Efficacy of a church-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members: a randomized controlled trial in Pretoria, South Africa.

Supa Pengpid,Karl Peltzer,Linda Skaal

doi:10.1186/1471-2458-14-568

Abstract

BackgroundIn persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively. Elevated blood glucose and elevated blood pressure are prototype of preventable chronic cardiovascular disease risk factors.Lifestyle interventions have been shown to control high normal blood pressure and/or high normal blood glucose.Methods/DesignThis study proposes to evaluate the efficacy of a community (church)-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members in a randomized controlled trial in Gauteng, South Africa. The objectives are to: (1) measure non-communicable diseases profile, including hypertension and diabetes, health behaviours, weight management and psychological distress of church members; (2) measure the reduction of blood glucose and blood pressure levels after the intervention; (3) prevent the development of impaired glucose tolerance; (4) compare health behaviours, weight management and psychological distress, blood glucose and blood pressure levels between intervention and control groups, and within group during 6, 12, 24 and 36 months during and post intervention. The study will use a group-randomized design, recruiting 300 church members from 12 churches. Churches will be randomly assigned to experimental and control conditions.DiscussionLifestyle interventions may prevent from the development of high blood pressure and/or diabetes. The findings will impact public health and will enable the health ministry to formulate policy related to lifestyle interventions to control blood pressure and glucose.Trial registration numberPACTR201105000297151

Highlights

In persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively
Lifestyle interventions may prevent from the development of high blood pressure and/or diabetes
The findings will impact public health and will enable the health ministry to formulate policy related to lifestyle interventions to control blood pressure and glucose

Summary

Introduction

In persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively. Lifestyle interventions have been shown to ameliorate or prevent the progression of prediabetes and prehypertension to diabetes and hypertension [3,4] Such a nonpharmacological approach to primary prevention and disease interruption carries enormous public health significance [3]. In trials conducted in China, Finland and the USA, for example, study participants have significantly improved their diet and/or physical activity, and shown improved levels of blood pressure, blood glucose, cholesterol and triglycerides within one year of commencing a programme, with improvements continuing for at least six years. Participants with prehypertension or stage-1 hypertension were randomly assigned to an advice only control group, a 6-month intensive behavioural intervention group of established recommendations (EST), or an established recommendations plus DASH group (EST + DASH) Both EST and EST + DASH reduced the primary outcome variable, systolic blood pressure [10]. The Seventh Report of the Joint National Committee on Hypertension recommended only lifestyle changes for most prehypertensive patients [14]

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