressure and 4.74% in diastolic blood pressure after three months of walking [7]. Paula et al. studied 40 diabetic patients with hypertension. They divided the patients into two groups of diet and walking and diet alone and found that diet and walking together significantly reduced systolic and diastolic blood pressure [21], which is consistent with the results of the study. Elmer et al. also concluded that lifestyle modification for 18 months can be effective in controlling patients' blood pressure [22]. ... [23-26].
Suggestions
None
Limitations
One of the limitations of the study was the attrition of the samples; therefore, more samples were included.
Conclusions
Educational intervention in lifestyle and modification and application of principles in personal habits and behaviors and behavioral self-management can have a great impact on control of blood pressure in diabetic people.
Acknowledgments
The authors are grateful to the Diabetic Association of West Azerbaijan Province and all the staff of the center who contributed to the study, as well as all the patients who participated in this study by regular referrals.
Conflict of interest
None
Ethical Permissions
This study was approved by the Ethics Committee of Urmia University of Medical Sciences (80.191.214.190).
Funding Sources
None

TABLES and CHARTS

Show attach file