Effectiveness of Cucumber in reduction of Blood Pressure among hypertensive clients in selected Rural Area.

 

Mrs. S. Vimala1 , Dr. P. Mangalagowri2, Mr. Mubarak Ali3, Ms. Nivetha4, Ms. Amutha5,  Ms. Banupriya6

1Clinical Instructor, Department of Community Health Nursing, Saveetha College of Nursing, SIMATS, Chennai, Tamil Nadu, India

2Principal, Saveetha College of Nursing, SIMATS, Chennai, Tamil Nadu, India

3,4,5,6Student, Saveetha College of Nursing, SIMATS, Chennai, Tamil Nadu, India

*Corresponding Author E-mail: stsuvi24@gmail.com

 

ABSTRACT:

One third adults worldwide are hypertensive clients. Increase blood pressure a condition that causes around half of all death from stroke and heart diseases. In rural area 20% of total population are hypertensive clients, but among them only 25% of people follows regular treatment and the rest of 75% ignore it. The main objective of this study includes the level of Hypertension among rural people and to evaluate the effectiveness of cucumber salad in control of type II diabetes mellitus. A quantitative research approach was conducted with pretest post test only design among the hypertensive clients aged between 40-60 years. Simple random sampling technique was used for sample selection. 100 grams of cucumber was administered once daily in the mid morning for two weeks . At the end of the fourth week blood pressure was measured in both experimental and control group using sphygmomanometer by observing biological variables. Data were analyzed through descriptive (frequency, percentage, distribution, mean, standard deviation) and inferential statistical (independent, paired ‘t’ test and chi square test) methods. The cucumber found to be effective in experimental group by considering SBP 6.9% of blood pressure was reduced, considering DBP 9.8% of blood pressure was reduced than the pretest. and in control group 1.84% of systolic blood pressure and 3.67% reduction of DBP than the pretest. The study proves that cucumber is effective in controlling blood pressure level more specifically diastolic blood pressure level among hypertension patients and prevents them from developing complications. It is one of the cost effective alternative source of reducing blood pressure among hypertensive clients in the community.

 

KEYWORDS: Cucumber salad, Hypertension, blood pressure, homecare, controlling BP.

 

 


INTRODUCTION:

Depends on the cardiac output and the resistance of the blood vessels. Hypertension is having a blood pressure higher than 140 over 90 mmHg, a definition shared by all the medical guidelines. High blood pressure, or hypertension, is a condition in which blood pressure is chronically elevated.

 

 

 

 

According to the National Institutes of Health, blood pressure readings of 140/90 mm-Hg1 and higher on recurring measurements is considered hypertension.2 Persistent hypertension is one of the highest risk factors for stroke, heart attack, heart failure, and arterial aneurysm. It is a leading cause of chronic kidney failure.

 

Essential or primary hypertension has no specific causes; it’s associated with genetics, environment, diet, and lifestyle factors, including salt intake, stress, and lack of exercise. Secondary hypertension is a result of other underlying-often serious-conditions such as tumors and kidney or liver disorders. Some medications, such as oral contraceptives, can also cause elevated blood pressure.3

 

Table 1: Classification of blood pressure for adults

Category

systolic, mm Hg

diastolic, mm Hg

Hypotension

< 90

< 60

Desired

90–119

60–79

Pre hypertension

120–139

80–89

Stage 1 hypertension

140–159

90–99

Stage 2 hypertension

160–179

100–109

Hypertensive urgency

≥ 180

≥ 110

Isolated systolic hypertension

≥ 160

< 90

 

Table 1 presented here shows the classification of blood pressure adopted by the American Heart Association for adults who are 18 years and older. It assumes the values are a result of averaging resting blood pressure readings measured at two or more visits to the Doctor.

 

In India, the prevalence of hypertension is reported to be increasing rapidly in the urban areas and the same trend is spreading gradually to rural area. Is estimated that there were about 66 million hypertensive in India (32 million rural and 34 million urban). Lack of knowledge about the morbidity, complications and the method of control of hypertension contributes to a large percentage of undetected and untreated hypertensive subjects in the community. Therefore, health care professionals must identify and treat patients with hypertension but also promote a healthy lifestyle and preventive strategies decrease prevalence of hypertension in the general populations

 

Management of hyper tension include and pharmacological and non pharmacological and Lifestyle modifications that effectively lower blood pressure are increased physical activity, weight loss, and limited alcohol consumption, reduce sodium intake and the dietary approaches to stop hypertension. Dietary approach to sleep hypertension (DASH) now recommended as an important nutrients and fiber but also includes foods that contain two half times the amounts of electrolytes potassium, calcium, and magnesium, phosphorus, potassium, and sodium.Population strategy is directed at the whole population irrespective if individual risk level. This involves multi factorial approach based on the non pharmacological intervention including nutrition (salt intake 5 gm per day moderate fat intake avoid alcohol) weight reduction of stress and smoking in valve yoga and meditation) self care.

