Effects Of Exercise Intervention With Health Education On Middle-aged And Elderly Hypertension Patients In Community

Objective:1.To evaluate the effects of exercise intervention combined with health education on clinical indicators (including:systolic blood pressure, diastolic blood pressure, fasting plasma glucose, two-hour postprandial plasma glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, BMI, WHR.) and psychological state of the community middle-aged and elderly hypertension patients,in order to provide a basis for effective interventions in hypertensive patients.2.To explore the effects of changes in the indicators on blood pressure changes before and after intervention.3.To assess the effects of the intervention on hypertension-related knowledge, awaress, attitude and behaveiors in middle-aged and elderly hypertension patients.Methods:Three communities of the similar economic condition were selected by cluster sampling from Wangdingdi community of Nankai District in Tianjin,according to the baseline data of physical eaxamination. Diagnostic criteria for hypertension recommended by the World Health Organization in 1999 was adopted.160 hypertension patients who were willing to participate in this study were chosen as the subjects. They were randomly divided into experimental group and control group.The control group was not given any intervention and the experimental group was given intensive exercise intervention three times per week for six months. At the same time the experimental group was asked to take part in the hypertension-related health education two times per month. Considering the ethical issue, the control group was given lectures about knowledge of hypertension after the program. Before and after the intervention, the general situation and the psychological states of of the hypertension patients were investigated by a questionnaires survey of hypertension-r elated knowledge scale. Blood pressure, blood glucose, blood lipids, weight and height, waist-hip ratio, hypertension-related knowledge score and psychological score were measured. The changes of all the indices, the psychological score and hypertens ion-related knowledge score after six months'exercise intervention were ana lyzed with SPSS17.0 statistical software,including t test, chi-square test,repeated measure ment analysis of variance, Wilcoxon rank test and Kruskal-Wallis rank test, bivariate correlation analysis, multiple linear stepwise regressions.Results:1.There were no statistically differences between intervention group subjects and control group subjects in constituent ratios of age, gender, nationality, occupation, education level, income level (all P>0.05) at baseline.2.There were no statistically differences between intervention group subjects and control group subjects in systolic blood pressure, diastolic blood pressure, BMI, WHR,fasting plasma glucose, two-hour postprandial plasma glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein before the invertention (all P>0.05)3.The changes compared before and after intervention there were statistically differences between intervention group subjects and control group subjects in systolic blood pressure, diastolic blood pressure, fasting plasma glueose, two-hour postprandial plasma glucose, total cholesterol, triglyceride,psychological score (all P <0.05). The changes compared before and after intervention there were no statistically difference between intervention group subjects and control group subjects in BMI, WHR high-density lipoprotein, low-density lipoprotein (all P>0.05)4.There was statistically difference between intervention group subjects and control group subjects in the scores of hypertension knowledge by t test (P< 0.05).From the multiple linear stepwise regression analysis,except for the behavior scores, statistical differences existed in the knowledge scores and the attitude scores between groups of different intervention (all P<0.05). Statistical differences existed in the knowledge scores and the attitude scores between groups before and after intervention (all P<0.05), furthermore,there was an interaction effect between intervention and time (all P<0.05).According to Wilcoxon rank test and Kruskal-Wallis rank test analysis, it was found that no statistically significant changes happened in hypertension-related knowledge of age, gender, nationality occupation, education level, income level (all P>0.05)5.There were significant positive correlations between the changes in total score of hypertension knowledge and the changes in systolic blood pressure, fasting glucose, two-hour postprandial plasma glucose, triglyceride before and after the intervention (all rs>0,P<0.05).There were significant negative correlations between the changes in total score of hypertension knowledge and the changes in psychological score (all rs<0,P<0.05)6.According to the multiple linear stepwise regression, the difference of the systolic blood pressure before and after the intervention was related to the differences of BMI,WHR,total cholesterol,triglyceride,high-density lipoprotein,low-density lipo protein,fasting plasma glueose,two-hour postprandial plasma glucose,hypertension-related knowledge score, psychological score before and after the intervention respectively. Stepwise regression equation was statistically significant (F=3.233, P=0.001).The difference of the diastolic blood pressure before and after the intervention was related to the differences of BMI,WHR, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, fasting plasma glueose, two-hour postprandial plasma glucose, hypertension-related knowledge score, psychological score before and after the intervention respectively. Stepwise regression equation was statistically significant (F=3.154, P=0.001)Conclusion:1.Exercise intervention can be helpful to improve the clinical effects of treatment of hypertensives. It is of effectiveness in reducing the levels of systolic blood pressure, diastolic blood pressure, fasting plasma glucose, two-hour postprandial plasma glucose, total cholesterol, triglyceride. But they were not found that the levels of low-density lipoprotein and increasing high-density lipoprotein have decreased in 6 months'intervention.2.The combination of exercise intervention and health education can improve the compliance of the subjects to participate in it. And it can make the effects much better and the hypertension-related knowledge improved.3.Increase of patients' hypertension-related knowledge level can be helpful to lower the levels of systolic blood pressure, diastolic blood pressure, fasting plasma glucose, two-hour postprandial plasma glucose, total cholesterol, triglyceride, etc. It also can improve the psychological status of hypertension and enhance the confidence in treatment of hypertension.4.The changes in BMI, WHR, total cholesterol, triglyceride fasting plasma glucose, two-hour postprandial plasma glucose, hypertension-related knowledge score, psychological score before and after the intervention can reduce systolic blood pressure and diastolic blood pressure levels.