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84
CHAPTER IV
DATA ANALYSIS AND INTERPRETATION
This chapter deals with the analysis and interpretation of the collected data to
assess the effect of biofeedback assisted relaxation among patients with hypertension.
The responses are tabulated and analysed under the following headings
Section I:
a) Distribution of background variables of patients with stage I hypertension in the
study and control groups (Tables 6 & 7)
b) Distribution of background variables of patients with stage II hypertension in
the study and control groups (Tables 31 & 32)
Section II:
a) Comparison of effect of BART on blood pressure and anxiety within and
between the groups among patients with stage I hypertension (Tables 8-28)
b) Comparison of effect of BART on blood pressure and anxiety within the groups
and between the groups among patients with stage II hypertension
(Tables 33-53)
Section III:
a) Relationship between blood pressure, anxiety and outcome of BART among
patients with stage I hypertension in the study and control groups
(Tables 29 & 30)
b) Relationship between blood pressure, anxiety and outcome of BART
among patients with stage II hypertension in the study and control groups (
(Tables 54 & 55)
85
Section IV: Comparison of effect of BART on blood pressure and anxiety between
patients with stage I & stage II hypertension (Table 56)
SECTION I
a) Distribution of background variables of patients with stage I hypertension in the
study and control groups
Table 6
Frequency, percentage and chi square distribution of background variables
among patients with stage I hypertension in the study and control groups (N=346).
Background Variables
Study Group
(n=173)
Control Group
(n=173)
χ2 & p
value No. % No. %
Age ( in years)
(a) 36-45
(b) 46-55
(c) 56-65
(d) 66-75
17
19
54
83
10.0
10.7
31.3
48.0
31
17
45
80
17.9
09.9
25.8
46.4
4.23
0.238
NS
Gender
(a) Male
(b) Female
86
87
49.8
50.2
86
87
49.8
50.2
.01
.957NS
Residence
(a) Rural
(b) Sub urban
(c) Urban
43
60
70
24.6
34.6
40.6
36
59
79
20.6
33.8
45.8
1.03
0.598
NS
Educational Status
(a) No formal education
(b) Primary
(c) High school
(d) Higher secondary
(e) Collegiate
11
31
54
13
64
06.2
18.4
31.2
07.6
36.6
09
39
47
31
47
05.4
22.6
27.2
18.0
27.2
8.47
0.076
NS
86
Table 6 Contd...
Frequency, percentage and chi square distribution of background variables
among patients with stage I hypertension in the study and control groups (N=346).
Background Variables
Study Group
(n=173)
Control Group
(n=173)
χ2 & p
value No. % No. %
Family Income (Rs/ Month)
(a) < 5,000
(b) 5,001 – 10,000
(c) 10,001- 15,000
(d) 15,001- 20,000
(e) > 20,000
11
13
05
135
09
6.0
7.4
2.6
78.4
5.4
04
04
02
146
17
2.0
2.0
0.1
85.4
10.0
11.99
0.017
NS
Type of Family
(a) Joint
(b) Nuclear
98
75
56.4
43.3
91
82
52.4
47.6
0.57
0.449
NS
Social Support
(a) Spouse
(b) Children
(c) Friends
(d) None
160
04
02
07
93.3
2.0
.06
4.0
168
0
0
5
97.6
-
-
02.6
4.57
0.206
NS
NS- Not Significant
Table 6 shows the distribution of demographic variables among patients with
hypertension in the study and control groups. Majority, 83 (48%) of the study group
and 80 (46.4 %) of the control group belonged to the age group of 66-75 yrs. The
residential area of 70 (40.6 %) patients of the study group and 79(45.8 %) of the control
group was urban. Collegiate education was obtained by 64 (36.6%) patients of the
study group and 47 (27.2 %) of the control group.
The family type of 98 (46.4%) patients of the study group and 91 (52.4%) of the
control group was joint. The monthly income of 135 (72.4%) patients of the study
group and 146 (76%) of the control group was in the range of Rs. 15,001- 20,000.
87
Majority of patients, 160 (93%) of the study group and 168 (97.6%) of the control
group received support from their spouse.
The above table depicts that there is no significant difference in the distribution of
background variables between the study and control groups.
Table 7
Frequency, percentage and chi square distribution of clinical variables among
patients with stage I hypertension in the study and control groups (N= 346).
Clinical Variables
Study Group
(n=173)
Control Group
(n=173) χ2 & p
value No. % No. %
Physical activity/Life style (a) Mild
(b) Moderate
(c) Heavy
99
70
04
57.2
40.6
02.0
93
70
10
53.8
40.6
06.0
3.15
0.207
NS
Habits- a. Alcoholism (a) Yes
(b) No
40
133
23.2
76.4
25
148
14.6
85.4
3.77
0.052 NS
b. Current smoking status
(including passive) (a) Yes
(b) No
29
144
16.6
83.4
28
145
16.0
84.0
0.03
0.877
NS
Dietary pattern (a) Vegetarian
(b) Mixed diet
24
149
14.0
86.0
23
150
13.2
86.8
0.04
0.868
NS
Menopause (of women) a) Attained
b) Not Attained
38
48
43.8
56.2
42
41
49.3
50.6
0.76
0.383 NS
Duration of hypertension (a) <1 year
(b) 1-5 years
(c) 5-10 years
(d) >10 years
11
64
49
49
06.6
37.2
28.0
28,0
23
68
42
40
13.2
39.0
24.6
23.2
4.36
0.225
NS
88
Table 7 Contd...
Frequency, percentage and chi square distribution of clinical variables among
patients with stage I hypertension in the study and control groups (N= 346).
Clinical Variables
Study Group
(n=173)
Control Group
(n=173) χ2 & p
value No. % No. %
BMI (kg/m²)
(a) <18
(b) 18-22.99
(c) 23-30
(d) >30
06
47
102
18
03.4
28.0
59.8
10.6
05
36
101
31
02.6
21.2
58.4
18.0
4.28
0.233
NS
FBS (mg/ dl)
a) <100
b) 101-130
c) >130
61
66
46
35.3
38.0
26.7
64
40
69
37.1
23.2
39.7
1.13
1.001
NS
Hypercholesterolemia
a) Yes
b) No
51
122
29.3
70.6
60
113
34.4
65.5
0.90
1.00 NS
Antihypertensive medications
a) 1( Diuretics)
b) 1+ 2
c) 1+ 3
d) 1+ 4
e) 2 ( ACEI)
f) 2+3
g) 2+4
h) 3 (ARB)
i) 4+3
j) 4 (CCB)
k) 1+2+3
l) 2+1+4
55
22
14
03
50
03
01
06
02
14
02
0
32.0
12.7
08.0
02.0
28.7
02.0
0.70
03.3
01.3
08.0
01.3
-
52
23
11
06
50
05
02
05
07
14
01
0
29.8
13.2
6.6
3.3
28.7
2.6
1.3
2.6
4.0
7.3
0.7
-
3.77
0.953
NS
NS- Not Significant
Table 7 shows that majority, 97 (57.2%) of the study group and 93 (53.8 %) of
the control group were engaged in mild physical activity only. Alcoholism was
prevailing among 40 (23.2 %) patients of the study group and 25 (14.6 %) of the
89
control group. Study group had 29 (16.6%) members with the habit of smoking and in
the control group 28 (16%) were smokers. Majority, 149 (86%) of the study group and
150 (86.4%) of the control group were consuming mixed diet. Menopause was attained
by 38 (43.8 %) women in the study group and 42 (49.3%) in the control group.
A majority 64 (37.2%) of the study group and 68 (69.6%) of the control group
were having hypertension for a duration of 1-5 yrs. BMI range 23-30 kg/m2 was
maintained by 102 (57.8%) patients of the study group and 101 (58.4 %) of the control
group.
Majority of members, 66 (38%) of the study group maintained a fasting blood
sugar range of 101-130 mg/dl, while in the control group, majority, 69 (39.7%)
patients’ FBS was maintained below 100 mg/dl. A maximum of 122 (75 %) patients of
the study group and 113 (70%) of the control group were having elevated cholesterol
levels.
A majority, 55 (32%) patients of the study group and 52 (29.8 %) of the control
group were taking diuretics as antihypertensive. The above table depicts that there is no
significant difference in the distribution of clinical variables among the study and
control groups.
90
Section II: Comparison of effect of BART on blood pressure and anxiety within
and between the groups among patients with stage I hypertension
Table 8
Comparison of level of systolic BP among patients with stage I hypertension
between the study and control groups before and after intervention.
Duration
Systolic
BP in
mm of Hg
Study Group
Control Group χ2 and p
value No. % No. %
Pretesta,b
<120 0 - 0 -
0.36
0.549 NS
120-139 41 27.3 46 30.5
140-159 109 72.7 105 69.5
>159 0 - - -
Posttest Ic,d
<120 04 2.7 0 -
10.37 0.006**
120-139 64 42.7 45 29.8
140-159 82 54.7 106 70.2
>159 0 - 0 -
Posttest IIe,f
< 120 06 4.0 0 -
23.40 0.001***
120-139 78 52.0 47 31.1
140-159 66 44 102 67.5
>159 0 - 2 1.3
Posttest IIIg,h
< 120 05 3.3 0 -
29.32 0.001 ***
120-139 87 58.0 49 32.5
140-159 58 38.7 99 65.6
>159 0 - 03 2.0
NS- Not Significant ** p< 0.01 *** p<0.001 a n=173, c n=162, e n=156, g n=150
for the study group b n=173, d n=165, f n= 158, h n=151 for the control group
Table 8 represents level of blood pressure among patients between the study
and control groups. During the pretest, 48 (27.3%) of the study group and 53 (30.5 %)
of the control group were having systolic BP of range 120-139 mm of Hg. The number
of patients with systolic BP value of range 140-159 mm of Hg was 125 (72.7%) in the
study group and 120 (69.5%) in the control group. There was no difference between the
91
groups , homogeneity between the groups was maintained and the Chi square value was
0.359 with p value of 0.549.
During posttest I, 5(2.7%) patients of the study group had their systolic BP
lowered to <120 mm Hg. 68 (42.7%) of the study group and 49 (29.8%) of the control
group had BP value of range 120-139 mm of Hg. Number of patients with BP range of
140-159 mm of Hg was lowered to 89 (54.7%) in the study group, but in the control
group, the number was 116 (70.2%). There was a significant difference between the
groups which is exhibited by the chi square value of 10.373 and p value 0.006.
During poststest II, six patients (4%) of the study group had BP <120 mm of
Hg. Of the study group, 79 (52%) patients and of the control group, 49 (31.1 %)
patients had BP value in the range 120-139 mm of Hg. 69 (44 %) of the study group
patients and 107 (67.5%) of the control group patients’ BP value was between 140-159
mm of Hg. Two (1.3%) patients of the control group had their BP raised to >159 mm of
Hg. There was a significant difference between the groups which is exhibited by the chi
square value of 23.399 and p value 0.001.
During poststest III, five (3.3%) patients of the study group had BP <120 mm of
Hg. Out of the study group patients, 87 (58%) and out of the control group, 49 (32.5 %)
had BP value in the range 120-139 mm of Hg. 58 (38.7 %) of the study group patients’
and 99 (67.6%) of the control group patients’ BP value was between 140-159 mm of
Hg. Three (2%) patients of the control group had their BP raised to >159 mm of Hg.
There was a significant difference between the groups which is exhibited by the Chi
square value of 29.322 and p of 0.001.
0
10
20
30
40
50
60
70
80
<120
0
2.74 3.3
Per
cen
tsge
0
10
20
30
40
50
60
70
80
<120
0
30.5
0 0 0
Per
cen
tage
Figure 3: Comparison of level of systolic blood pressure among patients with
stage I hypertension in the study group
Figure 4: Comparison of level of systolic blood pressure among patients with
stage I hypertension in the control group
120-139 140-159 >159
27.3
72.7
0
42.7
54.7
0
52
44
0
58
38.7
0
BP in mm of Hg
120-139 140-159 >159
30.5
69.5
0
29.8
70.2
0
31.1
67.5
1.3
32.5
65.6
2
BP in mm of Hg
Comparison of level of systolic blood pressure among patients with
stage I hypertension in the study group before and after intervention.
Comparison of level of systolic blood pressure among patients with
stage I hypertension in the control group before and after intervention.
92
Pretest
Posttest I
Posttest II
Posttest III
Pretest
Posttest I
Posttest II
Posttest III
Comparison of level of systolic blood pressure among patients with
before and after intervention.
Comparison of level of systolic blood pressure among patients with
before and after intervention.
93
Table 9
Comparison of diastolic BP among patients with stage I hypertension in the study
and control groups before and after intervention.
Duration
Diastolic BP
in mm of
Hg
Study Group Control Group χ2 and p
value No. % No. %
Pretesta,b
<80
10
4.0
01
0.7 4.26
0.119
NS
80-89 51 29.3 60 34.4
90-99 115 66.7 113 65.9
>99 0 - 0 -
Posttest Ic,d
<80 07 4.0 01 0.7
10.16
0.006 **
80-89 76 41.3 59 35.7
90-99 79 48.7 105 63.5
>99 0 - 0 -
Posttest IIe,f
<80 06 4.0 0 -
45.69
0.001***
80-89 109 70.0 58 36.4
90-99 41 26.0 100 63.6
>99 0 - 0 -
Posttest IIIg,h
<80 08 5.3 0 -
73.09
0.0001
***
80-89 115 76.7 52 34.4
90-99 27 18.0 97 64.2
>99 0 - 02 1.2
NS- Not Significant ** p< 0.01 *** p<0.001 a n=173, c n=162, e n=156, g n=150 for
the study group, b n=173, d n=165, f n= 158, h n=151 for the control group
Table 9 represents the level of diastolic blood pressure among patients between
the study and control groups. During the pretest, 10 (4 %) of the study group and one
(0.7 %) of the control group were having diastolic BP of range <80 mm of Hg. 51 (29.3
%) of the study group and 60 (34.4 %) of the control had blood pressure ranging from
80-89 mm of Hg. Majority, 115 (66.7%) of the study group and 113 (65.9%) of the
94
control group maintained BP of range 90-99 mm of Hg. There was no difference
between the groups, homogeneity between the groups was maintained and the Chi
square value was 4.26 with p value of 0.119.
During posttest I, 7 (4%) patients of the study group maintained their diastolic
BP <80 mm of Hg. The number of patients with BP of range 80-89 mm of Hg of the
study group was 67 (41.3%) and of the control group it remained as before. The
number of patients with BP of >99 mm of Hg was 79 (48.7%) in the study group. There
was a significant difference between the groups which is exhibited by the chi square
value of 10.16 with p value of 0.006.
During poststest II, 109 (70%) of the study group patients and 58 (36.4 %) of
the control group patients had BP value in the range 80-89 mm of Hg. The number of
patients with BP value 90-99 mm of Hg was 41 (26 %) in the study group and 100
(63.6 %) in the control group. There was a significant difference between the groups
which is exhibited by the chi square value of 45.69 with p value of 0.001.
