Health education: the effects of an educational program on the health of hypertensive patients with low educational level

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): FAPEMIG Introduction Health education is one of the most complete practices for supporting of patients with chronic diseases such as hypertension. It is important, however, to investigate which strategies would be more assertive in this process, depending on the objective and profile of the patient. Objective: The aim of this study was to evaluate the effect of an interactive educational program on the health of hypertensive patients with low educational level in a Basic Health Unit in Brazil. Methods: This is an almost experimental study, with a multidisciplinary approach, with 6 months of duration. Interactive workshops were held where topics related to hypertension, such as: pathophysiology, complications, drug and non-drug therapeutic approach and lifestyle change. It is important to emphasize that the work used interactive and playful sessions, such as games, videos and group dynamics. The sample consisted of 35 hypertensive individuals submitted to blood pressure (systolic = SBP and diastolic = DBP) measurement, quality of life (Minichal), adherence to treatment (Martín-Bayarre-Grau), level of knowledge of the disease, physical activity (IPAQ) and anthropometric study evaluation. In addition, for analysis of the data, the sample was divided into two subgroups, according to the participation in the activities: adhered (n = 11) or not adhered (n = 24). Initially, descriptive statistics were used to present the study variables. Subsequently, the WILCOXON test was used to compare before and after and MANN-WHITNEY to compare the two groups, p = 0.05 was considered significant. Results: No significant difference was found relating the initial data in the two subgroups. After the educational program, a significant reduction was observed in relation to the SBP values: 9.8 mmHg in the adherent subgroup. On the other hand, there was increased 0.7 mmHg among non-adherents. The other evaluations did not change. It should be emphasized that the studied population demonstrated a satisfactory level of knowledge of the pathology and the therapeutic process necessary since the initial evaluation in both groups. Such finding, however, was not related to adherence to treatment. Conclusion: the findings suggest that an adapted educational approach could help to control blood pressure levels of hypertensive patients with low educational level. In addition, it was observed that knowledge does not seem to be associated with action, and it is necessary to develop strategies that can increase adherence to therapeutic interventions.

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Educational approach for hypertensive people with low educational level

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.464 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Pereira de Sousa ◽

A P Prado Campos ◽

C Maia Araújo ◽

I Gomes da Silva Moreira ◽

G Santos ◽

...

Keyword(s):

Blood Pressure ◽

Educational Level ◽

Educational Process ◽

The Other ◽

Wilcoxon Test ◽

Therapeutic Interventions ◽

Educational Approach ◽

Low Level ◽

Quasi Experimental ◽

Level Of Knowledge

Abstract Introduction The educational process in the treatment of patients with arterial hypertension is common but, generally exclude from the sample illiterate individuals or those with a low level of schooling. Objective evaluate the effect of an educational program based on group interventions on the health of hypertensive individuals with low level of schooling in a Basic Health Unit in Brazil. Methods This is a educational quasi-experimental study, adapted to the level of schooling of the participants, carried out during a period of 23 weeks. It was evaluated 35 hypertensive individuals submitted to blood pressure (BP) measurement, quality of life (Minichal), adherence to treatment (Martín-Bayarre-Grau), level of knowledge of the disease, physical activity (IPAQ) and anthropometric study evaluation. In addition, for analysis of the data, the sample was divided into two subgroups, according to the participation in the activities: adhered (n = 11) or not adhered (n = 24). Descriptive statistics were used to present the study variables. The WILCOXON test was used to compare before and after and MANN-WHITNEY to compare the two groups, p = 0.05 was considered significant. Results a significant reduction was observed in relation to the systolic BP values: 9.8 mmHg in the adherent subgroup, after the intervention. On the other hand, there was increased 0.7 mmHg among non-adherents. The other evaluations did not change. It should be emphasized that the studied population demonstrated a satisfactory level of knowledge of the pathology since the initial evaluation in both groups. Conclusions the findings suggest that an adapted educational approach could help to control blood pressure levels of hypertensive patients with low educational level. In addition, it was observed that knowledge does not seem to be associated with action, and it is necessary to develop strategies that can increase adherence to therapeutic interventions. Key messages Educational intervention. Low educational level.

