A Randomized Controlled Trial of the Effect of a Hypertensive Educational Program on Home Blood Pressure in Hypertensive Patients at King Chulalongkorn Memorial Hospital

Background: The effectiveness of various non-pharmacological hypertensive therapies (including diet, exercise, Qigong, meditation) on “office” blood pressure (BP) control has been reported in previous studies. However, little is known about the effects of a hypertensive educational program on “home” BP control. Objective: The aim of the study was to determine the effects of our unique one-day hypertensive educational program on home BP in patients with hypertension. Methods: 66 patients (age 57.73 ± 9.04 years, 17% male) with mild to moderate hypertension were prospectively enrolled and randomly assigned to two groups: an educational intervention program and a control group. The education program of our hospital is a unique 8-hour didactic educational workshop consisting of a special high fiber and low salt recipe, meditation walk, Qigong practice, and a standard education for hypertensive patients, including basic knowledge of the disease and related complications, salt and diet control, activities, and exercise. The primary end point was the difference of home BP between baseline and that at 3 months after randomization. Home BP was defined as a mean of home BP measured by a digital self-recorder twice a day for 7-consecutive days. The secondary endpoints were the differences of body weight, waist and hip circumferences, fasting plasma glucose, and lipid profiles. Results: A total of 31 patients in the intervention group and 33 patients in the control group completed the study at 3 months. The baseline characteristics between both groups were similar. In the intervention group, the baseline BP was 141.27 ± 13.91/83.40 ± 9.3 mmHg and at 3-months the BP was 137.46 ± 15.55/82.49 ± 10.45 mmHg. In the control group, the baseline BP was 134.83 ± 10.32/81.63 ± 10.12 mmHg and at 3-months BP was 136.31 ± 10.94/82.26 ± 9.74 mmHg. Systolic BP declined 3.81 ± 7.45 mmHg in the intervention group, but increased 1.48 ± 6.77 mmHg in the control group (p = 0.011). There was no significant changes of diastolic BP decline in the study group and control group (p = 0.200). The delta body weight, waist and hip circumferences, fasting plasma glucose, lipid profiles were not significantly different between both groups. Conclusions: Our unique educational program with a combination between conventional and traditional/integrative means for hypertensive patients had a significant impact on home BP reduction at 3 months-follow up. Whether this means that an objective home practice and compliant quantification had incremental and/or superior effects, to a conventional educational program on home BP needs further study.