During poststest III, eight (5.3%) patients of the study group had BP <80 mm of
Hg. Out of the study group, 115 (76.7%) patients and out of the control group, 52 (34.4
%) patients had BP value in the range 80-89 mm of Hg. Two (1.2%) patients of the
control group had their BP raised to >99 mm of Hg. There was a significant difference
between the groups which is exhibited by the chi square value of 73.09 with p value of
0.001.
0
10
20
30
40
50
60
70
80
<80
4 4 4 5.3
Per
cen
tage
0
10
20
30
40
50
60
70
<80
0.7 0 0 0
Per
cen
tag
e
Figure 5: Comparison of level of diastolic blood pressure among p
stage I hypertension in the study group
Figure 6: Comparison of level of diastolic blood pressure among patients with
stage I hypertension in the control group
80-89 90-99 >99
29.3
66.7
0
41.3
48.7
0
70
26
05.3
76.7
18
0
BP in mm of Hg
80-89 90-99 >99
34.4
65.9
0
35.7
63.5
0
36.4
63.6
00
34.4
64.2
2
BP in mm of Hg
Comparison of level of diastolic blood pressure among p
stage I hypertension in the study group before and after intervention.
Comparison of level of diastolic blood pressure among patients with
stage I hypertension in the control group before and after intervention.
95
Pretest
Posttest I
Posttest II
Posttest III
Pretest
Posttest I
Posttest II
Posttest III
Comparison of level of diastolic blood pressure among patients with
before and after intervention.
Comparison of level of diastolic blood pressure among patients with
before and after intervention.
96
Table 10
Comparison of overall blood pressure among patients with stage I hypertension in
the study and control groups before and after intervention.
Duration
BP grades
Study Group Control Group χ2 and p
value No % No %
Pretesta,b
Pre HT 0 - 0 -
Stage I 173 100 173 100
Stage II 0 - 0 -
Posttest IIIc,d
Pre HT 21 14.0 05 3.3
20.06
0.001*** Stage I 129 86.0 141 93.4
Stage II 0 - 05 3.3
*** p<0.001 a n=173 c n=150 (study group) b n= 173, d n= 151(control group)
Table 10 represents the overall level of blood pressure among patients between
the study and control groups before and after the intervention. During the pretest, all
patients in the study and control group belonged to stage I category with either systolic
BP in the range of 140-159 mm of Hg or diastolic BP in the range 90-99 mm of Hg.
During posttest III, 21(14%) of the study group and 5 (3.3%) of the control moved to
pre- hypertension. In the control group, 5(3.3%) patients moved to stage II
hypertension. There was significant difference between the groups, which was revealed
by the Chi square value was 20.06 with p value of 0.001.
Table 11
Comparison of pretest mean score of blood pressure among patients with stage I
hypertension in the study and control group
Blood
Pressure
Study
(n=1
Mean
Systolic 140.77
Diastolic 88.24
NS- Not Significant
0
10
20
30
40
50
60
70
80
90
100
Pre- HT
0
14
Per
cen
tage
Figure7: Comparison of
hypertension in the study and control groups
Comparison of pretest mean score of blood pressure among patients with stage I
hypertension in the study and control groups (N=346).
Study Group
(n=173)
Control Group
(n=173)
SD Mean SD
140.77 8.31 140.60 9.81 0
88.24 5.42 88.28 4.07 0
Not Significant
HT Stage I Stage II Pre- HT Stage I Stage II
Study group Control group
100
0 0
100
0
86
03.3
93.4
3.3
Stages of BP
p= 0.001
Comparison of overall blood pressure among patients with stage I
hypertension in the study and control groups before and after intervention.
97
Comparison of pretest mean score of blood pressure among patients with stage I
t & p value
0.17, 0.866 NS
0.07, 0.948 NS
Pretest
Posttest I
pressure among patients with stage I
intervention.
98
Table 11 represents the mean level of blood pressure among patients between
the study and the control groups. During the pretest, the mean systolic BP was 140.77
mm of Hg with SD of 8.31 in the study group. In the control group, the mean value was
140.60 and SD was 9.808. The mean diastolic BP was 88.24 with SD of 5.42 in the
study group and 88.28 with SD of 4.067 in the control group. Homogeneity between
the groups was maintained and the Chi square value was 0.169 with p value of 0.866
for systolic BP and 0.066 and 0.948 for diastolic BP.
Table 12
Comparison of posttest (I, II, III) mean score of blood pressure among patients
with stage I hypertension in the study and control groups.
Blood
Pressure
Post
test
Study Group
Control Group
t & p value Mean SD Mean SD
Systolic
Ia,b 139.43 8.20 140.61 9.38
1.161
0.246 NS
IIc,d 138.15 8.09 141.03 9.24
2.882
0.004 **
IIIe,f 136.93 7.96 141.06 9.30
4.134
0.0001 ***
Diastolic
Ia,b 87.67 5.25 88.44 4.40
1.379
0.169 NS
IIc,d 86.79 4.88 88.64 4.80
3.426
0.001 ***
IIIe,f 85.77 4.66 88.70 4.57 5.496
0.0001 ***
NS- Non Significant ** p< 0.01 *** p<0.001 a n=162, c n=156, e n=150 for the
study group, b n=165, d n= 158, f n=151 for the control group
Table 12 reveals that during
SD 8.20 in the study group and 140.61 and 9.38 in the control group. Posttest
reveals that the mean value for systolic BP was 136.93 in the study group and 141.06 in
the control group with SD 7.96 and 9.30
groups indicated by the t value of 4.134 and
Regarding diastolic pressure, posttest I mean score in the study group was
with SD of 5.25. In the
During posttest III, the mean diastolic value of the study group was 85.77with SD 4.66.
The control group mean value was 88.70 and SD was 4.57. The mean values showed
significant difference between the groups indicated by the t value 5.496 at the level of
p< 0.001.
There was a significant difference in the level of systolic and diastolic blood
pressures between the study and control groups during all the posttests.
134
135
136
137
138
139
140
141
142
Pretest
140.77140.6
Mea
n B
P i
n m
m o
f H
g
p=0.866
Figure 8: Comparison of mean
hypertension in the study
Table 12 reveals that during posttest I, the mean systolic BP was 139.43 with
SD 8.20 in the study group and 140.61 and 9.38 in the control group. Posttest
reveals that the mean value for systolic BP was 136.93 in the study group and 141.06 in
the control group with SD 7.96 and 9.30. There was significant difference between the
groups indicated by the t value of 4.134 and p 0.0001 during posttest III.
egarding diastolic pressure, posttest I mean score in the study group was
with SD of 5.25. In the control group, the mean value was 88.44 with SD of 1.379.
During posttest III, the mean diastolic value of the study group was 85.77with SD 4.66.
ntrol group mean value was 88.70 and SD was 4.57. The mean values showed
significant difference between the groups indicated by the t value 5.496 at the level of
s a significant difference in the level of systolic and diastolic blood
sures between the study and control groups during all the posttests.
Posttest I Posttest II Posttest III
139.43
138.15
136.93
140.61141.03 141.06
Study group
Control group
Duration
p=0.0001p=0.004p=.0246
Comparison of mean systolic blood pressure among patients with stage I
hypertension in the study and control groups before and after intervention.
99
posttest I, the mean systolic BP was 139.43 with
SD 8.20 in the study group and 140.61 and 9.38 in the control group. Posttest III
reveals that the mean value for systolic BP was 136.93 in the study group and 141.06 in
There was significant difference between the
during posttest III.
egarding diastolic pressure, posttest I mean score in the study group was 87.67
ue was 88.44 with SD of 1.379.
During posttest III, the mean diastolic value of the study group was 85.77with SD 4.66.
ntrol group mean value was 88.70 and SD was 4.57. The mean values showed
significant difference between the groups indicated by the t value 5.496 at the level of
s a significant difference in the level of systolic and diastolic blood
Study group
Control group
blood pressure among patients with stage I
s before and after intervention.
Table 13
Comparison of mean difference of
hypertension in the study and control groups before and after intervention
Systolic BP
Study
MeanDifference
Pretesta,b-
Posttest Ic,d 1.35
Pretest-
Posttest IIe,f 2.63
Pretest-
Posttest IIIg,h 3.84
*** p<0.001 a n=173,
b n=173,
84
84.5
85
85.5
86
86.5
87
87.5
88
88.5
89
Pretest
88.24M
ean
BP
in
mm
of
Hg
p=0.948
Figure 9: Comparison of mean
I hypertension in the study and
Comparison of mean difference of systolic BP among patients with stage I
in the study and control groups before and after intervention
Study Group
Control Group
t & p valueMean Difference
SD Mean
difference SD
1.35 1.05 -0.01 1.51 0.000
2.63 1.31 -0.44 2.01 0.000
3.84 1.53 -0.46 2.43 0.000
=173, c n=162, e n=156, g n=150 for the study group
=173, d n=165, f n= 158, h n=151 for the control group
Pretest Posttest I Posttest II Posttest III
87.67
86.79
85.77
88.28 88.4488.64 88.7
Duration
p=0.0001p=0.001p=0.0169p=0.948
Comparison of mean diastolic blood pressure among patients with stage
study and control groups before and after intervention.
100
BP among patients with stage I
in the study and control groups before and after intervention.
t & p value
9.015
.0001 ***
15.63
.0001 ***
18.39
.0001 ***
for the study group
for the control group
Study group
Control group
blood pressure among patients with stage
s before and after intervention.
101
Table 13 depicts that from pretest to posttest I, the mean difference was 1.35
with SD of 1.05 in the study group and -0.01 and 1.51 in the control group. The mean
difference during the pretest to posttest II was 2.63 with SD of 1.31 in the study group
and -0.44 with 2.01 in the control group. The mean difference from the pretest to
posttest III was 3.84 with SD of 1.53 in the study group and -0.46 with 2.43 in the
control group. There was a highly significant difference in the MD during all the
intervals between the study and control groups at a level p< 0.001.
Table 14
Comparison of mean difference of diastolic blood pressure among patients with
stage I hypertension in the study and control groups before and after intervention.
Diastolic BP
Study Group
Control Group
t &
p value Mean
Difference SD
Mean
Difference SD
Pretesta,b-
Posttest Ic,d 0.57 0.97 -0.16 1.12 6.08
0.0001 ***
Pretest-
Posttest IIe,f 1.45 1.16 -0.36 1.63
11.09
0.0001 ***
Pretest-
Posttest IIIg,h 2.47 1.63 -0.42 1.94
13.99
0.0001 ***
*** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Table 14 depicts that from pretest to posttest I, the mean difference was 0.57
with SD of 0.97 in the study group and -0.16 with 1.12 in the control group for DBP.
The mean difference fromthe pretest to posttest II was 1.45 with SD of 1.16 in the
study group and -0.36 with 1.63 in the control group. The mean difference from the
pretest to posttest III was 2.47 with SD of 1.63 in the study group and -0.42 with 1.94
in the control group. There is a highly significant difference in the MD during all the
intervals between the study and control
Table 15
Repeated measures ANOVA of systolic BP among patients with stage I
hypertension between the study and the control groups
intervention.
Duration Study
Pretesta,b 140.77
Posttest Ic,d 139.43
Posttest IIe,f 138.15
Posttest IIIg,h 136.93
*** p <0.001 ** p< 0.01
-0.5
0
0.5
1
1.5
2
2.5
3
3.5
4
Pretest - Posttest
I
Systolic BP
1.35
-0.01
Mea
n d
iffe
ren
ce
p=0.0001
p=0.0001
Figure 10: Comparison of mean difference of BP among patients with stage I
hypertension in the study and control groups
the control group. There is a highly significant difference in the MD during all the
the study and control groups at a level p <0.001.
Repeated measures ANOVA of systolic BP among patients with stage I
hypertension between the study and the control groups before and after
Study Group F &
p value Control Group
140.77 469.08
0.0001
***
140.59
139.43 140.61
138.15 141.03
136.93 141.06
** p< 0.01 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Pretest - Posttest
II
Pretest - Posttest
III
Pretest - Posttest
I
Pretest - Posttest
II
Pretest - Posttest
III
Systolic BP Diastolic BP
2.63
3.84
0.57
1.45
2.47
0.01 -0.44 -0.46 -0.16 -0.36 -0.42
p=0.0001p=0.0001
p=0.0001
p=0.0001
p=0.0001 p=0.0001
Comparison of mean difference of BP among patients with stage I
hypertension in the study and control groups before and after intervention
102
the control group. There is a highly significant difference in the MD during all the
Repeated measures ANOVA of systolic BP among patients with stage I
before and after
F &
p value
6.20
0.003**
n=150 for the study group
for the control group
0.42
Study Group
Control Group
Comparison of mean difference of BP among patients with stage I
before and after intervention.
103
The table reveals the RM ANOVA of systolic BP among patients with stage I
hypertension. During pretest, the mean score was 140.77 and posttest I mean score was
139.43. During posttest II, the mean score was 138.15 and during posttest III, it was
136.93. So there was a highly significant reduction in the level of systolic BP from
pretest to posttests I, II and III with p value of 0.0001 in the study group, whereas in the
control group, it was significant raise from pretest to posttest I, II and III with an F
value of 6.20 with p value 0.003.
Table 16
Repeated measures ANOVA of diastolic BP among patients with stage I
hypertension between the study and the control groups before and after
intervention.
Duration Study Group
F &
p value
Control Group
F &
p value
Pretesta,b 88.24
208.21
0.000 ***
88.28
4.70
0.008 **
Posttest Ic,d 87.67 88.44
Posttest IIe,f 86.79 88.64
Posttest IIIg,h 85.77 88.70
*** p<0.001 ** p< 0.01 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Table 16 reveals the RMANOVA of diastolic BP among patients with stage I
hypertension. During pretest, the mean was 88.24 and posttest I mean score was 87.67.
During posttest II, the mean was 86.79 and during posttest III, it was 85.77. So there
was a highly significant reduction in the level of diastolic BP from pretest to posttests I,
II and III with F value of 208.21 and p value 0.000 in the study group. In the control
group, it was significant raise from pretest to posttests I, II and III which was indicated
by F value of 4.70 and p value 0.008.
104
Table 17
Comparison of effect of various antihypertensive medications on systolic BP
among the patients with stage I hypertension between study and control groups
before and after intervention.
Anti hypertensive medications
Duration
Study Group Control Group t & p value
Mean SD Mean SD
Diuretics
Pretesta,b
Posttest IIc,d
140.73
136.95
8.30
7.58
137.37
138.11
9.88
9.04
1.64, 0.105 NS
-0.62, 0.537 NS
ACE I
Preteste,f
Posttest IIIg,h
139.84
136.00
8.07
7.67
140.61
141.56
9.18
9.09
-0.38, 0.703, NS
-2.85, 0.006 **
Diuretics+
ACEI
Pretesti,j
Posttest IIIk,l
137.56
133.85
8.10
7.29
143.33
142.89
8.00
7.98
-2.36, 0.023 *
-3.92, 0.000 ***
CCB
Pretestm,n
Posttest IIIo,p
138.17
133.83
7.51
8.16
145.05
145.47
13.44
12.13
-1.67, 0.117 NS
-2.93, 0.007 **
NS- Not Significant *p<0.05 ** p< 0.01 *** p<0.001 an=55 cn=44 en=22 gn=18
in=50 kn=44 mn=14 on=12 (SG) bn=52 dn=35 fn=23 hn=18 jn=50 ln=35 nn=14 pn=8(CG)
The table 17 depicts that when the mean value of systolic BP for diuretics is
compared between the study and control groups, there is no significant difference
observed both during pretest and posttest III. The hypertensive patients on ACEI
showed a significant difference between the study and the control groups during
posttest III with t value of -2.85 and p value 0.006. The combination of Diuretics &
ACEI showed significant difference during both pre and posttests with t values of
-2.36 and -3.92. This was significant with p value of 0.023 and 0.0001 respectively.
