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Randomized Controlled Trial
. 2010 Jun 7:340:c2641.
doi: 10.1136/bmj.c2641.

Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial

Tazeen H Jafar  1 , Muhammad Islam, Juanita Hatcher, Shiraz Hashmi, Rasool Bux, Ayesha Khan, Neil Poulter, Salma Badruddin, Nish Chaturvedi; Hypertension Research Group
Collaborators, Affiliations
Randomized Controlled Trial

Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial

Tazeen H Jafar et al. BMJ. .

Abstract

Objective: To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting.

Design: Cluster randomised controlled trial.

Setting: 12 randomly selected geographical census based clusters in Karachi, Pakistan.

Participants: 4023 people aged 5-39 years.

Intervention: Three monthly family based home health education delivered by lay health workers.

Main outcome measure: Change in blood pressure from randomisation to end of follow-up at 2 years.

Results: Analysed using the intention to treat principle, the change in systolic blood pressure (adjusted for age, sex, and baseline blood pressure) was significant; it increased by 1.5 (95% confidence interval 1.1 to 1.9) mm Hg in the control group and by 0.1 (-0.3 to 0.5) mm Hg in the home health education group (P for difference between groups=0.02). Findings for diastolic blood pressure were similar; the change was 1.5 mm Hg greater in the control group than in the intervention group (P=0.002).

Conclusions: Simple, family based home health education delivered by trained lay health workers significantly ameliorated the usual increase in blood pressure with age in children and young adults in the general population of Pakistan, a low income developing country. This strategy is potentially feasible for up-scaling within the existing healthcare systems of Indo-Asia.

Trial registration: Clinical trials NCT00327574.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Flow diagram of study. *Participants excluded for protocol violation. †Participants who successfully completed two years of follow-up and were included in analyses
See this image and copyright information in PMC

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