 

Need for the study:

Hypertension is the most prevalent chronic disease, one in three adult hypertensive clients, approximately 20% adult population worldwide. The prevalence of hypertension in India is reported ranging from 59.9 and 69.9 per 1000 males and females in urban population and 35.5 and 35.9 per 1000 males and females in the rural population.

 

 

As a report of Daily News at Hindu, at the state level 79.8% above 35 years of age have developed hypertension. In Tamil Nadu 65.4/1000 males, 47.8/1000 females were exposed to hypertension in urban areas and 22.8/1000 males and 17.3/1000 females in rural areas. In Chennai total population affected by the hypertension is 3.041.038. In that 1.528.308 males and 1.512.730 females affected.

 

Many studies shows that cucumber which has low sodium, high amount of potassium and diuretic effect which can be used in reducing hypertension, As a community health professional, the researcher finds that cucumber which is easily available in the market can be consumed as one of the primary preventive measure for hypertension in the community settings. This vegetable is easily accepted by the clients and available at affordable cost.

 

Statement of the problem:

Effectiveness of Cucumber in reduction of blood pressure among hypertensive clients in selected rural area

 

OBJECTIVES:

To determine the effectiveness of cucumber salad in reduction of blood pressure.

 

METHODOLOGY:

An experimental study was conducted to evaluate the effectiveness of cucumber salad among hypertensive clients in a selected rural area. The setting was selected based on the feasibility of conducting the study, availability of sampling and proximity of setting to the investigator. The research tool consists of three sections include Demographic profile, Clinical variables and measurement of Blood pressure. In order to test the feasibility of the study, a pilot study was conducted among six clients in the same manner as final study. Hypertensive clients (6 in number 3 for experimental and 3 for control group) were selected using simple random sampling technique for the purpose of pilot study. Their blood pressure were assessed by the pre test using the research tools and then 100 grams of cucumber was given to the experimental group and routine treatment for control group was maintained. After a week post assessment was conducted to check the level of reduction of blood pressure using the research tool in both groups. Results were analyzed; there was a significant decrease in the level of blood pressure among hypertensive clients in experimental group after consumption of cucumber. The effect of the dependent variable on the both groups is seen before the treatment. Later, the intervention is carried out in experimental group only, and after interventions, Observation of the dependent variable is made for the both groups to examine the effect of the manipulation of the independent variable on the dependent variable.

 

There are 60 hypertensive clients between 40-60 years, who fulfill the selection criteria, were divided in two groups were selected for the main study. A self introduction was given by the investigator and the informed written consent was obtained from the patients and benefits of cucumber was explained to the participants. The objectives and purpose of the study were explained and confidentiality was maintained. The data collection procedure was done for the period of 4 weeks and the time taken for the data collection for each patient was 15-20 minutes and 5-10 minutes for checking blood pressure for each patient and the investigator selected 60 samples (30 participants in experimental and 30 in control group) by simple random sampling technique based on the inclusion and exclusion criteria. Pre and post-assessment of blood pressure level was assessed by blood pressure monitor in both experimental and control group. Left hand was used commonly and the procedure was performed in upright sitting position. The experimental group of the hypertension clients with high blood pressure above 140 mmHg was informed about benefits of the cucumber. 100gms of sliced cucumber everyday in the mid morning was given to the study participants in the experimental group for fourteen days. Then the blood pressure was taken for both experimental and control group. Control group received no intervention other than their routine treatment, and the investigator advised the study participants if they notices any adverse event they have to report it. The collected data was analyzed by using SPSS statistical package.

 

RESULT AND ANALYSIS:

Table 2: Pre and post test level of blood pressure among hypertensive clients in the experimental group

S.

No

Blood pressure

N

Mean

SD

Students paired t test

1.

Pre systole value

30

149.83

11.18

t=14.42

p=0.001

Post systole value

30

139.50

10.37

2.

Pre diastole value

30

95.33

4.9

t=16.28

p=0.001

Post diastole value

30

86.67

4.61

The above table depicts that pre test mean value of SBP is 149.83 and the post systolic blood pressure value is 139.50 . The difference is 10.33 which is considered as large difference value. So it is statistically significant (P≤0.001) in student’s paired ‘t’ test. Regarding the DBP, in the pretest mean value is 95.33 and the post test mean value is 86.67. The difference is 8.66 which is considered as large difference value. So it is statistically significant (P=0.001) in student’s paired ‘t’ test.

 

Table 3: pre test and post test level blood pressure among hypertensive clients in the control group

S.No

Blood pressure

No

Mean

SD

Student’s paired ‘t’ test

1.