CCBs also produced a significant difference between the study and control groups
during posttest III with t values of -2.93 and p value of 0.007 respectively.
Table 18
Comparison of effect of various antihypertensive medications
the patients with stage I hypertension between study and control group
after intervention.
Anti
hypertensive
medications
Duration
Diuretics
Pretesta,b
Posttest III
ACE I
Preteste,f
Posttest III
120
125
130
135
140
145
150
Pre
test
Po
stte
st II
I
Diuretics
140.73
136.95
137.37 138.11
BP
in m
mof
Hg
p=0.105
p=0.537
Figure 11: Comparison of effect of
BP among the patients with stage I hyperten
various antihypertensive medications on diastolic BP
the patients with stage I hypertension between study and control group
Duration
Study group Control group
Mean SD Mean SD
Posttest IIIc,d
88.27
85.95
4.85
4.03
89.31
89.20
4.06
3.64
-1.02
-3.71
Posttest IIIg,h
87.37
85.05
6.03
5.05
87.44
88.17
6.10
5.06
-0
-
Pre
test
Po
stte
st II
I
Pre
test
Po
stte
st II
I
Pre
test
Po
stte
st II
I
ACEI Diuretics+ ACEI CCB
136.95 139.84 136137.56
133.85
138.17
133.83
138.11140.61 141.56
143.33 142.89145.05 145.47p=0.537
p=0.703p=0.006
p=0.023
p=0.005p=0.117 p=0.007
: Comparison of effect of various antihypertensive medications on systolic
BP among the patients with stage I hypertension between study and control
105
diastolic BP among
the patients with stage I hypertension between study and control groups before and
t & p value
1.02, 0.312 NS
3.71, 0.0001 ***
0.05, 0.957 NS
-2.52, 0.014 *
145.47
Study Group
Control Group
p=0.007
various antihypertensive medications on systolic
sion between study and control groups
106
Table 18 Contd..
Comparison of effect of various antihypertensive medications on diastolic BP
among the patients with stage I hypertension between study and control groups
before and after intervention.
Anti
hypertensive
medications
Duration
Study group Control group
t & p value Mean SD Mean SD
Diuretics+
ACEI
Pretesti,j
Posttest IIIk,l
88.59
85.93
4.89
4.45
87.89
89.56
6.15
6.64
0.43, 0.672 NS
-2.20, 0.033 *
CCB
Pretestm,n
PosttestIIIo,p
86.33
84.17
8.69
7.41
89.58
90.11
3.24
3.49
-1.49, 0.148 NS
-3.02, 0.005 **
NS- Not Significant *p <0.05 ** p < 0.01 *** p <0.001 an=55 cn=44 en=22 gn=18
in=50 kn=44 mn=14 on=12(SG), bn=52 dn=35 fn=23 hn=18 jn=50 ln=35 nn=14 pn=8(CG)
Table 18 depicts that when the mean value of DBP for diuretics was compared
between the study and control groups, there was a significant difference observed
among patients during poststest III with t value -3.71 at p <0.001. The ACEI, CCBs and
the combination of diuretics + ACEI also produced a significant difference between the
study and control groups during posttest III with t values of -2.52 (p<0.05), -3.02
(p<0.05) and 2.20 (p<0.01) respectively.
Table 19
Comparison of frequency and percentage distribution and chi square value of
reduction of antihypertensive
hypertension in the study and control groups
Number of dose
reductions of
antihypertensive
medications
No
19
** p < 0.01
Table 19 depicts that there were 19 dose reductions reported
group patients during posttest III
reductions reported. Difference in the number of dose reductions of anti hypertensive
medications between the study and control group patients
with Chi square value of 7.47.
70
75
80
85
90
95
Pre
test
Po
stte
st II
I
Diuretics
88.27 85.95
89.31 89.2B
P in
mm
of
Hg
p=0.0001
p=0.312
Figure 12: Comparison of effect of
among the patients with stage I hypertension between study and control groups
Comparison of frequency and percentage distribution and chi square value of
antihypertensive medications among patients with stage I
hypertension in the study and control groups during posttest III (N=301)
Study Group
(n= 150)
Control Group
(n= 151)
No. % No. %
19
12.7
06
4.0
depicts that there were 19 dose reductions reported among
during posttest III while among the control group, there were
Difference in the number of dose reductions of anti hypertensive
medications between the study and control group patients was significant a
with Chi square value of 7.47.
Po
stte
st II
I
Pre
test
Po
stte
st II
I
Pre
test
Po
stte
st II
I
Pre
test
Po
stte
st II
I
ACEI Diuretics+ ACEI CCB
85.95 87.3785.05
88.59
85.93 86.3384.17
89.287.44 88.17 87.89
89.56 89.58 90.11
p=0.148
p=0.033
p=0.672
p=0.014p=0.957
p=0.0001p=0.005
: Comparison of effect of antihypertensive medications on diastolic
among the patients with stage I hypertension between study and control groups
107
Comparison of frequency and percentage distribution and chi square value of dose
among patients with stage I
(N=301).
χ2 and p
value
7.47
0.005 **
among the study
while among the control group, there were six dose
Difference in the number of dose reductions of anti hypertensive
s significant at p < 0.05
90.11
Study Group
Control Group
p=0.005
on diastolic BP
among the patients with stage I hypertension between study and control groups
Table 20
Comparison of level of state
the study and control group
Duration State
Anxiety
Pretesta,b
Mild ModerateSevere
Posttest Ic,d
Mild ModerateSevere
Posttest IIe,f
Mild ModerateSevere
Posttest IIIg,h Mild ModerateSevere
NS- Not Significant *** p<0.001
group b n=173, d n=165,
0
5
10
15
20
No.
of d
ose
red
uct
ion
s
Figure 13: Comparison
among the patients with stage I hypertension between study and control groups
(N=301).
Comparison of level of state anxiety among patients with stage I hypertension in
the study and control groups before and after intervention.
State Anxiety
Study group
Control group
No % No % 30 17.3 25 16.6
Moderate 113 65.4 112 74.1Severe 30 17.3 14 9.3
30 18.6 24 15.9Moderate 108 66.6 104 68.8Severe 24 14.6 23 15.2
33 21.3 22 14.6Moderate 99 64.0 99 65.6Severe 24 12.6 30 19.8
35 23.4 22 14.6Moderate 110 73.3 97 64.2Severe 05 3.3 31 20.6
*** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study
=165, f n= 158, h n=151 for the control group
Study Group Control Group
19
6
p=0.005
: Comparison of antihypertensive dose reductions during
among the patients with stage I hypertension between study and control groups
108
anxiety among patients with stage I hypertension in
χ2 and p value
6 4.55
0.103 NS 1 3
9 .41 0.817 NS 8
5.2
6 5.45 0.065 NS 6
19.8
6 0.07 0.0001
*** 2
20.6 for the study
during posttest III
among the patients with stage I hypertension between study and control groups
109
Table 20 represents level of state anxiety among patients between the study and
control groups. During the pretest, 30 (17.2 %) of the study group and 29 (16.6 %) of
the control group were having mild state anxiety. Moderate anxiety was found in 113
(65. 4%) patients of the study group and 128 (74.4%) of the control group. Severe
anxiety was found in 30 (17.2 %) patients of the study group and 16 (9.4 %) of the
control group. There was no difference between the groups, homogeneity between the
groups was maintained and the Chi square value was 4.55 with p value of 0.103.
During posttest I, 30 (18.6 %) of the study group and 26 (16.0%) of the control
group were having mild state anxiety. Moderate anxiety level was found in 108 (66.4
%) patients of the study group and 114 (69.2 %) of the control group. The number of
patients with severe anxiety was 24 (14.6%) in the study group and 25 (15.2 %) in the
control group. There was no significant difference between the groups which is
exhibited by the chi square value of 0.41 with p value 0.817.
During poststest II, 33 (21.3%), 99 (64%) and 24 (14.6%) patients of the study
group belonged to the mild, moderate and severe category while in the control group,
the proportions were 23 (14.6%), 104 (65.6%) and 31 (19.8 %).There was no
significant difference between the groups which is exhibited by the chi square value of
5.45 with p value of 0.065.
During poststest III, 35 (23.2%), 110 (73%) and 5 (3.4%) patients of the study
group belonged to the mild, moderate and severe category respectively, while in the
control group, the proportions were 22 (14.6%), 97 (64.4%) and 62 (20.6%). There was
a significant difference between the groups which is exhibited by the chi square value
of 12.07 with p value 0.0001.
0
10
20
30
40
50
60
70
80
Pretest
17.3
65.4
17.3
Per
cen
tage
0
10
20
30
40
50
60
70
80
Pretest
16.6
74.1
Per
cen
tage
Figure 14: Comparison of level of state anxiety among patients with stage I
hypertension in the study group
Figure 15: Comparison of level of state anxiety among patients with stage I
hypertension in the control group
Pretest Posttest I Posttest II Posttest III
18.6 21.3 23.4
65.4 66.6 6473.3
17.3 14.6 12.6
3.3
Duration
Pretest Posttest I Posttest II Posttest III
16 14.6 14.6
74.168.8
65.6 64.2
9.315.2
19.8 20.6
Duration
Comparison of level of state anxiety among patients with stage I
hypertension in the study group before and after intervention.
Comparison of level of state anxiety among patients with stage I
hypertension in the control group before and after intervention.
110
Mild
Moderate
Severe
Mild
Moderate
Severe
Comparison of level of state anxiety among patients with stage I
before and after intervention.
Comparison of level of state anxiety among patients with stage I
before and after intervention.
111
Table 21
Comparison of level of trait anxiety among patients with stage I hypertension in
the study and control groups before and after intervention.
Duration Trait
Anxiety
Study group Control group χ2 and p
value No. % No. %
Pretesta,b
Mild 19 11.2 28 16.0 2.25
0.325 NS Moderate 126 72.4 112 65.0 Severe 28 16.4 33 19.0
Posttest Ic,d
Mild 22 13.4 18 11.0 26.95
0.0001
***
Moderate 135 83.2 107 65.0 Severe 05 3.4 40 24.0
Posttest IIe,f
Mild 27 17.2 12 7.4 32.70
0.0001
***
Moderate 124 79.4 106 67.6 Severe 05 3.4 40 25.0
Posttest IIIg,h
Mild 49 32.6 8 5.4 71.49
0.0001
***
Moderate 101 67.4 101 67.2
Severe 0 - 42 27.4
NS- Not Significant *** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study
group b n=173, d n=165, f n= 158, h n=151 for the control group
Table 21 represents level of trait anxiety among patients between the study and
control groups. During the pretest, 19 (11.2 %) of the study group and 28 (16 %) of the
control group were having mild trait anxiety. 126 (72.4 %) of the study group and 112
(65.2 %) of the control had trait anxiety of moderate levels. The severe anxiety
proportions were 28 (16 %) and 29 (19.2%) in the study and the control group.
Homogeneity between the groups was maintained and the Chi square value was 2.25
with p value of 0.325.
During posttest I, 22 (13.4%) of the study group and 18 (11 %) of the control
group were having mild trait anxiety. 135 (83.2 %) of the study group and 107 (65 %)
of the control group had trait anxiety of moderate levels. 5 (3.4 %) patients of the study
group and 40 (24 %) of the control group had severe trait anxiety. There was a
significant difference between the groups
value of 0.0001.
During poststest II, 2
of patients with mild, moderate and severe
group, the proportions were 1
significant difference between the groups which
of 32.70 with p value of 0
During poststest III, 49(32.6%) and 101(67.2%) patients were with mild and
moderate anxiety in the study group,
8(5.4%), 101(67.2%) and 42
significant difference between the groups which is exhibited by the chi square value of
71.49 with p value 0.0001
0
10
20
30
40
50
60
70
80
90
Pretest
11.2
72.4
16.4
Per
cen
tage
Figure 16: Comparison of level of
hypertension in the study group
ference between the groups, with Chi square value was 26.95 with p
poststest II, 27 (17. 2%), 124 (79%) and 5 (3.4%) were the p
mild, moderate and severe anxiety in the study group. In the control
group, the proportions were 12(7.4%), 106 (67.8%) and 40 (25.2%). There was a
significant difference between the groups which was exhibited by the chi square value
0.0001.
poststest III, 49(32.6%) and 101(67.2%) patients were with mild and
in the study group, while in the control group, the proportions were
8(5.4%), 101(67.2%) and 42 (28 %) for mild, moderate and severe anxiety.
significant difference between the groups which is exhibited by the chi square value of
01.
Posttest I Posttest II Posttest III
13.417.2
32.6
83.279.4
67.4
3.4 3.40
Duration
Comparison of level of trait anxiety among patients with stage I
hypertension in the study group before and after intervention.
112
Chi square value was 26.95 with p
(79%) and 5 (3.4%) were the proportions
anxiety in the study group. In the control
(25.2%). There was a
exhibited by the chi square value
poststest III, 49(32.6%) and 101(67.2%) patients were with mild and
while in the control group, the proportions were
for mild, moderate and severe anxiety. There was a
significant difference between the groups which is exhibited by the chi square value of
Mild
Moderate
Severe
anxiety among patients with stage I
before and after intervention.
Table 22
Comparison of pretest mean score of anxiety among patients with stage I
hypertension in the study and control groups
(N= 346).
Anxiety
Study Group (n=1
Mean
State 51.49
Trait 48.76
NS- Not Significant
Table 22 represents the mean anxiety score among patients between the study
and control groups. During the pretest
SD of 9.57 in the study group and
mean trait anxiety score was 48.76 with SD o
with SD of 10.31 in the control group There was
in both the parameters
square value was .10 with p value of .92
trait anxiety.
0
10
20
30
40
50
60
70
Pretest
16
65
19
Per
cen
tag
e
Figure 17: Comparison of level of trait
hypertension in the control group
Comparison of pretest mean score of anxiety among patients with stage I
the study and control groups before and after intervention
Study Group (n=173)
Control Group (n=173)
t & p valueSD Mean SD
9.58 50.93 9.92 0.10,
11.95 48.89 10.31 0.50,
represents the mean anxiety score among patients between the study
and control groups. During the pretest, the mean state anxiety score was 51.9 with
of 9.57 in the study group and 50.93 with SD of 9.92 in the control group. The
mean trait anxiety score was 48.76 with SD of 11.95 in the study group and
with SD of 10.31 in the control group There was no difference between the groups
in both the parameters, homogeneity between the groups was maintained and the Chi
0 with p value of .921 for state anxiety and 0.50
Posttest I Posttest II Posttest III
117.4 5.4
65 67.6 67.2
1924 25.2 27.4
Duration
Comparison of level of trait anxiety among patients with stage I
hypertension in the control group before and after intervention.
