International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 7 Issue 1, January-February 2023 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

A Study to Assess the Effectiveness of Amla Juice with

Honey to Reduce the Blood Pressure Level among
Hypertension Patients in Selected Urban Area
Mrs. Sindhu Priya. R1, Ms. Umamageshwari S2, Ms. Kanimozhi. N2
1
M.Sc., (N), Clinical Instructor, Department of Community Health Nursing, Saveetha College of Nursing,
2
B.Sc(N), Saveetha College of Nursing,
1,2
Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India

ABSTRACT How to cite this paper: Mrs. Sindhu

BACK GROUND: The present study aim to effectiveness of Amla Priya. R | Ms. Umamageshwari S | Ms.
Juice with Honey to reduce the blood pressure level among Kanimozhi. N "A Study to Assess the
hypertensive patients in selected urban area. METHODS AND Effectiveness of Amla Juice with Honey
MATERIALS: The quantitative approach with One group pretest to Reduce the Blood Pressure Level
among Hypertension Patients in Selected
posttest experimental research design was used for the present study.
Urban Area"
A total 100 samples were collected using non probability purposive Published in
sampling technique. The demographic data and clinical variables International Journal
were gathered using self-administered questionnaire, followed by that of Trend in Scientific
data was gathered and analyzed. RESULTS: In the pretest, 37(37%) Research and
had systolic BP less than 120 mmHg, 31(31%) had 121 – 139, Development (ijtsrd),
28(28%) had 141 – 159 mmHg and 4(4%) had ≥160 mmHg of ISSN: 2456-6470, IJTSRD52637
systolic BP whereas in the post-test, 62(62%) had less than 120 Volume-7 | Issue-1,
mmHg and 38(38%) had 121 – 139 mmHg of systolic BP.37(27%) February 2023, pp.107-114, URL:
had diastolic BP less than 80 mmHg, 30(30%) had 80 – 89 mmHg, www.ijtsrd.com/papers/ijtsrd52637.pdf
26(26%) had 90 – 99 mmHg and 7(7%) had ≥100 mmHg of diastolic
Copyright © 2023 by author (s) and
BP whereas in the post-test, 57(57%) had less than 80 mmHg and
International Journal of Trend in
43(43%) had 80 – 89 mmHg of diastolic BP. CONCLUSION: Thus, Scientific Research and Development
the present despites that reduce the blood pressure level among Journal. This is an
hypertensive patients. Open Access article
distributed under the
KEYWORDS: Hypertension, Amla juice, Honey, Blood Pressure terms of the Creative Commons
Level Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)

INTRODUCTION
Hypertension is a condition in which blood pressure is closer to 12.8%. Nearly 40% of people worldwide
is abnormally high when the average of at least two who are 25 years of age or older have hypertension;
accurate blood pressure measurements obtained at this is an increase from the 600 million cases reported
least twice in two visits is equal to or higher than 140 in 1980 to roughly 1 billion cases reported in 2008
mmHg for the systolic blood pressure (SBP) and/or [3].The leading cause of preventable illnesses and
90 mmHg for the diastolic blood pressure (DBP), the deaths in India is hypertension. It is a significant
condition is known as hypertension. [1] contributor to the risk of cardiovascular disease,
More than 41 million people worldwide pass away which contributed to 32% of adult fatalities and 23%
each year from non-communicable diseases (NCDs), of all deaths between 2010 and 2013. In order to
achieve the Sustainable Development Goals (SDG)
accounting for 71% of all fatalities. Of the 15 million
people who pass away between the ages of 30 and 70, aim of lowering premature mortality from
many of them do so prematurely. [2]Untreated noncommunicable diseases (NCDs) by one-third by
hypertension is one of the major issues in developing 2030, India has pledged to implement a number of
nations since it can result in serious and perhaps fatal initiatives [4].HTN is the most prevalent non-
illnesses. According to the statistics data, communicable disease in the majority of African
hypertension is thought to be the cause of 7.5 million nations, and in Cameroon in particular[5].According
fatalities worldwide each year, but the actual number to various evaluations, the prevalence of HTN in the

