March Providing a Tailored Educational Intervention Programme Can Have a Positive Impact on Hypertension Control

Hypertension affects in excess of 50% of people over 50 years of age in Ireland  

Lifestyle change is a critical element in blood pressure control

Hypertension control is only effective when the individual understands their condition and are empowered to take action

New research completed by NUI Galway, Croí­ - the West of Ireland Cardiac and Stroke Foundation, and the National Institute for Prevention and Cardiovascular Health, has explored the impact of a structured hypertension educational intervention programme on patient knowledge, lifestyle behaviours and blood pressure control. The study, published in the international medical journal SN Comprehensive Clinical Medicine, found a significant improvement in hypertension knowledge and awareness and a measurable increase in blood pressure control.

First author of the paper Dr Haroon Zafar, Programme Lead for the Masters in Interventional Cardiovascular Medicine at NUI Galway, and Science Foundation Ireland and Irish Research Council funded Principal Investigator, said: “Hypertension (raised blood pressure) is an increasingly prevalent condition in Ireland, affecting in excess of 50 per cent of those over 50 years of age. While many people undergo adequate clinical treatment, their standard of blood pressure control still remains sub-optimal mainly due to poor medication adherence fuelled by poor awareness level.

“Providing a tailored educational intervention programme can have a positive impact on hypertension control, knowledge and self-care management within community-based settings. With upward trends for hypertension and cardiovascular disease across Ireland, the need for a new model to effectively treat and control hypertension among the Irish community becomes indispensable.”

Over 100 participants from disadvantaged/underserved communities in County Mayo participated in the study. Participants from the interventional group were invited to attend the structured interactive educational programme on lifestyle management of hypertension. The aim of this session was to create knowledge and awareness on hypertension and was delivered by a multidisciplinary group including a Specialist Nurse, Dietician, Physiotherapist and Cardiologist. Educational topics included understanding and taking control of blood pressure, the effects of exercise and diet on blood pressure, smoking cessation, stress management, and current medication updates and adherence.

Eligible participants (adults of 40 years and older) with high blood pressure were randomly assigned to either a control group or an intervention group. The control group were given standard care, which included blood pressure and Body Mass Index measurements, lifestyle guidance, and referral to General Practitioner in accordance with European Society of Cardiology guidelines, and the interventional group received an educational session to improve knowledge and understanding of hypertension.

A follow-up assessment was conducted for all participants four-six months after the educational interventional programme. Participants from the intervention group showed higher blood pressure reduction by the end of the study on each of the four measured blood pressure indicators (SBP-R, SBP-L, DBP-R and DBP-L), compared to participants from the control group. The educational session provided to intervention participants also raised their awareness level regarding hypertension and the importance of exercise in controlling hypertension along with reduction in alcohol consumption and avoiding smoking altogether.

Professor Faisal Sharif, Consultant Interventional Cardiologist at University Hospital Galway and senior author of the paper, said: “The study highlights the importance of patient empowerment and engagement in management of chronic diseases such as hypertension. Through patient education we can achieve superior clinical results by modifying the patient’s behaviour. Further, larger studies are required to confirm this effect. Also, it will be interesting to assess the long-term effects of patient intervention on clinical outcomes.”

Neil Johnson, Chief Executive of Croí - the West of Ireland Cardiac and Stroke Foundation, and the National Institute for Prevention and Cardiovascular Health, commented: “Raised blood pressure remains the biggest single risk factor for heart attack and stroke, which constitute the leading cause of death and disability in Ireland and across the world. Effective treatments for high blood pressure are readily available and relatively cheap. However, a critical element in blood pressure control is lifestyle change which is only effective when the individual understands their condition and are empowered to take action. This research study confirms the significance of patient empowerment through education and it’s a good example of the significant impact of the work of Croí in the local community.”

The research was funded by an unrestricted educational grant from Global Medtronic Philanthropic Foundation and an Irish Research Council New Foundations Grant.

A copy of the full study, published in the journal SN Comprehensive Clinical Medicine is available at: https://bit.ly/3cIkLfc.

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