113
Comparison of pretest mean score of anxiety among patients with stage I
before and after intervention
t & p value
, 0.921 NS
, 0.619 NS
represents the mean anxiety score among patients between the study
, the mean state anxiety score was 51.9 with
50.93 with SD of 9.92 in the control group. The
f 11.95 in the study group and 48.89
no difference between the groups
, homogeneity between the groups was maintained and the Chi
50 and 0.619 for
Mild
Moderate
Severe
anxiety among patients with stage I
before and after intervention.
114
Table 23
Comparison of posttest mean score of anxiety among patients with stage I
hypertension in the study and control groups.
Anxiety Posttest Study Group Control Group
t & p value Mean SD Mean SD
State
Ia,b 47.85 9.29 52.24 9.26 4.11, 0.0001***
IIc,d 44.95 9.18 52.95 9.23 7.52, 0.0001 ***
IIIe,f 41.53 8.30 53.58 9.07 12.03, 0.0001 ***
Trait
Ia,b 47.23 11.85 49.364 10.57 1.65, 0.1001 NS
IIc,d 45.47 11.70 49.71 10.77 3.27, 0.001**
IIIe,f 44.89 10.84 49.89 10.73 4.02, 0.0001 ***
NS- Not Significant ** p< 0.01 *** p<0.001 a n=162, c n=156, e n=150 for the study
group b n=165, d n= 158, f n=151 for the control group
Table 23 depicts that the mean state anxiety score in the study group patients
was 47.85 with SD of 9.92during posttest I, 44.95 with SD 9.18 for posttest II and
41.53 with SD 8.30 during posttest III. In the control group, the mean scores were
52.24, 52.95 and 53.58 respectively for posttests I, II and III. Table reveals that during
posttest I, II and III, the mean state anxiety score between the study and control group
had a statistically significant reduction at the level of p<0.001.
The mean trait anxiety scores for study group were 47.23, 45.47 and 44.89
respectively for the posttests I, II and III. For the control group patients, the mean
values were 49.36, 49.71 and 49.89 for the posttests. The mean trait anxiety scores
showed a significant difference between the study and control groups during posttests
II and III with t values of 3.27 and 4.02 respectively with p values of 0.001 and 0.0001
respectively.
0
10
20
30
40
50
60
Pretest
51.4950.93
Mea
nA
nxi
ety
scor
e
p=0.099
42
43
44
45
46
47
48
49
50
Pretest
48.7648.89
Mea
nA
nxi
ety
scor
e
p=0.498
Figure 18: Comparison of mean
hypertension in the study and control groups
Figure 19: Comparison of mean trait anxiety
hypertension in the study and control group
Posttest I Posttest II Posttest III
47.8544.95
41.53
52.24 52.95 53.58
Duration
p=0.0001p=0.0001p=0.0001
Posttest I Posttest II Posttest III
47.23
45.4744.89
49.36449.71 49.89
Duration
p=0.100 p=0.001 p=0.0001
Comparison of mean state anxiety among patients with stage I
hypertension in the study and control groups before and after intervention.
Comparison of mean trait anxiety among patients with stage I
hypertension in the study and control groups before and after intervention.
115
Study group
Control group
Study group
Control group
among patients with stage I
before and after intervention.
among patients with stage I
before and after intervention.
116
Table 24
Comparison of mean difference of state anxiety among patients with stage I
hypertension in the study and control groups before and after intervention.
State anxiety Study Group Control Group
t & p value Mean Difference
SD
Mean difference
SD
Pretesta,b-
Posttest Ic,d 3.65 2.16 -2.01 2.85 20.15, 0.0001
***
Pretest-
Posttest IIe,f 6.55 3.47 -2.64 3.99
23.38,0.0001
***
Pretest-
Posttest IIIg,h 9.97 3.88 -2.71 2.02
27.82, 0.0001
***
*** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Table 24 depicts that from pretest to posttest I, the mean difference for state
anxiety was 3.65 with SD of 2.16 in the study group. In the control group, the mean
difference was -2.01 and the SD was 2.85. From pretest to posttest II, the mean
difference was 6.55with SD of 3.47 in the study group. In the control group, the mean
difference was -2.64 and the SD was 3.99. From pretest to posttest III, the mean
difference was 9.97 with SD of 3.88 in the study group and in the control group, the
mean difference was -2.71 and the SD was 2.02. There was a significant change in the
mean difference of the level of state anxiety between study and the control groups at p
value of 0.0001 at all durations of measurement.
117
Table 25
Comparison of mean difference of trait anxiety among patients with stage I
hypertension in the study and control groups before and after intervention.
Trait anxiety
Study Group Control Group
t & p value Mean
Difference
SD
Mean
Difference SD
Pretesta,b-
Posttest Ic,d 1.53 1.25 -.48 1.94 10.68
0.0001 ***
Pretest-
Posttest IIIe,f 3.29 2.82 -.82 2.97
12.30
0.0001 ***
Pretest-
Posttest IIIg,h 3.87 4.22 -1.00 3.36
11.08
0.0001 ***
*** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Table 25 depicts that from pretest to posttest I, the mean difference for trait
anxiety was 1.53 with SD of 1.25 in the study group and -.48 with 1.94 in the control
group. The mean difference from the pretest to posttest II was 3.29 with SD of 2.82 in
the study group and -.82 with 2.97 in the control group. The mean difference from the
pretest to posttest III was 3.87 with SD of 4.22 in the study group and -1.00 with 3.36
in the control group. There was a significant difference in the MD between the study
and control groups at a level p < 0.001 at all durations of measurement.
Table 26
Repeated measures ANOVA of state anxiety among patients with stage I
hypertension among the
intervention.
Duration Study group
Pretesta,b
Posttest Ic,d
Posttest IIe,f
Posttest IIIg,h
*** p<0.001 a n=173,
b n=173,
Table 26 reveals the RM
hypertension. Among the study group
-4
-2
0
2
4
6
8
10
Pretest -Posttest I
State anxiety
3.65
-2.01
p=0.0001
Mea
n d
iffe
ren
ce
p=0.0001
Figure 20: Comparison
hypertension in the study
Repeated measures ANOVA of state anxiety among patients with stage I
the study and the control groups before and after
Study group
F &
p value
Control group
51.49
610.80
0.0001 ***
50.93
47.57 52.24
44.95 52.95
41.53 53.58
=173, c n=162, e n=156, g n=150 for the study group
=173, d n=165, f n= 158, h n=151 for the control group
reveals the RM ANOVA of state anxiety among patients with stage I
Among the study group, during pretest, the mean score was 51.49 and
Pretest -Posttest
II
Pretest - Posttest
III
Pretest - Posttest
I
Pretest - Posttest
II
Pretest - Posttest
III
State anxiety Trait anxiety
6.55
9.97
1.53
3.29 3.87
2.01-2.64 -2.71 -0.48 -0.82 -1
p=0.0001
p=0.0001
p=0.0001p=0.0001
p=0.0001
of mean difference of anxiety among patients with stage I
hypertension in the study and control groups before and after intervention.
118
Repeated measures ANOVA of state anxiety among patients with stage I
before and after
F & p
value
50.16
0.0001 ***
n=150 for the study group
for the control group
ANOVA of state anxiety among patients with stage I
mean score was 51.49 and
Study Group
Control Group
among patients with stage I
before and after intervention.
119
posttest I mean score was 47.49. During posttest II and III, the mean scores were
44.947 and 41.57 respectively. There was a significant difference in the level of state
anxiety during pretest, posttest I, II and III with F value 610.80 at level p<0.01 in the
study group, whereas in the control group, it was significant raise of state anxiety
between pretest and posttests as revealed by the F value 50.16 and p value 0.0001.
Table 27
Repeated measures ANOVA of trait anxiety among patients with stage I
hypertension between the study and the control groups before and after
intervention.
Duration Study Group
F &
p value
Control
Group
F &
p value
Pretesta,b 48.76
80.71
0.0001 ***
48.89
10.75
0.0001 ***
Posttest Ic,d 47.23 49.36
Posttest IIe,f 45.47 49.71
Posttest IIIg,h 44.89 49.89
*** p<0.001 a n=173, c n=162, e n=156, g n=150 for the study group
b n=173, d n=165, f n= 158, h n=151 for the control group
Table 27 reveals the RM ANOVA of trait anxiety among patients with stage I
hypertension. Among the study group, the mean score was 48.76 during pretest, and
47.23 during posttest I. Mean scores for posttests II and III were 45.47 and 44.89
respectively. There was a significant difference in the level of trait anxiety between
pretest and posttests among the study group with F value 80.71 and p value of 0.0001.
Among the control group, it was significant raise from pretest to posttests as evidenced
by the F value 10.75 and p value of 0.0001.
Table 28
Comparison of mean score of galvanic skin response (GSR) among patients with
stage I hypertension in the study
GSR
value
(in kilo
ohms)
Pretesta
Mean SD
559.
63
226.
33
*** p<0.001 a n=173, b n
The table 28 depicts that the mean GSR value during pretest was 559.63 in the
study group. The mean values for posttest I, II and I
respectively. The difference
between the pre and posttests
p< 0.001.
530
540
550
560
570
580
590
600
610
620
Pretest
559.63
Mea
n G
SR
in k
ilo
ohm
s
Figure 21: Comparison of
hypertension in the study group
score of galvanic skin response (GSR) among patients with
stage I hypertension in the study group before and after intervention.
Posttest Ib Posttest IIc Posttest III
Mean SD Mean SD Mean SD
226.
578.
29
225.
98
600.
79
225.
28
615.
03
232.
24
n=162, c n=156, d n=150
depicts that the mean GSR value during pretest was 559.63 in the
study group. The mean values for posttest I, II and III were 578.29, 600.79 and
. The difference in the galvanic skin response in the study group patients
between the pre and posttests was significant with an F value of 80.2
Pretest Posttest I Posttest II Posttest III
559.63
578.29
600.79
615.03
p=0.0001
Figure 21: Comparison of mean GSR among the patients with stage I
hypertension in the study group before and after intervention.
120
score of galvanic skin response (GSR) among patients with
.
Posttest IIId F & p
value SD
232.
24
80.21
0.0001
***
depicts that the mean GSR value during pretest was 559.63 in the
II were 578.29, 600.79 and 615.30
in the galvanic skin response in the study group patients
s significant with an F value of 80.21 at level
Pretest
Posttest I
Posttest II
Posttest III
GSR among the patients with stage I
before and after intervention.
Section III: Relationship between anxiety, blood pressure and outcome of BART among patients with stage I hypertension in the study
and control groups
Table 29
Correlation between blood pressure, anxiety , GSR and abdominal breathing practice among patients with stage I hypertension in the
study group before and after intervention.
Variable
Pretest systolic
BP r & p value
Pretest diastolic
BP r & p value
Pretest trait
Anxiety r & p value
Pretest state
anxiety r & p value
Posttest Systolic
BP r & p value
Posttest Diastolic
BP r & p value
Posttest Trait
anxiety r & p value
Posttest state
anxiety r & p value
Pretest GSR r & p value
Posttest GSR r & p value
Days of Home Practice
r & p value
Pretest a
systolic BP
1 0.07
0.379 NS
0.07
0.379 NS
0.41
0.020*
0.98
0.001***
0.01
0.204 NS
0.07
0.432 NS
0.08
0.307 NS
0.79
0.022*
-0.01
0.905 NS
-0.14
0.908 NS
Pretest
diastolic BP
1 0.08
0.337 NS
0.08
0.316 NS
0.07
0.421 NS
0.96
0.0001***
0.11
0.192 NS
0.01
0.866 NS
0.13
0.124 NS
0.16
0.047*
0.07
0.384 NS
Pretest
trait anxiety
1 0.91
0.0001***
0.05
0.556 NS
0.10
0.238 NS
0.94
0.0001***
0.86
0.0001***
0.40 S
0.047*
0.06
0.479 NS
-0.02
0.772 NS
Pretest
state anxiety
1 0.01
0.885 NS
0.11
0.118 NS
0.86
0.0001***
0.92
0.0001***
0.13
0.113 NS
0.13
0.114 NS
-0.01
0.950 NS
Posttest III b
Systolic BP
1 0.02
0.855 NS
0.41
0.067 NS
0.51
0.054*
-0.01
0.926 NS
0.90
0.010**
-0.11
0.194 NS
Posttest III
Diastolic BP
1 0.15
0.117 NS
0.03
0.687 NS
0.12
0.154 NS
0.15
0.062 NS
-0.66
0.036*
121
Table 29 Contd...
Correlation between blood pressure, anxiety , GSR and abdominal breathing practice among patients with stage I hypertension in the
study group before and after intervention.
Variable
Pretest systolic
BP r & p value
Pretest diastolic
BP r & p value
Pretest trait
Anxiety r & p value
Pretest state
anxiety r & p value
Posttest Systolic
BP r & p value
Posttest Diastolic
BP r & p value
Posttest Trait
anxiety r & p value
Posttest state
anxiety r & p value
Pretest GSR r & p value
Posttest GSR r & p value
Days of Home Practice
r & p value
Posttest III
Trait anxiety
1 0.85
0.0001**
*
0.05
0.584 NS
0.70
0.696 NS
-0.98
0.002**
Posttest III
state anxiety
1 0.05
0.536 NS
0.63
0.633 NS
-0.57
0.047*
Pretest GSR 1 0.96 S 0.0001***
0.03 0.702 NS
Posttest III GSR
1 0.30 0.044*
Days of home Practice
1
NS- Not Significant *p<0.05 ** p< 0.01 *** p<0.001 a n=173, b n=150
Table 29 depicts the correlation of the systolic and diastolic BP, state and trait anxiety, GSR and home practice during pre and post tests
in the study group. During pretest, there was positive correlation observed between state anxiety & systolic BP (r=0.41) and SA and base GSR
122
(r=0.79). During posttest III, positive correlation was observed between SBP & TA (r=0.41) and SBP & SA (r=0.51). Negative correlation was
observed between GSR & SBP (r=0-.90), GSR & SA (r=-0.63) and GSR & TA (r= -0.70). Negative correlation also existed between total days of
home practice with SBP (r=0.19), DBP(r= -0.62), SA (r= -0.57), TA (r= -0.98) and GSR (r= -0.30) value. All were significant at p <0.05.
Table 30
Correlation between blood pressure and anxiety among patients with stage I hypertension in the control group before and after
intervention.
Variable
Pretest systolic BP r & p value
Pretest diastolic BP r & p value
Pretest trait Anxiety r & p value
Pretest state anxiety r & p value
Posttest Systolic BP r & p value
Posttest Diastolic BP r & p value
Posttest Trait anxiety r & p value
Posttest state anxiety r & p value
Pretest a
systolic BP
1
0.12
0.131 NS
0.01
.0131 NS
0.89
0.012*
0.97
0.0001***
0.11
0.172 NS
0.67
0.035 *
0.40
0.077*
Pretest
diastolic BP
1 0.89
0.012*
0.07
0.956 NS
0.09
0.257 NS
0.91
0.0001***
0.02
0.850 NS
0.06
0.462 NS
Pretest
trait anxiety
1 0.62
0.0001***
0.73
0.028*
0.06 0.460 NS
0.95
0.0001***
0.56
0.0001***
Pretest state
anxiety
1 0.05
0.564 NS
0.59
0.044*
0.60
0.000 ***
0.92
0.000***
123
Table 30 Contd...