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
Middle East and eastern Mediterranean countries [11] Its antibacterial, carminative, hypoglycemic,
ranged from 17 to 39%, and recent social and stomachine hypotensive, and astringent activity also
economic changes in these regions contributed to the controls hyperacidity and prevents infection, aids in
high prevalence of the condition [6].One of the main ulcer healing, and treats jaundice, dyspepsia, and
causes of the rising prevalence of hypertension in cough. Alma is a good cardio tonic, and its modest
India is a lack of awareness. Many people are heart stimulating activity aids in blood pressure
unaware of their hypertension condition, and in some regulation. Gooseberry continues to be a widely used
cases the cause of death is still unknown because tonic. The fruit of the gooseberry contains 81.2%
most people with hypertension remain healthy and are water, making it an excellent source of moisture for
only identified when cardiovascular disease or a the skin. The highest natural source of vitamin C is
stroke manifests. According to the estimate of the found there. About 700 mg of vitamin C may be
global burden of diseases from 2015, hypertension is found in 100 g of amla, which is thirty times more
one of the leading causes of death[7].Both urban and than in an orange. Additionally, it contains tannic
rural populations are now more likely to have HTN. acids, calcium, iron, protein, carbs, sugar, and
In India, the prevalence of hypertension has increased phosphorus. [12]
over the past 60 years from 2% to 25% in urban areas
MATERIAL AND METHODS:
and from 2% to 15% in rural areas. [8] Study design: The quantitative approach with one
This includes weight loss by food intervention, group pre-test post-test experimental design was
quitting smoking, and engaging in physical activity. designed to investigate the effectiveness of Amla
Comprehensive hypertension care should prioritise Juice with Honey to reduce the blood pressure level
lowering cardiovascular risk as well as blood pressure among hypertensive patients in selected urban area.
through lifestyle changes, cholesterol control, quitting Study Setting: This study was conducted for 1 month
smoking, and regular exercise. [9] from 1st March 2022 till 30th march 2022 in the
It is a silent killer since very few early symptoms are Nerkundram.
ever noticed before a serious medical emergency like Ethical Approval: After obtaining ethical clearance
a heart attack, stroke, or chronic renal disease occurs. from the Institutional Ethical Committee (IEC) of
Only through measures may elevated blood pressure Urban Primary Health Centre(UPHC) and formal
be found since people are not aware of it. Although permission from the medical officer the main study
the majority of hypertension patients experience no was conducted.
symptoms, some HTN sufferers report headaches,
dizziness, vertigo, blurred vision, or fainting episodes. Study participants: A total 100 reproductive women
[10] aged between 40 to 60 years identify the hypertensive
patients. The inclusion criteria for the study, Clients
Thiazide diuretics and beta blockers are examples of with hypertension who are willing to participate,
medications used to treat high blood pressure. ACE Clients who are in the age group of 40 to 60 years of
drugs, or angiotensin-converting enzyme inhibitors. age, Clients who are having hypertension above
Blockers of the angiotensin II receptor (ARBs) 140/90 mmHg, Clients with hypertension who had no
Blockers of calcium channels Vasodilators and Renin other co morbidities, exclusion criteria for the study
Inhibitors. This study supports non-pharmacological are, Clients with hypertension not willing to
interventions for the management of high blood participate in the study, Clients with hypertension
pressure, including weight loss, increased physical with other comorbid conditions were excluded,Clients
activity, moderate alcohol consumption, reduced salt who are sensitivity to amla juice, Clients who are
intake, fish oil supplementation, behavioural having hypertension above 180/110 mmHg.
techniques like meditation and yoga, herbal remedies,
and garlic. Indian gooseberry, fish oil, and omega-3 Sampling Technique: A total of 100 hypertensive
fatty acids can lessen the effects of hypertension. The patients were recruited based on the inclusion criteria
most popular herb in ayurveda is amla; it balances the by using convenience sampling technique.
three Doshas of vayu, pitta, and kapha, aids with Informed Consent: The purpose of the study was
cardiac and digestive issues, strengthens the immune explained by the investigator to each of the study
system, enhances vision, provides a healthy glow to participants and a written informed consent was
the skin and hair, and is a rich source of vitamin C. obtained from them.

