Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial.

Journal Article (Multicenter Study;Journal Article)


To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting.


Cluster randomised controlled trial.


12 randomly selected geographical census based clusters in Karachi, Pakistan.


4023 people aged 5-39 years.


Three monthly family based home health education delivered by lay health workers.

Main outcome measure

Change in blood pressure from randomisation to end of follow-up at 2 years.


Analysed using the intention to treat principle, the change in systolic blood pressure (adjusted for age, sex, and baseline blood pressure) was significant; it increased by 1.5 (95% confidence interval 1.1 to 1.9) mm Hg in the control group and by 0.1 (-0.3 to 0.5) mm Hg in the home health education group (P for difference between groups=0.02). Findings for diastolic blood pressure were similar; the change was 1.5 mm Hg greater in the control group than in the intervention group (P=0.002).


Simple, family based home health education delivered by trained lay health workers significantly ameliorated the usual increase in blood pressure with age in children and young adults in the general population of Pakistan, a low income developing country. This strategy is potentially feasible for up-scaling within the existing healthcare systems of Indo-Asia.

Trial registration

Clinical trials NCT00327574.

Full Text

Duke Authors

Cited Authors

  • Jafar, TH; Islam, M; Hatcher, J; Hashmi, S; Bux, R; Khan, A; Poulter, N; Badruddin, S; Chaturvedi, N; Hypertension Research Group,

Published Date

  • June 2010

Published In

Volume / Issue

  • 340 /

Start / End Page

  • c2641 -

PubMed ID

  • 20530082

Pubmed Central ID

  • PMC2881949

Electronic International Standard Serial Number (EISSN)

  • 1756-1833

International Standard Serial Number (ISSN)

  • 0959-8138

Digital Object Identifier (DOI)

  • 10.1136/bmj.c2641


  • eng