Evaluating a community-based walking intervention for hypertensive older people in Taiwan: A randomized controlled trial

ObjectiveTo study the effect of a community-based walking intervention on blood pressure among older people.MethodThe study design was a randomized controlled trial conducted in a rural area of Taiwan between October 2002 and June 2003. A total of 202 participants aged 60 years and over with mild to moderate hypertension was recruited. Participants randomized to the intervention group (n = 102) received a six-month community-based walking intervention based on self-efficacy theory. A public health nurse provided both face-to-face and telephone support designed to assist participants to increase their walking. Control group participants (n = 100) received usual primary health care. Primary outcome was change in systolic blood pressure and secondary outcomes were exercise self-efficacy, self-reported walking and diastolic blood pressure.ResultsAt six-month follow-up the mean change in systolic blood pressure was a decrease of 15.4 mmHg and 8.4 mmHg in the intervention and control group, respectively. The difference in mean change between the two groups was − 7.0 mmHg (95% CI, − 11.5 to − 2.5 mmHg, p = 0.002). Improvement in exercise self-efficacy scores was greater among intervention group participants (mean difference 1.23, 95% CI, 0.5 to 2.0, p = 0.001). Intervention group participants were more likely to report walking more (p < 0.0005) but no differences were observed in diastolic blood pressure (p = 0.19).ConclusionsAmong hypertensive older people, a six-month community-based walking intervention was effective in increasing their exercise self-efficacy and reducing systolic blood pressure.