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RESULTS AND DICUSSION
DESCRIPTION OF THE DEMOGRAPHIC VARIABLES OF THE CLIENTS WITH HYPERTENSION
Table 1: Frequency and percentage distribution of demographic variables of clients with hypertension
n = 100
Demographic Variables F %
Age in years
26 – 35 29 29.0
36 – 45 33 33.0
46 – 55 22 22.0
>55 16 16.0
Marital status
Married 74 74.0
Unmarried 12 12.0
Widow 5 10.0
Divorce 9 18.0
Religion
Hindu 55 55.0
Muslim 20 20.0
Christian 25 25.0
Others 0 0
Educational status
Primary 36 36.0
Secondary 26 26.0
Higher secondary 19 19.0
Degree 19 19.0
Illiterate - -
Occupational status
Employed 38 38.0
Unemployed 16 16.0
Business 31 31.0
Labourer 15 15.0
Income
Rs.3000 – 4999 27 27.0
Rs.5000 – 9999 41 41.0
Rs.10,000 – 14,999 10 10.0
Rs.15,000 and above 22 22.0
Type of family (composition of family)
Nuclear 78 78.0
Joint 22 22.0
Extended - -
Type of diet
Vegetarian 29 29.0
Non-vegetarian 22 22.0
Mixed 49 49.0
Mode of delivery
Normal vaginal delivery 55 55.0
Caesarean delivery 31 31.0
Instrumental delivery 14 14.0
Area of residence
Urban 57 57.0
Rural 38 38.0
Others 5 5.0

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Socio economic status
Lower 7 7.0
Middle 73 73.0
Upper 20 20.0
The table 1 shows that most of the clients with hypertension, 33(33%) were aged between 36 – 45, 74(74%)
were married, 55(55%) were Hindus, 36(36%) had primary education, 38(38%) were employed, 41(41%) had an
income of Rs.5000 – 9999, 78(78%) belonged to nuclear family, 49(49%) were mixed diet, 55(55%) had normal
vaginal delivery, 57(57%) were residing in urban area and 73(73%) belonged to middle class.

Percentage distribution of educational status of the clients with hypertension

Percentage distribution of area of residence of the clients with hypertension

ASSESSMENT OF BLOOD PRESSURE AMONG CLIENTS WITH HYPERTENSION
Table 2: Frequency and percentage distribution of pretest and post-test level of systolic BP among
clients with hypertension
n= 100
Pretest Post-test
Systolic BP
F % F %
Less than 120 mmHg 37 37.0 62 62.0
121 – 139 mmHg 31 31.0 38 38.0
141 – 159 mmHg 28 28.0 - -
≥160 mmHg 4 4.0 - -

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The above table shows that in the pretest, 37(37%) had systolic BP less than 120 mmHg, 31(31%) had 121 –
139, 28(28%) had 141 – 159 mmHg and 4(4%) had ≥160 mmHg of systolic BP whereas in the post-test,
62(62%) had less than 120 mmHg and 38(38%) had 121 – 139 mmHg of systolic BP.

Percentage distribution of pretest and post-test level of systolic BP among clients with hypertension
Table 3: Frequency and percentage distribution of pretest and post-test level of diastolic BP among
clients with hypertension
n= 100
Pretest Post-test
Diastolic BP
F % F %
Less than 80 mmHg 37 37.0 57 57.0
80 – 89 mmHg 30 30.0 43 43.0
90 – 99 mmHg 26 26.0 - -
≥100 mmHg 7 7.0 - -
The above table shows that in the pretest, 37(27%) had diastolic BP less than 80 mmHg, 30(30%) had 80 – 89
mmHg, 26(26%) had 90 – 99 mmHg and 7(7%) had ≥100 mmHg of diastolic BP whereas in the post-test,
57(57%) had less than 80 mmHg and 43(43%) had 80 – 89 mmHg of diastolic BP.

Percentage distribution of pretest and post-test level of diastolic BP among clients with hypertension