Correlation between blood pressure and anxiety among patients with stage I hypertension in the control group before and after
intervention.
Variable
Pretest systolic BP r & p value
Pretest diastolic BP r & p value
Pretest trait Anxiety r & p value
Pretest state anxiety r & p value
Posttest Systolic BP r & p value
Posttest Diastolic BP r & p value
Posttest Trait anxiety r & p value
Posttest state anxiety r & p value
Posttest IIIb
Systolic BP
1 0.06 0.505 NS
0.74
0.028*
-0.76 0.025 NS
Posttest III
Diastolic BP
1 0.12
0.141 NS
0.12
0.136 NS
Posttest III
Trait anxiety
1 0.58
0.0001***
Posttest III
state anxiety
1
NS- Not Significant *p<0.05 ** p< 0.01 *** p<0.001 a n=173, bn=151
The above table (table 30) shows that among the control group, there was significant positive correlation between SBP& SA
(r=.89) and DBP& TA (r=.89) during pretest. During posttest III, there was positive correlation observed between SBP& TA (r=0.735),
SBP& SA (r=0.76) and TA & SA (r=0.58).
124
125
RESULTS- STAGE II HYPERTENSION
Section I b) Distribution of background variables among patients with stage II
hypertension in the study and control groups
Table 31
Frequency, percentage and chi square distribution of demographic variables
among patients with stage II hypertension in the study and control groups (N=320).
Background Variables
Study Group
(n=160)
Control Group
(n=160) χ2 & p
value No. % No. %
Age ( in years):
(a) 36-45
(b) 46-55
(c) 56-65
(d) 66-75
33
25
18
84
20.4
15.3
11.7
52.6
33
26
24
77
20.7
16.4
15.0
47.9
0.93
0.818 NS
Gender
(a) Male
(b) Female
80
80
50.0
50.0
80
80
50.0
50.0
0.81
0.401NS
Residence:
(a) Rural
(b) Sub urban
(c) Urban
43
54
63
27.0
33.6
39.4
50
50
60
31.4
31.4
37.1
2.62
0.454
NS
Educational Status:
(a) No formal education
(b) Primary
(c) High school
(d) Higher secondary
(e) Collegiate
07
55
39
36
23
4.0
34.3
24.1
22.6
14.6
11
45
45
48
11
7.1
27.9
27.9
30.0
7.1
7.20
0.126
NS
Family Income (Rs/ Month):
(a) < 5,000
(b) 5,001 – 10,000
(c) 10,001- 15,000
(d) 15,001- 20,000
(e) > 20,000
09
24
20
99
07
5.8
15.3
12.4
62.0
4.4
14
18
03
115
09
8.6
11.4
2.1
72.1
5.7
12.91
0.012
NS
126
Table 31 Contd..
Frequency, percentage and chi square distribution of demographic variables among
patients with stage II hypertension in the study and control groups (N=320).
Background Variables
Study Group
(n=160)
Control Group
(n=160) χ2 & p
value No. % No. %
Type of Family:
(a) Joint
(b) Nuclear
68
92
42.3
57.7
70
90
43.6
56.4
0.04
0.835 NS
Social Support:
(a) Spouse
(b) Children
(c) Friends
(d) None
160
0
0
0
100
-
-
-
149
09
02
0
92.9
5.7
1.4
-
10.15
0.006**
NS- Not Significant **p<0.01
Table 31 shows the distribution of demographic variables among patients with
hypertension in the study and control groups. Majority, 84 (52.6%) of the study group
and 77 (47.9%) of the control group belonged to the age group of 66-75 yrs. 63 (39.4%)
of the study group and 60 (37.1%) of the control group were residing in urban area.
Again, 7 (4.4%) of samples of the study group had primary education and 48 (30 %) of
the control group acquired collegiate education. The family type of 92 (57.7%) patients
of the study group and 90 (56.4%) of the control group was joint. Again 99 (62%) of
study group and 115 (72.1%) of the control group patients had monthly income in the
range of Rs. 15,001- 20,000. Majority, 160 (100%) of the study group and 149 (92.9%)
of the control group received support from their spouse.
The above table depicts that there is no significant difference in the distribution
of background variables between study and control groups except for the social support.
127
Table 32
Frequency, percentage and chi square distribution of clinical variables among
patients with stage II hypertension in the study and control groups (N= 320).
Clinical Variables
Study Group
(n=160)
Control Group
(n=160) χ2 & p
value No. % No. %
Physical activity/Life style:
(a) Mild
(b) Moderate
(c) Heavy
83
64
13
51.1
40.1
8.0
80
78
06
49.9
48.6
3.6
4.66
0.199 NS
Habits- a. Alcoholism
(a) Yes
(b) No
28
132
17.5
82.5
25
135
15.7
84.3
0.16
0.748 NS
b. Current Smoking status
(including passive)
(a) Yes
(b) No
23
137
14.6
85.4
25
135
15.7
84.3
0.07
0.868 NS
Dietary pattern
(a) Vegetarian
(b) Mixed diet
16
144
10.2
89.8
13
147
79
92.1
0.49
0.535 NS
Menopause
a) Attained
b) Not Attained
20
21
25.5
26.3
15
22
19.3
27.1
0.18
0.824 NS
Duration of hypertension
(a) <1 year
(b) 1-5 years
(c) 5-10 years
(d) >10 years
20
68
36
36
12.4
42.3
22.6
22.6
12
58
50
40
7.8
36.4
30.7
25.0
3.89
0.273 NS
BMI (kg/m²)
(a) <18
(b) 18-22.99
(c) 23-30
(d) >30
38
98
24
0
23.4
61.3
15.3
-
29
123
08
0
17.9
77.1
5.0
-
10.83
0.004**
128
Table 32 Contd..
Frequency, percentage and chi square distribution of clinical variables among
patients with stage II hypertension in the study and control groups (N= 360).
Clinical Variables
Study Group
(n=160)
Control Group
(n=160) χ2 & p
value No. % No. %
FBS (mg/dl)
a) <100
b) 101-130
c) >130
68
48
44
42.3
29.9
27.9
72
43
45
45.0
27.1
27.9
0.30
0.860 NS
Hypercholesterolemia
a) Yes
b) No
55
105
34.3
65.7
50
110
31.4
68.6
0.26
0.701 NS
Drugs and doses
a) 1( Diuretics)
b) 1+ 2
c) 1+ 3
d) 1+ 4
e) 2 ( ACEI)
f) 2+3
g) 2+4
h) 3 (ARB)
i) 4+3
j) 4 (CCB)
k) 1+2+3
19
57
06
08
08
33
16
09
02
02
0
11.6
35.7
3.6
4.3
4.3
20.4
10.2
5.8
1.4
1.4
-
06
60
03
11
08
36
19
09
09
09
02
3.5
37.1
2.1
7.1
5.0
22.1
11.4
5.7
5.7
5.7
1.4
11.08
0.32 NS
NS- Not Significant ** p< 0.01
Table 32 shows that the majority, 83(51.1%) of the study group and 80(49.9 %)
of the control group were engaged in mild physical activity. Again 28 (17.5 %) and
25(15.7%) respectively of the study and control group patients were alcoholics. Smoking
habit prevailed among 23(14.6%) of the study group and 25 (15.7%) of the control group
patients. Majority, 144 (89.8%) of the study group and 147 (92.1%) of the control group
were consuming mixed diet. Menopause was attained by 20 (25.5 %) of the study group
129
women while of the control group 15 (19.3%) were post menopausal. A majority of 68
(42.3%) of the study group and 58 (36.4%) of the control group were having
hypertension for a duration of 1-5 yrs. The BMI of 98 (61.3%) of the study group and
123 (77.1%) of the control group were in the range 23-30 kg/m2. FBS of 68 (42.3%) of
the study group and 72 (45%) of the control group was maintained in the range of 101-
130 mg%. Again 105 (65.7%) of the study group and 110 (68.6%) of the control group
were having elevated cholesterol levels. The combination of diuretics and ACEI was the
treatment received by 57 (35.8%) patients of the study group and 60 (37.1%) of the
control group.
The above table depicts that there is no significant difference in the distribution
of clinical variables among the study and control groups except for BMI.
Section II: Comparison of blood pressure and anxiety within the groups and
between the groups before and after intervention (BART).
Table 33
Comparison of level of systolic BP among patients with stage II hypertension
between the study and control groups before and after intervention.
Duration
Systolic
BP in
mm of Hg
Study Group
Control
Group χ2and p
value No. % No. %
Pretesta,b
<120 0 - 0 -
5.17
0.067 NS
120-139 24 15.3 08 5.0
140-159 53 32.8 57 35.7
>159 83 51.8 95 59.2
Posttest Ic,d
<120
0
-
0
-
10.46
0.005 **
120-139 32 19.7 11 7.1
140-159 56 37.9 57 37.8
>159 62 42.3 84 55.0
130
Table 33 Contd..
Comparison of level of systolic BP among patients with stage II hypertension
between the study and control groups before and after intervention.
Duration Systolic BP
in mm of Hg
Study Group
Control
Group χ2and p
value No. % No. %
Posttest IIe,f
<120 0 - 0 -
18.87
0.0001 ***
120-139 36 25.5 11 7.1
140-159 53 37.2 56 38.5
>159 53 37.2 79 54.2
Posttest IIIg,h
<120 0 - 0 -
21.69
0.0001 ***
120-139 36 26.2 09 6.4
140-159 51 37.2 55 39.2
>159 50 36.4 75 53.5
NS- Not Significant *p<0.05 ** p< 0.01 *** p<0.001 a n=160 c n=148 e n=143 g n=137
for the study group b n=160 d n=152 f n=145 h n=140 for the control group
Table 33 represents levels of blood pressure among patients between the study
and control group. During the pretest, 24 (15.3%) of the study group and 8 (5 %) of the
control group were having systolic BP of range 120-139 mm of Hg. Of the study group,
53 (32.8 %) patients and of the control group, 57 (35.7 %) had blood pressure ranging
from 140-159 mm of Hg. A majority of 83 (51.8%) of the study group and 95 (59.2%) of
the control group had systolic BP of range >159 mm Hg. There was a difference between
the groups, with the Chi square value was 8.169 with p value of 0.019.
131
During posttest I, 32 (19.7 %) patients of the study group and 11 (7.1%) of the
control group had their systolic BP in the range of 120-139 mm of Hg. The number of
patients with BP value of 140-159 mm of Hg was 56(37.9 %) of the study group and 57
(37.8 %) of the control group. The number of patients with SBP > 159 mm of Hg in the
study group reduced to 62 (42.3 %) while in the control group, the proportion remained
as 84(55%). There was a significant difference between the groups which is exhibited by
the chi square value of 10.463 and p 0.005.
During poststest II, 36 (25.5%) patients of the study group had BP 120- 139 mm
of Hg. Again, 53 (37.2 %) of the study group patients and 53 (38.5 %) of the control
group had BP value in the range 140-159 mm of Hg. The majority of 56 (37.2%) patients
of the study group and 79 (54.2 %) of the control group had their BP raised to >159 mm
of Hg. There was a significant difference between the groups which is exhibited by the
chi square value of 18.866 and p value of 0.001.
During poststest III, 36 (26.2%) of the study group patients and 9 (6.4 %) in the
control group had BP value in the range 120-139 mm of Hg. 37.2 % of the study group
patients’ and 39.2% of the control group patients’ BP value was between 140-159 mm of
Hg. The number of patients in the study group with SBP value > 159 mm of Hg reduced
to 50 (36.45) while in the control group, the number was 75(53.5%). There was a
significant difference between the groups which is exhibited by the Chi square value of
21.686 and p value of 0.001.
0
10
20
30
40
50
60
<120
0 0 0 0
Per
cen
tage
0
10
20
30
40
50
60
<120
0 0 0 0
Per
cen
tage
Figure 22: Distribution of level of systolic blood pressure among
stage II hypertension in the study group before and after intervention
Figure 23: Distribution of level of systolic blood pressure among
stage II hypertension in the control group before and after intervention
120-139 140-159 >159
15.3
32.8
51.8
19.7
37.9
42.3
25.5
37.237.2
26.2
37.236.4
BP in mm of Hg
120-139 140-159 >159
5
35.7
59.2
7.1
37.8
55
7.1
38.5
54.2
6.4
39.2
53.5
BP in mm of Hg
istribution of level of systolic blood pressure among patients with
stage II hypertension in the study group before and after intervention
Figure 23: Distribution of level of systolic blood pressure among patients with
hypertension in the control group before and after intervention
132
Pretest
Posttest I
Posttest II
Posttest III
53.5
Pretest
Posttest I
Posttest II
Posttest III
patients with
stage II hypertension in the study group before and after intervention.
patients with
hypertension in the control group before and after intervention.
133
Table 34
Comparison of diastolic BP among patients with stage II hypertension in the study
and control groups before and after intervention.
Duration
Diastolic
BP in mm
of Hg
Study Group Control Group χ2 and p
value No. % No. %
Pretesta,b
<80 0 0 02 1.0
5.98
0.113 NS
80-89 10 6 22 13.5
90-99 58 35.7 55 34.2
>99 92 57.6 81 50.7
Posttest Ic,d
<80 0 0 01 0.7 27.93
0.0001
***
80-89 27 18.2 25 15.7
90-99 89 59.8 50 32.8
>99 32 21.8 77 50.7
Posttest IIe,f
<80 0 0 01 0.7 49.68
0.0001
***
80-89 35 24.8 25 17.1
90-99 98 67.8 57 38.5
>99 10 7.2 63 43.5
Posttest IIIg,h
<80 0 0 01 0.7 55.46
0.0001
***
80-89 35 25.5 23 16.4
90-99 95 69.3 56 40.0
>99 7 05 60 42.8
NS- Not Significant *** p<0.001 a n=160 c n=148 e n=143 g n=137 for the study
group b n=160 d n=152 f n=145 h n=140 for the control group
Table 34 represents level of blood pressure among patients between the study and
control group. During the pretest, 2 (1 %) of the control group were having diastolic BP
of range <80 mm of Hg. Again, 10 (6 %) of the study group and 22 (13.5 %) of the
control group had diastolic blood pressure ranging from 80-89 mm of Hg. Majority, 92
(57.6%) of the study group and 81(50.7%) of the control group were having DBP in the
range of >99 mm of Hg. There was no difference between the groups, homogeneity
between the groups was reflected by the Chi square value was 5.98 with p value of
0.113.
134
During posttest I, 27 (18.2 %) of the study group and 25 (15.7 %) of the control
group had diastolic BP value of 80-89 mm of Hg. Again, 89 (59.8 %) of the study group
and 50 (32.8%) of the control group had DBP of range 90-99 mm of Hg. At the same
time, 32 (21.8 %) of the study group and 77 (50.7%) of the control group had DBP of
range >99 mm of Hg. There was a significant difference between the groups which is
exhibited by the chi square value of 27.93 with p value of 0.001.