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KNOWLEDGE AND APPLICATION OF BALANCED NUTRITION ON TODDLERS DURING PANDEMIC

INTERNATIONAL JOURNAL OF NURSING AND MIDWIFERY SCIENCE (IJNMS) ◽

10.29082/ijnms/2021/vol5/iss1/334 ◽

2021 ◽

Vol 5 (1) ◽

pp. 24-29

Author(s):

Hesty Widowati Widowati ◽

Sri Mukhodim Faridah Hanum ◽

Umi Khoirun Nisak ◽

Widya Nurfadillah

Keyword(s):

Health Education ◽

Nutrition Education ◽

T Test ◽

Wilcoxon Test ◽

P Value ◽

Test Results ◽

Significant Difference ◽

Before And After ◽

Level Of Knowledge ◽

Paired T Test

Toddlers are an age group that is vulnerable to nutritional disorders. A balanced nutritional intake will have an impact on children's development and also play an important role in immunity to prevent and fight COVID-19, especially in early childhood. Nutrition education is an effective effort in changing the behavior of mothers. The purpose of this study was to determine the effect of health education on knowledge and behavior of mothers in the application of toddler’s balanced nutrition in Sidoarjo region. This study used a pre-experimental design with a one group pre post test approach. The sample of this research is mothers who have children aged 1-5 years in the village of Sukodono Sidoarjo totaling 30 respondents, the sampling technique is purposive sampling. The statistical test used are the Paired T test and Wilcoxon test. The Paired t test results obtained p value 0.011 (α = 0.05), which means that there is an effect of health education on the level of knowledge about balanced nutrition in toddlers, while the Wilcoxon test results on the practice of implementing toddler’s balanced nutrition obtained p value 0.091 which means there is no effect health education on the practice of implementing balanced nutrition in toddlers. Thus it can be concluded that there is a significant difference in the level of knowledge of respondents before and after being given health education, while the practice of implementing toddler’s balanced nutrition has no difference before and after being given health education

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The Impact of a Health Education Program Targeting Patients with High Visit Rates in a Managed Care Organization

American Journal of Health Promotion ◽

10.4278/0890-1171-17.2.101 ◽

2002 ◽

Vol 17 (2) ◽

pp. 101-111 ◽

Cited By ~ 12

Author(s):

Diana L. Dally ◽

Wendy Dahar ◽

Ann Scott ◽

Douglas Roblin ◽

Allan T. Khoury

Keyword(s):

Blood Pressure ◽

Health Promotion ◽

Health Status ◽

Treatment Group ◽

Health Education ◽

Managed Care ◽

The Other ◽

Care Organization ◽

Significant Change ◽

Health Education Materials

Purpose. To determine if a mailed health promotion program reduced outpatient visits while improving health status. Design. Randomized controlled trial. Setting. A midsized, group practice model, managed care organization in Ohio. Subjects. Members invited (N = 3214) were high utilizers, 18 to 64 years old, with hypertension, diabetes, or arthritis (or all). A total of 886 members agreed to participate, and 593 members returned the initial questionnaires. The 593 members were randomized to the following groups: 99 into arthritis treatment and 100 into arthritis control, 94 into blood pressure treatment and 92 into blood pressure control, and 104 into diabetes treatment and 104 into diabetes control. Measures. Outpatient utilization, health status, and self-efficacy were followed over 30 months. Interventions. Health risk appraisal questionnaires were mailed to treatment and control groups before randomization and at 1 year. The treatment group received three additional condition-specific (arthritis, diabetes, or hypertension) questionnaires and a health information handbook. The treatment group also received written health education materials and an individualized feedback letter after each returned questionnaire. The control group received condition-specific written health education materials and reimbursement for exercise equipment or fitness club membership after returning the 1-year end of the study questionnaire. Results. Changes in visit rates were disease specific. Parameter estimates were calculated from a Poisson regression model. For intervention vs. controls, the arthritis group decreased visits 4.84 per 30 months (p < 0.00), the diabetes group had no significant change, and the hypertension group increased visits 2.89 per 30 months (p < 0.05), the overall health status improved significantly (−6.5 vs. 2.3, p < 0.01) for the arthritis group but showed no significant change for the other two groups, and coronary artery disease and cancer risk scores did not change significantly for any group individually. Overall self-efficacy for intervention group completers improved by −8.6 points (p < 0.03) for the arthritis group, and the other groups showed no significant change. Conclusions. This study demonstrated that in a population of 18 to 64 years with chronic conditions, mailed health promotion programs might only benefit people with certain conditions.