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
EFFECTIVENESS OF AMLA JUICE AND HONEY TO REDUCE THE BLOOD PRESSURE AMONG
CLIENTS WITH HYPERTENSION
Table 4: Comparison of pretest and post-test level of blood pressure among clients with hypertension
n = 100
Pretest Post-test
Variables Mean Difference score Paired ‘t’ test & p-value
Mean S.D Mean S.D
Systolic BP 126.60 18.43 113.50 10.48 13.10 t = 7.662 p=0.0001, S***
Diastolic BP 79.70 10.87 73.40 6.39 6.30 t = 5.096 p=0.0001, S***
***p<0.001, S – Significant
The table 4 shows that the mean score of systolic BP was 126.60±18.43 and the post-test mean score was
113.50±10.48. The mean difference score was 13.10. The mean score of diastolic BP was 79.70±10.87 and the
post-test mean score was 73.40±6.39. the mean difference score was 6.30. The calculated paired ‘t’ test value for
systolic BP (t=7.662) and diastolic BP (t=5.096) was found to be statistically significant at p<0.001 level which
clearly infers that the administration of Amla juice with Honey among clients with hypertension was found to be
effective in reducing the level of blood pressure in the post-test.
ASSOCIATION OF POST-TEST LEVEL OF BLOOD PRESSURE AMONG CLIENTS WITH
HYPERTENSION WITH SELECTED DEMOGRAPHIC VARIABLES
Table 5: Association of post-test level of blood pressure among clients with hypertension with selected
demographic variables
n = 100
Chi-square and p-value
Demographic Variables
Systolic BP Diastolic BP
Age in years
26 – 35 χ2=3.953 χ2=4.206
d.f=3 d.f=3
36 – 45
p=0.267 p=0.240
46 – 55
.N.S .N.S
>55
Marital status
Married χ2=0.884 χ2=3.595
d.f=3 d.f=3
Unmarried
p=0.829 p=0.309
Widow
.N.S .N.S
Divorce
Religion
Hindu χ2=1.570 χ2=0.909
d.f=2 d.f=2
Muslim
p=0.456 p=0.635
Christian
.N.S .N.S
Others
Educational status
Primary χ2=2.882 χ2=9.755
Secondary d.f=3 d.f=3
Higher secondary p=0.413 p=0.021
Degree .N.S .S*
Illiterate
Occupational status
Employed χ2=1.412 χ2=0.632
d.f=3 d.f=3
Unemployed
p=0.703 p=0.889
Business
.N.S .N.S
Labourer
Income
Rs.3000 – 4999 χ2=2.679 χ2=2.153
d.f=3 d.f=3
Rs.5000 – 9999
p=0.444 p=0.541
Rs.10,000 – 14,999
.N.S .N.S
Rs.15,000 and above

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Type of family (composition of family) χ2=0.665 χ2=0.069
Nuclear d.f=1 d.f=1
Joint p=0.415 p=0.792
Extended .N.S .N.S
Type of diet χ =1.975
2
χ =1.596
2

Vegetarian d.f=2 d.f=2

Non-vegetarian p=0.372 p=0.450
Mixed .N.S .N.S
Mode of delivery χ =0.038
2
χ =0.024
2

Normal vaginal delivery d.f=2 d.f=2

Caesarean delivery p=0.981 p=0.988
Instrumental delivery .N.S .N.S
Area of residence χ =6.353
2
χ =1.336
2

Urban d.f=2 d.f=2

Rural p=0.042 p=0.513
Others S .N.S
Socio economic status χ =0.662
2
χ =0.653
2

Lower d.f=2 d.f=2

Middle p=0.718 p=0.721
Upper .N.S .N.S
*p<0.05, S – Significant, N.S – Not Significant
The table 5 shows that the demographic variable area of residence (χ2=6.353, p=0.042) had shown statistically
significant association with post-test level of systolic BP among clients with hypertension at p<0.05 level and the
other demographic variables had not shown statistically significant association with post-test level of systolic BP
among clients with hypertension.
The table 5 shows that the demographic variable area of educational status2 (χ2=9.755, p=0.021) had shown
statistically significant association with post-test level of diastolic BP among clients with hypertension at p<0.05
level and the other demographic variables had not shown statistically significant association with post-test level
of diastolic BP among clients with hypertension.
CONCLUSION: REFERENCE:
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Juice with Honey to reduce the blood pressure level Uncontrolled Hypertension and Associated
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[2] Vijna, Mishra, Chandra Pati (2022). Prevalence
reducing the level of blood pressure. So, In order to
and predictors of hypertension. Journal of
contain and reduce the hypetension among clients
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with hypertension the Amla Juice with Honeycan be
2022 - Volume 11 - Issue 3 - p 1047-1054.
administered at hospital setting to promote early
recovery by the patients. [3] SahbanathulMissriya Ma, Johncey John (2017).
Assess the prevalence of hypertension and
ACKNOWLEDGMENT: knowledge regarding the prevention of stroke.
Authors would like to appreciate all the study
Asian J Pharm Clin Res, Vol 10, Issue 8, 177-
participants for their co-operation to complete the
180.
study successfully.
[4] Ghosh S, Kumar M. (2019). Prevalence and
CONFLICT OF INTEREST: associated risk factors of hypertension among
Authors declare no conflict of interest.
persons aged 15–49 in India: a cross-sectional
FINDING SUPPORT: study. BMJ Open; 9: e029714. doi: 10. 1136/
None bmjopen-2019-029714

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