chapter iv data analysis and …shodhganga.inflibnet.ac.in/bitstream/10603/50662/4/13...84 chapter...

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).


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...


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.


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


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


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





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


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


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


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


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.


ntrol group mean value was 88.70 and SD was 4.57. The mean values showed


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


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


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.


ntrol group mean value was 88.70 and SD was 4.57. The mean values showed


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


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


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


*** 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


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.


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


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


102

the control group. There is a highly significant difference in the MD during all the


before and after

F &

p value

6.20

0.003**

n=150 for the study group


0.42

Study Group

Control Group

Comparison of mean difference of BP among patients with stage I


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


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


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


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


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



Anti

hypertensive

medications

Duration



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


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



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


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


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


(N=301).

Comparison of level of state anxiety among patients with stage I hypertension in


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


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


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


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


18.6 21.3 23.4

65.4 66.6 6473.3

17.3 14.6 12.6

3.3

Duration


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.


hypertension in the control group before and after intervention.

110

Mild

Moderate

Severe

Mild

Moderate

Severe





111

Table 21

Comparison of level of trait anxiety among patients with stage I hypertension in


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


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


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.


01.


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


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


Mild

Moderate

Severe

anxiety among patients with stage I


Table 22

Comparison of pretest mean score of anxiety among patients with stage I


(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


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


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


113


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


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


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 19: Comparison of mean trait anxiety



47.8544.95

41.53

52.24 52.95 53.58

Duration

p=0.0001p=0.0001p=0.0001


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


Comparison of mean trait anxiety among patients with stage I


115

Study group

Control group

Study group

Control group





116

Table 24

Comparison of mean difference of state anxiety among patients with stage I


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

***



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


Trait anxiety


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 ***



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


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


118


before and after

F & p

value

50.16

0.0001 ***

n=150 for the study group


ANOVA of state anxiety among patients with stage I

mean score was 51.49 and

Study Group

Control Group



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


intervention.


F &

p value

Control

Group

F &

p value

Pretesta,b 48.76

80.71

0.0001 ***

48.89

10.75

0.0001 ***






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


score of galvanic skin response (GSR) among patients with


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


559.63

578.29

600.79

615.03

p=0.0001

Figure 21: Comparison of mean GSR among the patients with stage I


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


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


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).


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).


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


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..


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


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


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


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


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



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


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


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


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


Table 36

Comparison of pretest mean score of blood pressure among patients with stage II


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




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


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


137


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


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


155.15

153.61152.44

157.4 157.71158.57 158.43

Duration

p=0.001p=0.004p=0.100


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


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


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


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


intervention.

Duration Study

Pretesta,b 156.9

Posttest Ic,d 155.15



*** 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


intervention.



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



142


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



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


intervention.


F & p value

Control group

F & p value

Pretesta,b 96.69

384.16

0.0001 ***

95.67

0.89

0.418 NS




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


Anti

hypertensive

medications

Duration



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


systolic BP among patients with stage II hypertension in study and control groups


Comparison of effect of different groups of antihypertensive medications

iastolic BP among the patients with stage II hypertension between study and


Duration


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


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


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


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


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


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



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


146

antihypertensive medications and

on diastolic BP of stage II hypertension. When the mean value of SBP for


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


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.


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


Duration State

Anxiety


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


Figure 34: Distribution of level of state



7.2 7.4 9.4

78.984.7 87.6 88.6

14.98.1 5 2

Duration


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



149

Mild

Moderate

Severe

Mild

Moderate

Severe



anxiety among patients with stage II


150

Table 46

Comparison of level of trait anxiety among patients with stage II hypertension in


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


Figure 36: Distribution of level of trait anxiety among patients with stage II



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


: Distribution of level of trait anxiety among patients with stage II


151

Mild

Moderate

Severe

Mild

Moderate

Severe

it anxiety among patients with stage II


: Distribution of level of trait anxiety among patients with stage II


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


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



52.1849.61

46.65

55.23 57.5 59 60.57

p=.00001 p=0.0001 p=0.0001


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


: Comparison of mean score of trait anxiety among patients with stage II


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


155

Table 49

Comparison of mean difference of state anxiety among patients with stage II


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


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)


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


intervention.

Duration Study

Pretesta,b 54.32

Posttest Ic,d 52.18



*** 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




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


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


157


before and after

F & p value

169.24

0.0001***

ANOVA of state anxiety among patients with stage I


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


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


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 ***




*** 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


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.


593.57

626.73

654.28

682.68

Duration

p=0.0001

Comparison of GSR among the patients with stage II hypertension


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


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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