The effectiveness of a lifestyle-based intervention on physical activity, blood pressure, and health-related quality of life in older adults with hypertension

The purpose of this study was to explore the effects of a 6-month lifestyle intervention in older adults with hypertension. A secondary data analyses was used from Inter-University Consortium for Political and Social Research (ICPSR) to examine the differences between the intervention and the control groups in the changes in physical activity, blood pressure, and health-related quality of life (HRQOL) in older adults with hypertension, from pre-test (baseline) to post-test (6 months), accounting for stress and social support as mediating variables. This study was a randomized controlled trial with pretest-posttest design. A total of 196 participants were randomly assigned to the intervention group (n=103) and the control group (n=93). Descriptive statistics and hierarchical multiple regression were used to analyze characteristics of the sample and hypotheses testing. Most participants were women and low income. The results of hierarchical multiple regression analyses revealed that there were no statistically significant differences between the intervention and the control groups on change in physical activity, blood pressure, and HRQOL, but the final regression models were statistically significant. In the final hierarchical regression model, demographic variables (education, gender, race, age, and monthly income), social support at baseline, and intervention vs. control accounted for 18% of the variance in change in social support (R2=.18, p < .01); demographic variables, stress at baseline, and intervention vs. control accounted for 25% of the variance in change in stress (R2=.25, p < .001). Demographic variables, SF-36 mental component summary (MCS) score at baseline, intervention vs. control, stress at baseline, change in stress, social support at baseline, and change in social support accounted for 39% of the variance in change in the SF-36 MCS (R2=.39, p < .001); demographic variables, SF-36 physical component summary (PCS) score at baseline, intervention vs. control, stress at baseline, change in stress, social support at baseline, and change in social support accounted for 18% of the variance in change in the SF-36 PCS (R2=.18, p < .05). Demographic variables, systolic blood pressure (SBP) at baseline, intervention vs. control, stress at baseline, change in stress, social support at baseline, and change in social support accounted for 36% of the variance in change in SBP (R2=.36, p < .001); demographic variables, diastolic blood pressure (DBP) at baseline, intervention vs. control, stress at baseline, change in stress, social support at baseline, and change in social support accounted for 49% of the variance in change in DBP (R2=.49, p < .001). Also, in the last step, demographic variables, physical activity frequency at baseline, intervention vs. control, stress at baseline, change in stress, social support at baseline, and change in social support accounted for 33% of the variance in change in physical activity frequency (R2=.33, p < .001). As many older adults have hypertension, promoting effective hypertension self-management is crucial for older adults. Lifestyle interventions in combination with physical activity interventions are strongly recommended. Also, stress management and social support resources should be provided for older adults with hypertension. Further research should be considered within individual, interpersonal, societal, and cultural factors when developing lifestyle-based interventions for older adults with hypertension.