The Effect of Change in Lifestyle Measures on Weight and Body Mass Index among Adult Hypertensive Patients in a Tertiary Hospital in North Central Nigeria

Abstract

Background: The prevalence of obesity has reached epidemic levels over the past few decades, and this is more so among hypertensive adults. Concurrent with this rise are increase in numerous obesity associated diseases including heart disease, certain types of cancer and diabetes. The cornerstone of therapeutic interventions to treat or prevent these diseases is weight loss via lifestyle modification. Aim: The study was undertaken to determine the effect of change in lifestyle measures on weight and Body Mass Index (BMI) among adult hypertensive patients. Methods: The study was a randomized controlled study involving hypertensive adults aged 20 years and above presenting in the General Outpatients’ Clinic (GOPC) of Jos University Teaching Hospital (JUTH). Participants were consecutively selected and randomized to an intervention group that was offered structured counselling on lifestyle modification and a control group that was offered routine advice only. Participants in both groups were also taking antihypertensive medications. Participants were followed up monthly for twelve weeks and adherence to lifestyle modification measures noted. The proportion of observed changes were analysed using Chi square and Fischer’s exact tests. The means at 95% confidence intervals of the weight and BMI values were determined using the independent t-test. Data was analyzed on an intention-to-treat basis. A p-value of <0.05 was considered significant in all analyses. Results: Changes in lifestyle measures were notably more among the intervention group. Twenty four participants lost at least 0.5kg after the study, nine in the control group and 15 in the intervention group. Even though there was a difference in means of 2.47 kg (-11.46, 6.52; 95%CI) between the control and intervention groups at the end of the study, the difference was not statistically significant. Twenty three participants had at least 0.2kg/m2 decrease in BMI in the study group, nine in the control group and 14 in the intervention group. The difference in means between the two groups was 0.12kg/m2 (-3.38,3.62; 95%CI) and this was not statistical significant. Conclusion: This study shows that changes in lifestyle measures among hypertensive adults are associated with a decrease in weight and improved BMI. However the effect of lifestyle modification on these clinical indices, during a period of 12 weeks, following structured counselling may not differ from routine verbal advice only.