title: Non-pharmacological Interventions in Hypertension: A Community-based Cross-over Randomized Controlled Trial.
abstract: BACKGROUND
  Hypertension is the most prevalent non-communicable disease causing significant morbidity/mortality through cardiovascular, cerebrovascular, and renal complications.
  
  
  OBJECTIVE
  This community-based study tested the efficacy of non-pharmacological interventions in preventing/controlling hypertension.
  
  
  METHODS
  This is a cross-over randomized controlled trial (RCT) of the earlier RCT (2007) of non-pharmacological interventions in hypertension, conducted in the urban service area of our Institute. The subjects, prehypertensive and hypertensive young adults (98 subjects: 25, 23, 25, 25 in four groups) were randomly allotted into a group that he/she had not belonged to in the earlier RCT: Control (New Group I), Physical Exercise (NG II)-brisk walking for 50 to 60 minutes, three to four days/week, Salt Intake Reduction (NG III) to at least half of their previous intake, Yoga (NG IV) for 30 to 45 minutes/day, five days/week. Blood pressure was measured before and after eight weeks of intervention. Analysis was by ANOVA with a Games-Howell post hoc test.
  
  
  RESULTS
  Ninety-four participants (25, 23, 21, 25) completed the study. All three intervention groups showed significant reduction in BP (SBP/DBP mmHg: 5.3/6.0 in NG II, 2.5/2.0 in NG III, and 2.3/2.4 in NG IV, respectively), while the Control Group showed no significant difference. Persistence of significant reduction in BP in the three intervention groups after cross-over confirmed the biological plausibility of these non-pharmacological interventions. This study reconfirmed that physical exercise was more effective than Salt Reduction or Yoga. Salt Reduction, and Yoga were equally effective.
  
  
  CONCLUSIONS
  Physical exercise, salt intake reduction, and yoga are effective non-pharmacological methods for reducing blood pressure in young pre-hypertensive and hypertensive adults.
authors.affiliation: Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Hema
authors.initials: H
authors.lastname: Subramanian
authors.forename: M Bala
authors.initials: MB
authors.lastname: Soudarssanane
authors.forename: R
authors.initials: R
authors.lastname: Jayalakshmy
authors.forename: D
authors.initials: D
authors.lastname: Thiruselvakumar
authors.forename: D
authors.initials: D
authors.lastname: Navasakthi
authors.forename: Ajit
authors.initials: A
authors.lastname: Sahai
authors.forename: Lg
authors.initials: L
authors.lastname: Saptharishi
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