During poststest II, 35 (24.8 %) of the study group patients and 25 (17.1 %) of
the control group had BP value in the range 80-89 mm of Hg. Majority in the study
group, 98(67.8 %) patients’ BP value was between 90-99 mm of Hg. At the same time,
the control group majority, 63 (43.5%) maintained the DBP level of > 99 mm of Hg.
There was a significant difference between the groups which is exhibited by the chi
square value of 49.68 with p value of 0.001.
During poststest III, 35(25.5 %) of the study group patients and 23 (16.4 %) in
the control group had BP value in the range 80-89 mm of Hg. The study group majority
increased to 95 (69.3%) who had BP value was between 90-99 mm of Hg. But, the
control group majority, 60 (42.8%) had their BP as >99 mm of Hg. There was a
significant difference between the groups which is exhibited by the chi square value of
55.46 with p value of 0.001.
0
10
20
30
40
50
60
70
<80
0 0 0 0
Per
cen
tag
e
0
10
20
30
40
50
60
<80
1 0.70.70.7
Per
cen
tag
e
Figure 24: Distribution of diastolic blood pressure among
hypertension in the study group before and after intervention
Figure 25: Distribution of diastolic blood pressure among
hypertension in the control group before and after intervention
80-89 90-99 >99
6
35.9
57.8
18.4
59.8
21.824.8
67.8
7.4
25.7
69.3
5
BP in mm of Hg
80-89 90-99 >99
13.7
34.4
50.9
15.8
32.8
50.7
17.3
38.543.5
16.5
4042.8
BP in mm of Hg
Figure 24: Distribution of diastolic blood pressure among patients with
hypertension in the study group before and after intervention.
Figure 25: Distribution of diastolic blood pressure among patients with
control group before and after intervention.
135
Pretest
Posttest I
Posttest II
Posttest III
Pretest
Posttest I
Posttest II
Posttest III
patients with stage II
patients with stage II
136
Table 35
Comparison of overall blood pressure among patients with stage II hypertension in
the study and control groups before and after intervention.
Duration
of study
BP
grades
Study (n=137) Control (n=140) χ2 and p
value No. % No. %
Pretesta,b
Pre HT 0 - 0 -
- Stage I 0 - 0 -
Stage II 137 100 140 100
Posttest IIIc,d
Pre HT - - - - 7.44
0.001
***
Stage I 20 12.4 06 3.5
Stage II 140 87.6 154 96.4
*** P<0.001 a n=160 c n=137 (study group) b n= 160, d n= 140(control group)
Table 35 represents level of blood pressure among patients between the study and
control groups. During the pretest, all patients of the study and control group belonged to
stage II category with either systolic BP >159 mm Hg or diastolic BP in the range >99
mm Hg. 20 (12.4%) of the study group and 6 (3.5%) of the control had lowered their
blood pressure to stage I during posttest III. At the same time, 140 (87.6%) of the study
group and 154 (96.4%) of the control group remained in stage II category at the end of
intervention. There was a difference between the groups, with the Chi square value was
7.44 with p value of 0.001.
Table 36
Comparison of pretest mean score of blood pressure among patients with stage II
hypertension in the study and control group
Blood
Pressure
Study
(n= 1
Mean
Systolic 156.9
Diastolic 96.69
NS- Not Significant
Table 36 represents the mean level of blood pressure among patients between the
study and control groups. During the
with SD of 14.097 in the study group. In the control group,
and SD was 10.93. The mean diastolic BP was 96.69 with SD
and 95.67 with SD of 6.11 in the control group. There was n
groups, homogeneity between the groups was maintained and t
value were 0.93 & .35 and 1.42
0
20
40
60
80
100
Pre- HT
0 0
Per
cen
tag
e
Figure 26: Comparison of
hypertension in the study and control group
Comparison of pretest mean score of blood pressure among patients with stage II
on in the study and control groups (N=320).
Study Group
(n= 160)
Control Group
(n=160) t & p value
Mean SD Mean SD
156.9 14.10 157.40 10.93 0.93,
96.69 5.75 95.67 6.11 1.42,
represents the mean level of blood pressure among patients between the
study and control groups. During the pretest, the mean systolic BP was 156.9 mm of Hg
with SD of 14.097 in the study group. In the control group, the mean value was 157.40
SD was 10.93. The mean diastolic BP was 96.69 with SD of 5.74 in the study group
95.67 with SD of 6.11 in the control group. There was no difference between the
, homogeneity between the groups was maintained and the Chi square value
.35 and 1.42 & 0.16 respectively for systolic and diastolic BP.
Stage I Stage II Pre- HT Stage I Stage II
Study group Control group
0
100
0 0
100
12.4
87.6
0 3.5
96.5
Stage of hypertension
p=.001
Figure 26: Comparison of overall blood pressure among patients with stage II
hypertension in the study and control groups before and after intervention.
137
Comparison of pretest mean score of blood pressure among patients with stage II
t & p value
, 0.35 NS
, 0.16 NS
represents the mean level of blood pressure among patients between the
was 156.9 mm of Hg
the mean value was 157.40
5.74 in the study group
o difference between the
he Chi square value and p
for systolic and diastolic BP.
96.5
Pretest
Posttest I
blood pressure among patients with stage II
s before and after intervention.
138
Table 37
Comparison of posttest (I,II,III) mean score of blood pressure among patients with
stage II hypertension in the study and control groups.
Blood
Pressure Posttest
Study
group
Control
Group t & p value
Mean SD Mean SD
Systolic
Ia,b 155.15 14.179 157.71 11.65 -1.64, 0.10 NS
IIc,d 153.61 14.138 158.57 11.59 -2.94,0.004**
IIIe,f 152.44 13.989 158.43 11.66 -3.88,0.001***
Diastolic
Ia,b 95.52 5.544 95.50 6.592 .03, 0.10 NS
IIc,d 94.32 5.309 95.47 6.386 -1.63, 0.007 **
IIIe,f 93.50 5.530 95.56 6.288 -2.05,0.004 **
NS- Not Significant ** p< 0.01 *** p<0.001 a n=160 c n=148 e n=143 g n=137 (SG)
b n=160 d n=152 f n=145 h n=140 (CG)
Table 37 reveals that during posttest I, the mean systolic BP was 155.15 in the
study group and 157.71 in the control group. There was no difference between the groups
with t and p values of -1.644 and .10 respectively. The posttest II the mean systolic BP
was 153.61 and 158.57 for the study and control groups respectively. This showed a
statistically significant difference between the groups with t and p value of -2.94 and
0.004.
During posttest III, the mean systolic BP value for the study group was 152.44 with
SD 13.989. For the control group, the values were 158.43 and 11.66. At this measurement
also, there was a significant difference between the groups with t and p values of -3.875
and .001 respectively. When diastolic BP was considered, the posttest I did not show any
significant difference between the groups. Posttest II mean score of study group was 94.32
with SD 5.30. For the control group, the mean score was 95.47 with SD 6.386. The groups
differed significantly between them with p and t value of -2.053and 0.004 respectively.
148
150
152
154
156
158
160
Pretest
156.9157.4
BP
in
mm
of
Hg
p=0.350
91
92
93
94
95
96
97
Pretest
96.6995.67
BP
in m
m o
f H
g
p=0.160
Figure 27: Comparison of mean systolic
stage II hypertension in the study and control groups
intervention.
Figure 28: Comparison mean
II hypertension in the study and control groups be
Posttest I Posttest II Posttest III
155.15
153.61152.44
157.4 157.71158.57 158.43
Duration
p=0.001p=0.004p=0.100
Posttest I Posttest II Posttest III
95.52
94.32
93.5
95.67 95.5 95.47 95.56
Duration
p=0.100 p=0.007 p=0.004
ison of mean systolic blood pressure among patients with
stage II hypertension in the study and control groups before and after
Figure 28: Comparison mean diastolic blood pressure among patients with stage
hypertension in the study and control groups before and after intervention.
139
Study group
Control group
Study group
Control group
blood pressure among patients with
before and after
blood pressure among patients with stage
fore and after intervention.
140
Table 38
Comparison of mean difference of systolic BP among patients with stage II
hypertension in the study and control groups before and after intervention.
Systolic BP
Study Group
Control Group
t & p value Mean
Difference SD Mean
Difference SD
Pretesta,b-
Posttest Ic,d 0.83 1.28 -0.31 2.59 4.66
0.0001***
Pretest-
Posttest IIe,f 2.38 1.65 -0.77 3.060
10.63
0.0001***
Pretest-
Posttest IIIg,h 3.55 1.57 -1.03 3.21
15.04
0.0001***
*** p<0.001 a n=160 c n=148 e n=143 g n=137 for the study group
b n=160 d n=152 f n=145 h n=140 for the control group
Table 38 depicts that from pretest to posttest I, the mean difference was 0.83 with
SD of 1.27 in the study group and -0.31 and 2.59 in the control group. The mean
difference from pretest to posttest II was 2.38 with SD of 1.65 in the study group and
-0.77 with 3.60 in the control group. The mean difference from the pretest to posttest III
was 3.55 with SD of 1.57 in the study group and -1.03 with 3.025 in the control group.
There is a highly significant difference during all the intervals between the study and
control groups at a level < 0.001.
141
Table 39
Comparison of mean difference of diastolic BP among patients with stage II
hypertension in the study and control groups before and after intervention (N= 277).
Diastolic BP
Study Group
Control Group
t & p
value Mean
Difference SD
Mean
Difference SD
Pretesta,b-
Posttest Ic,d 1.17 1.25 -0.17 1.71 5.76
0.0001 ***
Pretest-
Posttest IIe,f 2.36 1.29 -0.20 1.83
11.36
0.0001 ***
Pretest-
Posttest IIIg,h 3.18 1.38 -0.31 1.93
15.17
0.0001 ***
*** p<0.001 a n=160 c n=148 e n=143 g n=137 for the study group
b n=160 d n=152 fn=145 h n=140 for the control group
Table 39 depicts that from pretest to posttest I, the mean difference was 1.17 with
SD of 1.25 in the study group and 0.17 with 1.705 in the control group. The mean
difference from the pretest to posttest II was 2.36 with SD of 1.288 in the study group
and 0.20 with 1.832 in the control group. The mean difference from the pretest to
posttest III was 3.18 with SD of 1.38 in the study group and 0.31 with 1.93 in the control
group. The mean difference of the two groups differed significantly between them at a
level p < 0.001 during all measurement intervals.
Table 40
Repeated measures ANOVA of systolic BP among patients with stage II
hypertension between the study and the control groups
intervention.
Duration Study
Pretesta,b 156.9
Posttest Ic,d 155.15
Posttest IIe,f 153.61
Posttest IIIg,h 152.44
*** p< 0.001 a n=160 c n=148
b n=160 d n=152
Table 40 reveals the RM
hypertension. During pretest, the mean
-1.5
-1
-0.5
0
0.5
1
1.5
2
2.5
3
3.5
4
Study Group
0.83
2.38
3.55
Mea
n d
iffe
ren
ce o
f B
P
p=0.0001
Figure 29: Comparison of mean difference of blood pressure among patients with
stage II hypertension in the study and control groups before and after
intervention.
Repeated measures ANOVA of systolic BP among patients with stage II
hypertension between the study and the control groups before and after
tudy Group
F & p value
Control group
156.90
365.64
0.0001 ***
157.40
155.15 157.71
153.61 158.57
152.44 158.43
n=148 e n=143 g n=137 for the study group
n=152 fn=145 h n=140 for the control group
reveals the RM ANOVA of systolic BP among patients with stage
hypertension. During pretest, the mean value among study group was 156.9
Control group
Study Group
Control group
Systolic BP Diastolic BP
-0.31
1.17
-0.17-0.77
2.36
-0.2-1.03
3.18
-0.31
p=0.0001p=0.0001
p=0.0001
Figure 29: Comparison of mean difference of blood pressure among patients with
stage II hypertension in the study and control groups before and after
142
Repeated measures ANOVA of systolic BP among patients with stage II
before and after
F & p value
10.17
0.0001 ***
ANOVA of systolic BP among patients with stage II
among study group was 156.90 and posttest
Pretest -Posttest I
Pretest -Posttest II
Pretest -Posttest III
Figure 29: Comparison of mean difference of blood pressure among patients with
stage II hypertension in the study and control groups before and after
143
I mean value was 155.15. During posttest II and III, the mean values were 153.61 and
152.44 respectively. There was a highly significant difference in the level of systolic BP
during pretest, posttest I, II and III at level p<0.001 in the study group, whereas in the
control group, there was a smaller but significant difference from pretest to posttests I, II
and III.
Table 41
Repeated measures ANOVA of diastolic BP among patients with stage II
hypertension between the study and the control groups before and after
intervention.
Duration Study Group
F & p value
Control group
F & p value
Pretesta,b 96.69
384.16
0.0001 ***
95.67
0.89
0.418 NS
Posttest Ic,d 95.52 95.50
Posttest IIe,f 94.32 95.47
Posttest IIIg,h 93.50 95.56
NS-Non Significant *** p< 0.001 a n=160 c n=148 e n=143 g n=137 for the study group
bn=160 d n=152 fn=145 h n=140 for the control group
Table 41 reveals the RMANOVA of diastolic BP among patients with stage II
hypertension. During pretest, the mean value was 96.69 among the study group patients.
During posttest I, II and III, the mean values were 95.52, 94.32 and 93.50 respectively.
So there was a highly significant difference in the level of diastolic BP from pretest to
posttests I, II and III at level p<0.01 in the study group, whereas in the control group,
there was a non significant change noted between pretest, posttests I, II and III.
144
Table 42
Comparison of effect of different antihypertensive medications on systolic BP
among the patients with stage II hypertension between study and control groups
before and after intervention
Anti
hypertensive
medications
Duration
Study group Control group
t & p value Mean SD Mean SD
ACEI
Pretesta,b
Posttest IIIc,d
152.80
149.20
14.45
13.76
157.38
158.75
6.19
6.53
-1.194,0.240 NS
-2.588,0.014 **
ACE I+
ARB
Preteste,f
Posttest IIIg,h
155.71
151.57
14.96
15.13
155.90
156.40
11.49
11.06
-0.041,0.968 NS
-1.076,0.290 NS
Diuretics+
ACEI
Pretesti,j
Posttest IIIk,l
157.10
153.80
14.95
14.49
156.68
157.50
11.26
12.16
0.167,0.868 NS
-1.422,0.158 NS
NS- Not Significant **p<0.01 an=57 cn=42 en=26 gn=23 in=50 kn=40 (Study Group)
bn=55 dn=46 fn=33 hn=23 jn=46 ln=35 (Control Group)
Table 42 depicts the effect of major drug/ combinations on systolic BP for stage
II hypertension. When the mean value of SBP for ACEI is compared between the study
and control groups, there was significant difference observed during pretest with t value
-2.59. The patients taking ACEI+ ARB and ACEI+ diuretics showed no significant
difference between the study and the control groups during pretest and posttest III.
