Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial.
OBJECTIVE
To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting.


METHODS
Cluster randomised controlled trial.


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


METHODS
4023 people aged 5-39 years.


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


METHODS
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.


BACKGROUND
Clinical trials NCT00327574.
Jafar
Tazeen H
TH
Department of Medicine, Aga Khan University, Karachi, Pakistan. tazeen.jafar@aku.edu
Islam
Muhammad
M
Hatcher
Juanita
J
Hashmi
Shiraz
S
Bux
Rasool
R
Khan
Ayesha
A
Poulter
Neil
N
Badruddin
Salma
S
Chaturvedi
Nish
N
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003150:Community Health Workers; D003906:Developing Countries; D003971:Diastole; D005260:Female; D006266:Health Education / Q000379:methods*; D006699:Home Care Services; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D008019:Life Style; D008297:Male; D010154:Pakistan; D013599:Systole; D055815:Young Adult