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Pregnant women and risk factors: a cross-sectional study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.916 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

V L a Fauci ◽

R Squeri ◽

C Genovese ◽

V Alessi ◽

A Facciolà

Keyword(s):

Risk Factors ◽

Young Adults ◽

Health Education ◽

Pregnant Women ◽

Educational Level ◽

Demographic Characteristics ◽

Alcoholic Beverages ◽

High Educational Level ◽

Significant Difference ◽

High Educational

Abstract Background Many investigations have shown the important role played by risk factors such as tobacco and alcohol in the development of congenital anomalies. Methods Through the administration of an hoc questionnaire, we evaluated the attitude towards smoking and alcohol of a sample of 200 pregnant women at the University Hospital of Messina. The questionnaire was structured to collect information about socio-demographic characteristics, type of gynaecological assistance and their lifestyles (smoking and alcohol). Statistical analysis was performed using version 10 of StatSoftVR software. Results 14% of the women continued to smoke despite pregnancy; the majority of these were young adults, divorced, employed and with a high educational level. Correlating the smoking habit with the socio-demographic characteristics of the studied women, we found a statistically significant difference for the marital status, with a higher number of smokers among the single women (p < 0.05).Moreover, we found a statistically significant difference also for the profession with a higher number of smokers in the worker women (p < 0.05). About the drinking habit, the 4.3% declared to be moderate drinkers (occasional use of alcohol equal to 2-3 glasses a week) despite pregnancy, the 34.4% stated they do not drink alcohol during pregnancy and the 56% stated do not usually drink alcohol. Particularly, about the drinkers' socio-demographic characteristics, the 50% of them were 24-25 years old and the 75% were married. About the type of alcoholic beverages consumed, 86% stated they usually drink bier during the weekend. Conclusions Our study shows that the awareness of the women about the importance of these risk factors is still rather poor. In order to improve the awareness of pregnant women on the importance of avoiding these risk factors and prevent CAs, health education campaigns at various levels surely represent the public health cornerstone. Key messages In our sample 14% of the pregnant women continued to smoke and 4.3% to drink despite pregnancy and they generally were young or young adults and with a high educational level. Our results highlight the importance of continuous health education about the risk to smoke and drink during pregnancy.

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The Relationship Between Blood Pressure Variability And Renal Progression In Hypertensive Patients With Chronic Kidney Disease

Gevher Nesibe Journal, IESDR ◽

10.46648/gnj.270 ◽

2021 ◽

Vol 6 (14) ◽

pp. 80-88

Author(s):

Huseyin Duru ◽

Ekrem KARA

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Blood Pressure Measurement ◽

Rapid Progression ◽

Night Time ◽

Hypertensive Patients ◽

Significant Difference ◽

Renal Progression

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.

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Pengaruh Medication Therapy Management (MTM) terhadap Outcome Klinik dan Kualitas Hidup Pasien Hipertensi di Puskesmas Kota Yogyakarta

JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) ◽

10.22146/jmpf.58113 ◽

2021 ◽

Vol 10 (4) ◽

Author(s):

Tiara Dewi Salindri Pratama ◽

Nanang Munif Yasin ◽

Susi Ari Kristina

Keyword(s):

Quality Of Life ◽

Blood Pressure ◽

Clinical Outcomes ◽

Medication Therapy Management ◽

Wilcoxon Test ◽

P Value ◽

Hypertensive Patients ◽

Therapy Management ◽

Medication Therapy

Medication therapy management (MTM), is a service model aimed at helping general health problems by preventing morbidity and mortality. Hypertension is a non-communicable disease which is a serious health problem which requires long-term therapy. This study aims to see the effect of MTM on clinical Outcomes and quality of life of patients in hypertensive patients. This type of research is a quasi experimental one group with a pretest-posttest design. Analysis using paired sample t-test and Wilcoxon test with a significance used P <0,05. Respondents were 70 people, 67,1% were women. The characteristics of the majority age are 55-64 years with a percentage of 51,4%, the majority of education level is high school with 42,8%, non-civil servant jobs with a percentage of 45,7%, the length of diagnosis is dominated by 1-10 years (77,1%) and comorbidities diabetes mellitus occurred the most (10,0%). The results showed that the quality of life increased from before getting MTM 54,4 ± 8,9 and after MTM intervention 60,4 ± 6,6 (P value <0,001). Clinical outcome from systolic 159,2 ± 8,9 mmHg and diastolic 103,8 ± 8,0 mmHg before MTM to 144,1 ± 14,4 mmHg for systolic and 89,7 ± 8,8 mmHg for diastolic with p value <0,001 (p <0,05) for systolic blood pressure and p value: 0,016 (p <0,05) after receiving MTM intervention. Medication Therapy Management (MTM) has a significant influence on improving the quality of life and clinical Outcomes of hypertensive patients. The higher the quality of life of patients, blood pressure becomes more controlled.