Table 43
Comparison of effect of different groups
diastolic BP among the patients with stage II hyperten
control groups before and after intervention
Antihypertensive
medications Duration
ACEI
Pretest
Posttest III
ACE I+
ARB
Pretest
Posttest III
Diuretics+
ACEI
Pretest
Posttest III
NS- Non Significant an=57
bn=55
144
146
148
150
152
154
156
158
160
Pretest Posttest
ACEI
152.8
149.2
157.38
Mea
n B
P i
n m
mof
Hg
p=0.014p=0.240
Figure 30: Comparison of effect of
systolic BP among patients with stage II hypertension in study and control groups
before and after intervention
Comparison of effect of different groups of antihypertensive medications
iastolic BP among the patients with stage II hypertension between study and
before and after intervention
Duration
Study Group Control Group
Mean SD Mean SD
Pretesta,b
Posttest IIIc,d
96.32
92.88
5.19
6.17
94.00
94.13
6.11
6.83
1.10
-0.66
Preteste,f
Posttest IIIg,h
96.86
93.71
4.13
3.83
98.10
98.20
5.05
5.54
-0.76
-
Pretestm,n
Posttest IIIo,p
96.90
93.80
6.14
5.54
95.18
94.97
6.64
6.79
1.14, 0
-0.92, 0
n=57 cn=42 en=26 gn=23 in=50 kn=40 (SG)
n=55 dn=46 fn=33 hn=23 jn=46 ln=35 (CG)
Posttest III
Pretest Posttest III
Pretest Posttest III
ACEI+ ARB ACEI+DIURETICS
149.2
155.71
151.57
157.1
153.8
158.75
155.9 156.4 156.68157.5
p=0.158p=0.868p=0.290p=0.968p=0.014
Comparison of effect of various antihypertensive medications
BP among patients with stage II hypertension in study and control groups
before and after intervention
145
of antihypertensive medications on
sion between study and
Group t & p value
1.10, 0.200 NS
0.66, 0.511 NS
0.76, 0.453 NS
-1.08,0.290 NS
1.14, 0.184 NS
0.92, 0.357 NS
Study Group
Control Group
various antihypertensive medications on
BP among patients with stage II hypertension in study and control groups
Table 43 depicts the effect of major
combinations on diastolic BP of stage II hypertension. When the mean value of SBP for
ACEI is compared between the study and control groups, there was no significant
difference observed during pretest and posttest I
Table 44
Comparison of frequency
antihypertensive medication
hypertension in the study and control group
No. of
antihypertensive
drug dose
reductions
No.
10
** p< 0.01
90
92
94
96
98
100
Pretest Posttest
ACEI
96.32
92.8894
Mea
n B
Pin
mm
of
Hg
p=0.511p=0.200
Figure 31: Comparison of effect of
diastolic BP among the patients with stage II hypertension in the study and
control groups before and after intervention
depicts the effect of major antihypertensive medications and
on diastolic BP of stage II hypertension. When the mean value of SBP for
ACEI is compared between the study and control groups, there was no significant
difference observed during pretest and posttest III for any major combinations.
Comparison of frequency, percentage and chi square distribution of
medication dose reduction among patients with stage II
hypertension in the study and control groups during third posttest (N=277
Study Group
(n= 137)
Control Group
(n=140)
No. % No %
10
7.3
01
0.7
Posttest III
Pretest Posttest III
Pretest Posttest III
ACEI+ ARB ACEI+DIURETICS
92.88
96.86
93.71
96.9
93.894.13
98.1 98.2
95.18 94.97
p=0.357p=0.184p=0.290p=0.453p=0.511
Comparison of effect of various antihypertensive medications on
BP among the patients with stage II hypertension in the study and
before and after intervention
146
antihypertensive medications and
on diastolic BP of stage II hypertension. When the mean value of SBP for
ACEI is compared between the study and control groups, there was no significant
I for any major combinations.
percentage and chi square distribution of
dose reduction among patients with stage II
N=277).
χ2 and p
value
7.87
0.005 **
Study Group
Control Group
various antihypertensive medications on
BP among the patients with stage II hypertension in the study and
Table 44 depicts that there were 10
group patients at the end of three months while among the control group, there
one dose reduction reported.
hypertensive medications between the study and control groups was significant at p<0.01
with chi square value 7.87.
0
2
4
6
8
10
Study Group
No
. of
dos
e re
du
ctio
ns
Figure 32: Comparison of
medications among the patients wit
control groups during posttest III
epicts that there were 10 dose reductions reported among the
group patients at the end of three months while among the control group, there
ction reported. Difference in the number of dose reductions of anti
medications between the study and control groups was significant at p<0.01
with chi square value 7.87.
Study Group Control Group
10
1
p=0.005
Comparison of dose reductions of various antihypertensive
among the patients with stage II hypertension in the study and
during posttest III (N=277).
147
dose reductions reported among the study
group patients at the end of three months while among the control group, there was only
Difference in the number of dose reductions of anti
medications between the study and control groups was significant at p<0.01
various antihypertensive
h stage II hypertension in the study and
148
Table 45
Comparison of level of state anxiety among patients with stage II hypertension in
the study and control groups before and after intervention.
Duration State
Anxiety
Study Group Control Group χ2 and p
value No. % No. %
Pretesta,b
Mild 10 6.2 0 - 4.91
0.325 NS Moderate 126 78.9 130 81.4
Severe 24 14.9 40 18.5
Posttest Ic,d
Mild 12 7.2 0 - 42.87
0.0001*** Moderate 126 84.7 104 68.5
Severe 12 8.1 48 31.4
Posttest IIe,f
Mild 10 7.2 0 - 76.25
0.0001*** Moderate 125 87.5 95 65.7
Severe 08 5.0 50 34.2
Posttest IIIg,h
Mild 13 9.4 0 - 117.96
0.0001*** Moderate 121 88.3 90 64.2
Severe 03 2.0 50 35.7
NS- Not Significant *** p<0.001 a n=160 c n=148 e n=143 g n=137 for the study group,
b n=160 d n=152 f n=145 h n=140 for the control group
Table 45 represents level of state anxiety among patients between the study and
control groups. During the pretest, majority of the patients of the study group, 126 (78.9
%) and the control group 130(81.4%) belonged to mild state anxiety category. Moderate
cases increased to 126 (84.68%) of the study group during posttest I while it reduced to
104 (68.5%) of the control group. There were 12 (7.2%) mild category patients in the
study group during posttest II, while in the control group, four (2.8 %) patients moved
from moderate to severe category. During posttest III, the study group reported three
(2%) severe cases. Of the control group, 50 (35.7%) were in the severe category during
posttest III. The group was homogenous during pretest. There was a significant
difference between the groups during posttest I, II and III at p level 0.001.
0
20
40
60
80
100
Pretest
6.2
78.9
Per
cen
tage
0
10
20
30
40
50
60
70
80
90
Pretest
0
84.4
18.5Per
cen
tage
Figure 33: Distribution of level of state anxiety among patients with stage II
hypertension in the study group
Figure 34: Distribution of level of state
hypertension in the control group before and after intervention
Pretest Posttest I Posttest II Posttest III
7.2 7.4 9.4
78.984.7 87.6 88.6
14.98.1 5 2
Duration
Posttest I Posttest II Posttest III
0 0 0
68.5 65.7 64.3
18.5
31.5 34.3 35.7
Duration
: Distribution of level of state anxiety among patients with stage II
ypertension in the study group before and after intervention
: Distribution of level of state anxiety among patients with stage II
hypertension in the control group before and after intervention
149
Mild
Moderate
Severe
Mild
Moderate
Severe
: Distribution of level of state anxiety among patients with stage II
before and after intervention.
anxiety among patients with stage II
hypertension in the control group before and after intervention.
150
Table 46
Comparison of level of trait anxiety among patients with stage II hypertension in
the study and control groups before and after intervention.
Duration Trait
Anxiety
Study group Control group χ2 and p
value No. % No. %
Pretesta,b
Mild 09 5.8 04 2.8 1.96
0.371 NS
Moderate 142 89.0 150 93.5
Severe 08 5.1 06 3.5
Posttest Ic,d
Mild 11 7.2 03 2.1 4.13
0.114 NS
Moderate 131 88.3 142 93.5
Severe 07 4.3 07 4.2
Posttest IIe,f
Mild 16 10.9 04 2.8 7.41
0.020 *
Moderate 124 86.8 136 93.5
Severe 03 2.1 05 3.5
Posttest IIIg,h
Mild 14 10.2 03 2.1 12.73
0.001 **
Moderate 122 89.0 129 92.1
Severe 01 0.7 08 5.7
NS- Not Significant *p<0.05 ** p< 0.01 a n=160 c n=148 e n=143 g n=137 for the
study group b n=160 d n=152 f n=145 h n=140 for the control group
Table 46 represents level of trait anxiety among patients between the study and
control groups. During the pretest, majority 142 (89%) the patients of the study group
and 150 (93.5 %) of the control group belonged to moderate category. Mild cases
increased to 11 (7.2 %) in the study group during posttest I. There were 16 (10.9 %) mild
category patients in the study group during posttest II, while in the control group there
was only 4 (2.8%). During posttest III, the study group reported only one (0.72%) severe
case. In the control group, 8 (5.7%) were in the severe category. The group was
homogenous during pretest with the Chi square value 1.96 and p value of 0.371.
During posttests II and III, there was a significant difference between the groups
at p<0.05 and p< 0.01 respectively.
0
10
20
30
40
50
60
70
80
90
Pretest
5.8
89
5.2
Per
cen
tage
0
20
40
60
80
100
1
2.8
93.5
Per
cen
tag
e
Figure 35: Distribution of level of tra
hypertension in the study group before and after intervention
Figure 36: Distribution of level of trait anxiety among patients with stage II
hypertension in the control group before and after intervention
Pretest Posttest I Posttest II Posttest III
7.210.9 10.2
88.5 86.8 89
5.2 4.3 2.3 0.7
Anxiety score
2 3 4
2.3 2.8 2.3
93.5 93.5 92.1
3.8 4.2 3.8 5.7
Anxiety scorre
: Distribution of level of trait anxiety among patients with
hypertension in the study group before and after intervention
: Distribution of level of trait anxiety among patients with stage II
hypertension in the control group before and after intervention
151
Mild
Moderate
Severe
Mild
Moderate
Severe
it anxiety among patients with stage II
hypertension in the study group before and after intervention.
: Distribution of level of trait anxiety among patients with stage II
hypertension in the control group before and after intervention.
152
Table 47
Comparison of pretest mean score of anxiety among patients with stage II
hypertension in the study and control groups (N= 320).
Anxiety
Study Group
(n= 160)
Control Group
(n=160) t & p value
Mean SD Mean SD
State 54.32 6.92 55.23 4.55 -1.292
0.005 NS
Trait 47.69 6.80 48.57 5.47 -1.185
0.320 NS
NS- Not Significant
Table 47 represents the mean anxiety score among patients between the study and
control groups. During the pretest, the mean state anxiety score was 54.32 with SD of
6.924 in the study group and 55.23 with SD of 4.546 in the control group. The mean trait
anxiety score was 47.69 with SD of 6.804 in the study group and 48.57 with SD of 5.47
in the control group. There was no difference between the groups for trait and state
anxiety, homogeneity between the groups was maintained and the Chi square and p
values were -1.29 with 0.921.and 0.498 with 0.619 respectively for state and trait
anxiety.
153
Table 48
Comparison of posttest mean score of anxiety among patients with stage II
hypertension in the study and control groups.
*** p<0.001 a n=160 c n=148 e n=143 g n=137 (SG)
b n=160 d n=152 f n=145 h n=140 (CG)
Table 48 reveals that during posttest I, the mean state anxiety score for study
group was 47.85 with SD 9.29. For the control group, the mean value was 52.24 with SD
9.26. During posttest II, the mean values for the study and control groups were 44.95
and 52.95 respectively. Again for posttest III, the mean state anxiety scores were were
41.53 and 60.57 for study and control groups. There was a statistically significant
difference between the study and control groups at the level of p< 0.001.
For trait anxiety, during posttest II, the study and control groups differed
statistically at p< 0.001. The posttest III mean score for trait anxiety were 44.89 and
49.89 for study and control groups, which also differed significantly at p< 0.01.
Anxiety Posttest
Study Group
Control Group
t & p value Mean SD Mean SD
State
Ia,b
52.18 9.29 57.50 9.26 -7.35,
0.0001 ***
IIc,d
49.61 9.18 59.0 9.23 -12.51,
0. 0001 ***
IIIe,f 46.65 8.29 60.57 9.07 -18.03,
0.0001 ***
Trait
Ia,b 46.29
11.85 49.44 10.57 -4.14,
0.0001 ***
IIc,d
44.81 11.70 49.50 10.77 -6.31,
0.0001 ***
IIIe,f
44.12 10.84 49.93 10.73 -8.13,
0.0001 ***
0
10
20
30
40
50
60
70
Pretest
54.3255.23M
ean
sco
re o
f an
xiet
y
p=0.0001
41
42
43
44
45
46
47
48
49
50
Pretest
47.69
48.57
Mea
n s
core
of
anxi
ety
p=0.320
Figure 37: Comparison of mean score of state anxiety among patients with stage II
hypertension in the study and
Figure 38: Comparison of mean score of trait anxiety among patients with stage II
hypertension in the study and control groups before and after intervention
Posttest I Posttest II Posttest III
52.1849.61
46.65
55.23 57.5 59 60.57
p=.00001 p=0.0001 p=0.0001
Posttest I Posttest II Posttest III
46.29
44.8144.12
48.57
49.44 49.549.93
p=0.320 p=0.0001 p=0.0001 p=0.0001
: Comparison of mean score of state anxiety among patients with stage II
hypertension in the study and control groups before and after intervention
: Comparison of mean score of trait anxiety among patients with stage II
hypertension in the study and control groups before and after intervention
154
Study group
Control group
Study group
Control group
p=0.0001
: Comparison of mean score of state anxiety among patients with stage II
control groups before and after intervention.
: Comparison of mean score of trait anxiety among patients with stage II
hypertension in the study and control groups before and after intervention.
155
Table 49
Comparison of mean difference of state anxiety among patients with stage II
hypertension in the study and control groups before and after intervention.
State
anxiety
Study Group
Control Group
t & p value
Mean
Difference
SD
Mean
difference SD
Pretesta,b-
Posttest Ic,d 2.15 0.97 -2.27 2.46 19.61
0.0001 ***
Pretest-
Posttest IIe,f 4.72 1.75 -3.77 3.24
27.03
0.0001 ***
Pretest-
Posttest IIIg,h 7.67 2.09 -5.34 4.24
32.28
0.0001 ***
*** p< 0.001 a n=160 c n=148 e n=143 g n=137 (SG)
b n=160 d n=152 f n=145 h n=140 (CG)
The table 49 depicts that from pretest to posttest I, the mean difference was 2.15
with SD of .974 in the study group, and in the control group, the mean difference was
-2.27 and the SD was 2.46. From pretest to posttest II, the mean difference was 4.72 with
SD of 1.75 in the study group and in the control group, the mean difference was -3.77
and the SD was 3.24. From pretest to posttest III, the mean difference was 7.67 with SD
of 2.087 in the study group and in the control group, the mean difference was -5.34 and
the SD is 4.24. There was a significant reduction in the mean difference of the level of
state anxiety between the study and control groups at the level of p< 0.001 at all
durations of measurement.
