blood pressure is an independent risk factor of cardiovascular disease (CVD) and is a major cause of disability and death. We aimed to investigate the effectiveness of a lifestyle modification intervention program for lowering blood pressure in Narail.
A total of 300 participants with 150 adults in the intervention and 150 adults in the control arms participated in this study. The education program comprises evidence-based information with pictures, fact sheets, and published literature about the effects of high blood pressure on CVD development, the harmful effect of smoking and the importance of its cessation, increased physical activity and reduced sedentary time, the role of a healthy diet in blood pressure management. The intervention also involved motivational phone calls on a weekly basis. The control group involved providing information booklets and general advice at the baseline data collection point.
The primary outcomes were: absolute difference in clinic systolic and diastolic blood pressure.
Secondary outcomes included the difference in percentage of people adopting regular exercise habits, cessation of smoking and reducing sodium chloride intake, health literacy of all participants, the perceived barriers and enablers to adopt behaviour changes by collecting qualitative data.
SUMMARY FINDINGS
Older age, no education or being poor were associated with high blood pressure
Of the 300 participants, 144 (46.9%) were on antihypertensive drugs.
Of 144 participants on antihypertensive drugs, 7 (5%) had taken two doses, 114 (79%) had taken one dose per day and 23 (16%) were irregular.
Although less than 50% people were on antihypertensive drugs, most of the participant’s blood pressure was uncontrolled.
189 (61.6%) people owned a mobile phone, 207 (67.4%) were willing to receive SMS, and 155 (50.5%) were willing to pay for receiving SMS for health information.
Overall, 83% of people were physically active.
Of total physical activity, 63% were work-related, and 1% were recreation-related for women, and these figures were 55% and 3% for men.
62 participants were smokers and they smoked 9.6 cigarettes or bidi on average per day;
54 (87%) knew that smoking was associated with cancer.
75% of people with a higher education, but 53% of people with no education intended to quit smoking
271 (78.5%) participants consumed raw salt;
More than 80% knew that reduced raw salt was good for controlling blood pressure;
Almost everyone knew that fruits and vegetables were good for health but 95% ate fruit irregularly.
**The study finds the effectiveness of the HLS-EU-Q12 tool as a possible survey tool for assessing health literacy among adults in Bangladesh.
PEER-REVIEWED PUBLICATIONS
- Islam FMA, Lambert EA, Islam SMS, IslamMA, Biswas D, McDonaldR, Maddison R, Thompson B and Lambert GW. 2021. Lowering blood pressure by changing lifestyle through a motivational education program: A Cluster Randomised Control Trial. Trials 22, 438 (2021). https://doi.org/10.1186/s13063-021-05379-2
- Islam, FMA.Study of the psychometric properties of the HLS-EU-12 questionnaire in rural Bangladesh. PLOS One. PLOS One. 2025. 10.1371/journal.pone.0323608
- Islam, FMA. Williams, J. 2023. Factors Associated with Smoking and Smokeless Tobacco Use, Intention to Quit, and the Number of Cigarettes Smoked among Adults with High Blood Pressure in a Rural District of Bangladesh, Applied Sciences, Vol. 13, no. 9 (2023), 5355
- Islam FMA, Islam MA, Hosen MA, Lambert EA, Maddison R, Lambert GW, Thompson BR 2023. Associations of physical activity levels, and attitudes towards physical activity with blood pressure among adults with high blood pressure in Bangladesh, PLOS ONE, Vol. 18, no. 2 (Feb 2023), p. e0280879, e0280879
- Islam FMA, Wong CK, Hosen MA, Bhowmik J. 2023. Perception of and Practice in Salt and Fruit Consumption and Their Associations with High Blood Pressure: A Study in a Rural Area in Bangladesh, Applied Sciences, Vol. 13, no. 3 (Jan 2023), 1622
- Islam FMA, Lambert EA, Islam SMS, IslamMA, Maddison R, Thompson B and Lambert GW. 2021. Factors associated with uncontrolled blood pressure and the adherence to antihypertensive medication in a rural area in Bangladesh: Baseline data from a cluster RCT. BMC Public Health. https://doi.org/10.1186/s12889-021-12379-z
- Islam FMA, Lambert EA, Islam SMS, Hosen A, Thompson B and Lambert GW. 2021. Understanding the sociodemographic factors associated with intention to receive SMS messages for health information in a rural area of Bangladesh. BMC Public Health. https://doi.org/10.1186/s12889-021-12418-9
- Islam FMA. 2021 Factors associated with physical activity among people with hypertension in a rural area in Bangladesh: Base-line data from a cluster randomized control trial. International Journal of Environmental and Public Health. DOI: 10.3390/ijerph18147365