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The EffectiveNess of LIfestyle with Diet and Physical Activity Education ProGram Among Prehypertensives and Stage 1 HyperTENsives in an Urban Community Setting (ENLIGHTEN) Study

  • Julieta Gabiola
  • Dante Morales
  • Olive Quizon
  • Ronald Ian Cadiz
  • Kyle Feliciano
  • Roberto L. Ruiz
  • Christine Joy Aguatis
  • Teresita Mararac
  • Jenssy Rojina
  • Ariadna Garcia
  • Haley Hedlin
  • Mark Cullen
  • Latha PalaniappanEmail author
Original Paper
  • 16 Downloads

Abstract

This study aims to determine the effectiveness of a monthly lifestyle education program, which included advice on nutritional changes and physical activity enhancement in the reduction of blood pressure and selected biochemical and anthropometric parameters among pre-hypertensive and stage 1 hypertensive participants in Manila, Philippines. Participants resided in two barangays (districts), in Manila, Philippines, and each barangay was assigned to either the intervention or attention-control group. The intervention group received monthly lectures on cardiovascular disease and organized classes on diet and exercise, while the attention-control group received monthly lectures on non-cardiovascular topics, with verbal advice that healthy diet and exercise are important. The primary outcome was systolic blood pressure, with secondary outcomes of BMI, waist circumference, and laboratory measures. Linear mixed effects models with an interaction between intervention group and time were used to estimate the 6-month change in each group. At 6 months, systolic blood pressure was lower in the intervention group compared to the attention-control group (− 12.7 mmHg (95% CI [− 14.5, − 10.9]) vs. − 0.24 mmHg (95% CI [− 1.87, 1.43]), p-value < 0.001). Waist circumference (p < 0.001), BMI (p < 0.001), and total cholesterol (p = 0.049) were also lower. However, no statistically significant difference in fasting glucose was observed between the two groups (p = 0.740). This study showed that participants receiving a non-pharmacological intervention, specifically a low-cost diet and active lifestyle education program, experienced a greater decrease in blood pressure, BMI, waist circumference, and total cholesterol than the attention-control group. Educational programs such as in ENLIGHTEN show promise for a developing country with limited resources to improve hypertension levels, and ultimately cardiovascular health. ENLIGHTEN deserves further study in randomized trials.

Keywords

Hypertension Lifestyle intervention Philippines Lecture Non-randomized interventional study Quasi-experimental study 

Notes

Acknowledgements

The authors would like to thank the members of the Quantitative Sciences Unit at Stanford University School of Medicine for their thoughtful review and suggestions on this study. This work was supported by the National Institute of Health/National Center for Research Resources (UL1 TR001085) and ABC’s for Global Health.

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10900_2019_764_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Julieta Gabiola
    • 1
  • Dante Morales
    • 2
  • Olive Quizon
    • 2
  • Ronald Ian Cadiz
    • 2
  • Kyle Feliciano
    • 3
  • Roberto L. Ruiz
    • 2
  • Christine Joy Aguatis
    • 2
  • Teresita Mararac
    • 2
  • Jenssy Rojina
    • 4
  • Ariadna Garcia
    • 5
  • Haley Hedlin
    • 5
  • Mark Cullen
    • 6
  • Latha Palaniappan
    • 1
    Email author
  1. 1.Division of Primary Care and Population HealthStanford University School of MedicineStanfordUSA
  2. 2.Manila Doctors HospitalManilaPhilippines
  3. 3.Stanford UniversityStanfordUSA
  4. 4.Oregon Health and Science University School of MedicinePortlandUSA
  5. 5.Quantitative Sciences UnitStanford University School of MedicineStanfordUSA
  6. 6.Center for Population Health SciencesStanford University School of MedicineStanfordUSA

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