156
Table 50
Comparison of mean difference of trait anxiety among patients with stage II
hypertension in the study and control groups before and after intervention.
Trait
anxiety
Study
Group
Control
Group
t & p value Mean
Difference SD
Mean
difference SD
Pretesta,b_
Posttest Ic,d 1.40 0.97 -0.87 1.19 15.33
0.0001 ***
Pretest-
Posttest IIe,f 2.88 1.67 -0.93 2.74
13.95
0.0001 ***
Pretest-
Posttest IIIg,h 3.57 2.09 -1.36 2.00
20.07
0.0001 ***
*** p< 0.001 a n=160 c n=148 e n=143 g n=137 (SG)
b n=160 d n=152 f n=145 h n=140 (CG)
Table 50 depicts that from pretest to posttest I, the mean difference was 1.40 with
SD of .97 in the study group and -0.87 with 1.19 in the control group. The mean
difference from the pretest to posttest II was 2.88 with SD of 1.67 in the study group
and -0.93 with 2.74 in the control group. The mean difference from the pretest to
posttest III was 3.57 with SD of 2.09 in the study group and -1.36 with 2.00 in the
control group. There was a significant difference in the trait anxiety mean difference
between the study and control groups at a level p < 0.001 at all durations of
measurement.
Table 51
Repeated measures ANOVA of state anxiety among patients with stage II
hypertension between the study and the control groups
intervention.
Duration Study
Pretesta,b 54.32
Posttest Ic,d 52.18
Posttest IIe,f 49.61
Posttest IIIg,h 46.65
*** p< 0.001 a n=160 c n=148
b n=160 d n=152 Table 51 reveals the RM
hypertension. During pretest and the three posttests, the mean scores of study group were
54.32, 52.18, 49.61 and 46.65 respect
-6
-4
-2
0
2
4
6
8
Study Group
State anxiety
2.15
-
4.72
7.67
Mea
n d
iffe
ren
ce o
f an
xiet
y
p=0.0001
Figure 39: Comparison of mean difference of anxiety among patients with stage II
hypertension in the study and control groups before and after intervention
Repeated measures ANOVA of state anxiety among patients with stage II
hypertension between the study and the control groups before and after
tudy Group F & p value Control Group
54.32
1341.94
0.0001***
55.23
52.18 57.50
49.61 59.00
46.65 60.57
n=148 e n=143 g n=137 (SG)
n=152 f n=145 h n=140 (CG)
reveals the RM ANOVA of state anxiety among patients with stage I
hypertension. During pretest and the three posttests, the mean scores of study group were
54.32, 52.18, 49.61 and 46.65 respectively. There was a significant difference
Control group
Study Group
Control group
State anxiety Trait anxiety
-2.271.4
-0.87
-3.77
2.88
-0.93-5.34
3.57
-1.36
p=0.0001 p=0.0001 p=0.0001
: Comparison of mean difference of anxiety among patients with stage II
hypertension in the study and control groups before and after intervention
157
Repeated measures ANOVA of state anxiety among patients with stage II
before and after
F & p value
169.24
0.0001***
ANOVA of state anxiety among patients with stage I
hypertension. During pretest and the three posttests, the mean scores of study group were
difference in the
1.36
Pretest -Posttest I
Pretest -Posttest II
Pretest -Posttest III
: Comparison of mean difference of anxiety among patients with stage II
hypertension in the study and control groups before and after intervention.
158
level of state anxiety during posttest I, II and III at level p<0.01, whereas in the control
group, it was significant raise during posttest I, II and III.
Table 52
Repeated measures ANOVA of trait anxiety among patients with stage II
hypertension between the study and the control groups before and after
intervention.
Duration Study Group F & p value
Control Group
F & p value
Pretesta,b 47.69
326.19
0.0001 ***
48.57
20.36
0.0001 ***
Posttest Ic,d 46.29 49.44
Posttest IIe,f 44.81 49.50
Posttest IIIg,h 44.12 49.93
*** p< 0.001 a n=160 c n=148 e n=143 g n=137 (SG)
b n=160 d n=152 f n=145 h n=140 (CG)
Table 52 reveals the RMANOVA of trait anxiety among patients with stage I
hypertension. During pretest and the three posttests, the mean scores of study group were
47.69, 46.29, 44.81 and 44.12 respectively. There was a significant reduction in the level
of state anxiety during posttest I, II and III at level p<0.01, whereas in the control group,
it was significant raise during posttest I, II and III.
Table 53
Comparison of mean score of galvanic skin response (GSR) among patients with
stage II hypertension in the study group before and after intervention.
GSR
value in
kilo
ohms
Pretesta Posttest Ib Posttest IIc Posttest IIId F & p
value Mean SD Mean SD Mean SD Mean SD
593.
57
187.
70 626.73
187.
45
654.
28
188.
38
682.
68
190.
92
358.16
0.0001
***
*** p < 0.001 a n=160 b n=148 c n=143 d n=137 (SG)
Table 53 depicts that the mean GSR value during pretest was 593.57 in the study
group. The mean values for
respectively. The difference
between the pre and posttests wa
540
560
580
600
620
640
660
680
700
Pretest
593.57
Mea
n G
SR
in
kil
o oh
ms
Figure 40: Comparison of GSR
in the study group before and after intervention
epicts that the mean GSR value during pretest was 593.57 in the study
group. The mean values for posttest I, II and III were 626.73, 654.28
respectively. The difference in the galvanic skin response in the study group patients
between the pre and posttests was significant with an F value of 358.16 at level p< 0.001.
Pretest Posttest I Posttest II Posttest III
593.57
626.73
654.28
682.68
Duration
p=0.0001
Comparison of GSR among the patients with stage II hypertension
before and after intervention.
159
epicts that the mean GSR value during pretest was 593.57 in the study
654.28 and 682.68
in the galvanic skin response in the study group patients
of 358.16 at level p< 0.001.
Pretest
Posttest I
Posttest II
Posttest III
among the patients with stage II hypertension
Section III: b) Relationship between anxiety, blood pressure and outcome of BART among patients with stage II hypertension in the
study and control group
Table 54
Correlation of blood pressure and anxiety with GSR and abdominal breathing practice among patients with stage II hypertension in the
study group during pretest and posttest III
Variable
Pretest
systolic
BP
r & p
value
Pretest
diastolic
BP
r & p
value
Pretest
trait
Anxiety
r & p
value
Pretest
state
anxiety
r & p
value
Posttest
Systolic
BP
r & p
value
Posttest
Diastolic
BP
r & p
value
Posttest
Trait
anxiety
r & p
value
Posttest
state
anxiety
r & p
value
Pretest
GSR
r & p
value
Posttest
GSR
r & p
value
Days of Home
Practice
r & p value
Pretesta systolic BP
1 -0.49
0.0001 ***
0.99 0.0001
***
-0.49 0.0001
***
0.05 0.605 NS
-0.03 0.738 NS
0.03 0.621 NS
-0.02 0.786 NS
-0.51 0.057 NS
-0.04 0.675 NS
-0.08
0.333 NS
Pretest diastolic BP
1 -0.47
0.0001 ***
0.97 0.0001
***
0.03 0.696 NS
-0.05 0.586 NS
0.07 0.402 NS
-0.03 0.733 NS
0.04 0.619 NS
-0.02 0.866 NS
0.05
0.589 NS
Pretest trait anxiety
1 -0.45
.000 *** 0.06
.518 NS -0.03
.576 NS 0.56
.048 * 0.82
.020 * -0.06
.522 NS -0.69 .035 *
0.36
.079 NS
Pretest state anxiety
1 0.05
0.559 NS -0.05
0.625 NS 0.31
0.087 NS 0.80
0.022 *
0.05 0.605 NS
-0.90 0.011 *
0.37
0.077 NS
160
Table 54 Contd...
Correlation of blood pressure and anxiety with GSR and abdominal breathing practice among patients with stage II hypertension in the
study group during pretest and posttest III
Variable
Pretest
systolic
BP
r & p
value
Pretest
diastolic
BP
r & p
value
Pretest
trait
Anxiety
r & p
value
Pretest
state
anxiety
r & p
value
Posttest
Systolic
BP
r & p
value
Posttest
Diastolic
BP
r & p
value
Posttest
Trait
anxiety
r & p
value
Posttest
state
anxiety
r & p
value
Pretest
GSR
r & p
value
Posttest
GSR
r & p
value
Days of Home
Practice
r & p value
Posttest IIIb Systolic BP
1 0.59 .0001 ***
0.95 .0001 ***
0.58 .0001 ***
0.01 0.953 NS
-0.04 0.658 NS
-0.01 0.973 NS
Posttest III Diastolic BP
1 0.54
0.0001 ***
0.95 0.0001
***
-0.12 0.178 NS
-0.11 0.196 NS
0.01
0.878 NS
Posttest III Trait anxiety
1 0.54
0.0001 ***
-0.02 0.840 NS
-0.46 0.063 NS
0.78 0.024 *
Posttest III state anxiety
1 -0.14
0.106 NS -0.12
0.135 NS
0.64 0.040 *
Pretest GSR
1 0.97
0.0001 *** -0.17
0.118 NS
Posttest III GSR
1 -0.323 0.085
Total days of home Practice
1
NS-Not Significant *p<0.05 ** p< 0.01 *** p<0.001 a n=160, b n=137 161
Table 54 depicts the correlation between the systolic and diastolic BP, state and trait anxiety , GSR & home practice during pre and post
tests in the study group. There was correlation between the systolic and diastolic BP, state and trait anxiety, GSR & home practice during pre
and post tests in the study group (table 55). During pretest, there was no correlation observed between anxiety and blood pressure. During
posttest III, significant positive correlation was observed between TA & SBP (r = 0.58) SA &SBP (r=0.82), SA& DBP (r =0.80). Significant
negative correlation was observed between GSR with SBP (r = -0.69), DBP(r = -0.90), SA (r = -0.11) & TA (r = -0.46). Negative correlation
also existed between total days of home practice with SBP (r = -0.36), DBP (r = -0.37), SA (r = -0.64), TA (r = -0.78) and GSR value (r = -0.32).
Table 55
Correlation between blood pressure and anxiety among patients with stage II hypertension in the control group during pretest and
posttest III.
Variable
Pretest
systolic BP
r & p value
Pretest
diastolic BP
r & p value
Pretest trait
Anxiety
r & p value
Pretest state
anxiety
r & p value
Posttest
Systolic BP
r & p value
Posttest
Diastolic BP
r & p value
Posttest
Trait anxiety
r & p value
Posttest state
anxiety
r & p value
Pretesta
systolic BP
1 -0.16 S
0.0001 ***
0.96
0.0001 ***
-0.47
0.0001 ***
0.17
0.046*
-0.08
0.342 NS
0.15
0.084 NS
0.60
0.046 *
Pretest
diastolic BP
1 -0.49
0.0001 ***
0.95
0.0001 ***
-0.11
0.205 NS
-0.07
0.399 NS
-0.10
0.259 NS
-0.62
0.092 NS
Pretest trait
anxiety
1 -0.47
0.0001 ***
0.17
0.049 *
0.19
0.315 NS
0.18
0.030 *
0.17
0.042 *
Pretest state
anxiety
1 -0.10
0.257 NS
0.05
0.524 NS
0.47
0.062 *
0.60
0.045 *
Posttest IIIb
Systolic BP
1 0.84
0.0001 ***
0.94
0.0001 ***
0.50
0.0001 ***
162
Table 55 Contd...
Correlation between blood pressure and anxiety among patients with stage II hypertension in the control group during pretest and
posttest III.
Variable
Pretest
systolic BP
r & p value
Pretest
diastolic BP
r & p value
Pretest trait
Anxiety
r & p value
Pretest state
anxiety
r & p value
Posttest
Systolic BP
r & p value
Posttest
Diastolic BP
r & p value
Posttest
Trait anxiety
r & p value
Posttest state
anxiety
r & p value
Posttest III
Diastolic BP
1 0.79
0.0001 ***
0.71
0.0001 ***
Posttest III
Trait anxiety
1 0.51
0.0001 ***
Posttest III
state anxiety
1
NS-Not Significant *p<0.05 ** p< 0.01 *** p<0.001 a n=160, b n=140
The above table shows that among the control group patients (table 56), there was positive correlation between SBP & TA (r = 0.169)
and DBP & TA (r = 0.11) during pretest. During posttest, positive correlations were observed between SA &SBP (r = 0.17), SA & DBP
(r = 0.60), TA & SBP (r = 0.18) and TA & DBP (r= 0.47).
163
164
Section IV: Comparison of effect of BART on blood pressure and anxiety between
the patients with stage I & stage II hypertension
Table 56
Comparison of effect of BART on BP and anxiety among the patients with stage I &
stage II hypertension between the study groups
Variable Duration of
the study
Mean
diff. in
stage I
Mean
diff. in
stage II
Mean diff.
I- Mean
diff. II
t & p
value
Systolic BP Pretesta,b-
posttest IIIc,d
3.74 3.55 0.19 1.47,
0.143 NS
Diastolic BP Pretesta,b-
posttest IIIc,d
2.47 3.18 -0.71 3.90,
0 .0001***
Trait anxiety Pretesta,b-
posttest IIIc,d
9.40 7.67 1.73 6.32,
0 .0001***
State anxiety Pretesta,b-
posttest IIIc,d
3.98 3.57 0.41 4.46,
0.0001 ***
GSR Pretesta,b-
posttest IIIc,d
55.30 89.01 -23.71 -3.34,
0.0001 ***
NS- Not significant *** p<0.001 a n=173 c n=150 for stage I, b n=160 d n=137 for stage II.
Table 56 depicts that the mean difference of systolic BP from pretest to posttest
III was 3.74 among patients with stage I hypertension and 0.19 for stage II hypertension.
The mean difference of diastolic BP from pretest to posttest III was 2.47 among patients
with stage I hypertension and 0.71 for stage II. For trait anxiety, the mean differences
were 9.40 and 1.73 for stage I and stage II respectively. The state anxiety mean
differences were 3.98 and 0.41 for stage I and II hypertension patients. Mean differences
for GSR among the stage I and II hypertension patients were 55.30 and 23.71. The mean
differences in the blood pressure, anxiety and GSR in the study group patients during
the pre and posttests between stage I Stage II hypertension patients was significant at
p<0.001 except for systolic BP, for which the change in the mean differences was not
statistically significant (t= 1.469 and p= 0.143) between the two stages of hypertension.
0
1
2
3
4
5
6
7
8
9
10
Systolic
3.74 3.547
Mea
n d
iffe
ren
ce p=0.143
Figure 41: Comparison of effect of
with the stage
Diastolic Trait State
2.47
9.4
3.98
3.182
7.672
3.569
p=0.0001p=0.0001
p=0.0001
Comparison of effect of BART on BP and anxiety among patients
with the stage I & stage II hypertension in the study groups
165
MD in stage I
MD in stage II
BART on BP and anxiety among patients
pertension in the study groups.
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