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Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽

10.35790/ecl.v7i2.26283 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

Cerelia E. C. Sugeng ◽

Emma Sy. Moeis ◽

Glady I. Rambert

Keyword(s):

Blood Pressure ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Blood Pressure Monitoring ◽

Office Blood Pressure ◽

Generalized Anxiety ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

Significant Difference ◽

The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

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Abstract 18144: Mobile Phone Text Messaging Improves Antihypertensive Drug Adherence in the Community

Circulation ◽

10.1161/circ.130.suppl_2.18144 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Paola Varleta ◽

Carlos Akel ◽

Monica Acevedo ◽

Claudia Salinas ◽

Javier Pino ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Mobile Phone ◽

Antihypertensive Drug ◽

Educational Level ◽

Text Messaging ◽

Health Concern ◽

Drug Adherence ◽

Hypertensive Patients

Introduction: Hypertension is a major public health concern and the leading cause of cardiovascular disease worldwide. Prevalence of adequate blood pressure control is low and it is mainly associated to poor antihypertensive drug adherence. We hypothesized that education through mobile phone text messaging (SMS) would improve antihypertensive drug adherence in hypertensive patients followed in a primary care setting. Methods: Recently diagnosed hypertensive patients receiving antihypertensive drug treatment for less than 6 months were randomised to receive SMS related to improve drug adherence and to follow a healthy life style or no messages. Exclusion criteria were history of stroke, heart failure, myocardial infarction and hemodialysis. Patients were recruited from 12 different primary care clinics in Santiago, Chile, where free antihypertensive drug therapy was provided. All patients signed an informed consent after which a survey was performed. Compliance was assessed using Morinsky- Green-Levine Questionnaire.Text messages were sent every 12± 2 days. After a 6-month follow-up, a new survey was applied. An Ordinary Least Squares regression model was used to analyse the net difference between the two groups. Results: A total of 314 subjects were recruited, mean age 60 ±10 years, 35% male, 67% with low or medium educational level (≤12 years). Mean drug pill number was 2.1 per day and the mean time of drug prescription was 4±1 months; 150 subjects were randomised to text messages. No statistical difference between the control and the intervention groups in regards to gender, age, educational level, blood pressure and baseline compliance was found. Eleven patients were lost of follow-up. Adherence in the control group decreased from to 59,7 % at baseline to 51,7% ( p<0,05) at 6 months. By contrast, in the intervention group, it increased from 50,9 % to 62,7 % ( p<0,05). The absolute difference in mean adherence rate between the two groups was 19,8 % (Standard error: 0.081, p: 0.015). Conclusion: This study shows that education through SMS in patients with recently prescribed antihypertensive drugs improved adherence to treatment. SMS could become a good and easy- to- use intervention tool to overcome low adherence to drug treatments in the community.

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Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

10.21203/rs.3.rs-283642/v1 ◽

2021 ◽

Author(s):

Emrah Ersoy ◽

Cuneyt Ardic

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Control Group ◽

Poor Sleep ◽

Study Group ◽

Confounding Factors ◽

Cross Sectional ◽

Hypertensive Patients ◽

Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

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The Influence of Physical Activity on Arterial Pressure during Ambulatory Recordings in Man

Clinical Science ◽

10.1042/cs0580115 ◽

1980 ◽

Vol 58 (1) ◽

pp. 115-117 ◽

Cited By ~ 45

Author(s):

D. B. Rowlands ◽

T. J. Stallard ◽

R. D. S. Watson ◽

W. A. Littler

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Heart Rate ◽

Arterial Pressure ◽

Ambulatory Blood Pressure ◽

Physical Activities ◽

Hypertensive Patients ◽

Arterial Blood ◽

Significant Difference ◽

Hypotensive Therapy

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.

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