Pre systole

30

150.67

10.48

t=3.610

p=0.07

Post systole

30

148.83

8.38

2.

Pre diastole

30

95.33

4.90

t=5.809

p=0.01

Post diastole

30

91.67

4.22

 

On the above table the pretest mean SBP value is 150.67 and the post value of SBP is 148.83 the difference is 1.84 which is consider small difference. So it is statistically not significant.(p>0.05) in student’s paired ‘t” test. The pre DBP is 95.33 and post DBP is 91.67 the difference is 3.66 the difference is small statistically significant in student’s paired ‘t’ test. So it is statistically significant (p≤0.08) in students paired ‘t’ test.

 

Table 4 Shows the comparison between the experimental and control blood pressure level . Differences between experimental and control group hypertension was analyzed using independent ‘t’ test .The result showed that the difference value is large. So there is a statistically significant between experimental group and control group

 

 

 

 

 


 

Table 4: Comparison of experimental and control group blood pressure

 

N

Pretest mean+SD

Post test mean+SD

Student’s paired ‘t’ test

Systole

Diastole

Systole

Diastole

Experimental group

30

149.83 ±11.18

95.33 ±4.9

139.50± 10.7

86.67±4.61

t=14.42 p=0.001***

Control group

30

150.67± 10.8

95.33±4.9

148.83±9.38

91.67±4.6

t=4.8 p=0.07

 


Table 5: Effectiveness of cucumber

 

 

 

Mean score

Mean hypertension difference with 95% Confidence Interval

Percentage of hypertension difference with 95% Confidence Interval

Experimental group

SBP

 

Pre test

149.83

10.33

(8.89-11.77)

6.9%

(5.93-7.87)

Post test

139.50

DBP

 

Pre test

95.33

8.66

(7.6-9.7)

9.08%

(7.6-9.7)

Post test

86.67

Control group

 

SBP

Pre test

150.67

1.84

(0.72-2.96)

1.22%

(0.22-2.34)

Post test

148.83

 

DBP

Pre test

95.33

3.67

(2.41-4.96)

3.84%

(2.41-4.93)

Post test

91.67

 


In experimental group considering SBP Clients blood pressure value have reduced 6.9% than pre test. Considering DBP Clients blood pressure value have reduced 9.08% of than pre test. Differences between pre test and post test score was analyzed using 95% CI(confidence Interval) and mean difference with 95% CI(confidence Interval). It shows the effectiveness of cucumber on blood pressure. In particular cucumber is more effect on diastolic than systolic blood pressure. In control group the reduction score was 1.84 of SBP and 3.84 % of DBP respectively. Here there is a minimal reduction of blood pressure with compare to experimental group.

 

DISCUSSION:

Hypertension is a disease which needs lifelong treatment. Left untreated or improperly treated, it shortens life considerably or debases its quality substantially. They can be largely avoided by taking simple precautions and proper control of the disease which would certainly make it possible to lead a normal, active and healthy life. Research has shown that blood pressure if maintained normally can prevent many hypertension-related complications. The purpose of the study was to evaluate the effectiveness of cucumber slices in control of blood pressure

 

Cucumber was found effective in reducing BP level among hypertensive clients . Comparison between the level of blood pressure value between experimental and control group showed that, in experimental group between pre test and post test the difference is large and statistically significant with p=0.0001. Natures can cure-Herbal health care,2012 reported that a study conducted by professional cardiologist, revealed that cucumbers can be amazingly useful in controlling high blood pressure. In fact, drinking its juice can help in lowering blood pressure without medications. The present study reported that the cucumber was found to be effective in experimental group by considering SBP value 6.9% of blood pressure was reduced than the pre test, and by considering DBP 9.08% blood pressure was reduced than the pre test. There is no significant reduction of blood pressure in control group.

 

CONCLUSION:

An experimental study with pretest post test control group research design was used to evaluate the effectiveness of cucumber in reducing blood pressure among hypertensive clients. Cucumber is cost effective and easily available can be used by all people daily and improve the general well being of the clients. It prevents clients from developing complication . A comparative study can be conducted using cucumber in control of Hypertension among urban and rural people. and a similar study can be conducted in other population like nurses, teachers, drivers, obese clients etc

 

ACKNOWLEDGEMENT:

Authors would like to appreciate the participating rural clients of selected villages in for their cooperation.

 

CONFLICT OF INTEREST:

Authors declares no conflict of interest

 

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Received on 01.12.2017                              Modified on 07.02.2018

Accepted on 06.03.2018                             © RJPT All right reserved

Research J. Pharm. and Tech 2018; 11(7): 2914-2917.

DOI: 10.5958/0974-360X.2018.00537.1