BANGALORE, KARNATAKA
ANNEXURE II
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6.1 NEED FOR THE STUDY:
European or other developed societies ranging from 10 per cent among adults. 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.1
defined as a Systolic blood pressure of 120 to 139 or Diastolic blood pressure of 80 to 89. These
individuals are at high risk of developing hypertension. The prevalence of hypertension increases
with age. People who don’t have hypertension at age of 55yrs have a 90% chance of developing
hypertension in India (eight states) out of 15,662 patients, 7,212 patients had hypertension and
Gandhi Institute of Medical Sciences, Lucknow in India revealed a high prevalence of pre-
hypertension and hypertension was noted in urban north India. Among 1112 adults belonging to
above 30yrs age, the prevalence of pre-hypertension was 32.3 percent. It was significantly higher
in males (36%) compared to females (28.1%; p< 0.0001) and the prevalence of hypertension was
factors.4
2
Potassium is a mineral that provides support to the blood pressure system as the body
requires it for regulating fluid and electrolyte levels that regulate the amount of fluid in the
bloodstream. This function directly impacts the bloodpressure in the body. The Institute Of
Medicine recommends that all adults should consume at least 4,700mg of potassium per day.5
The National Heart Lung and Blood Institute created the Dietary Approaches to Stop
Hypertension, known as the DASH diet, as a dietary guide to help patients with high blood
pressure.5
The research group called DASH, conducted scientific studies to ascertain the value of
cucumber in the control of high blood pressure. Among pre-hypertensive individuals, the DASH
diet reduced Systolic BP by 3.5 and Diastolic BP by 2.1mmHg and in hypertensive individuals,
individuals. An apparently small reduction in BP, if applied to an entire population, could have
should lead to an 8% reduction in stroke mortality and 5% reduction in mortality from coronary
heart disease.7
As a community health nurse, the researcher finds that cucumber which is easily
available in the market can be consumed as one of the primary preventive measure for pre-
HYPERTENSION:
treatment, control and risk factors for hypertension in a rural population of south India. Cross-
Hypertension was coexistent in 2,247 patients. 1,682 patients were newly diagnosed with
hypertension. The study demonstrated the substantial burden of hypertension is on the rise in
India.8
A community based cross-sectional study was conducted in rural areas of central India.
The prevalence rate for hypertension was 19.04%. It was found to be higher in females (23.4%)
In an urban community based survey in West Bengal, 1662 participants of age 18 yrs and
above were screened. Participants (58.7%) were categorized in pre-hypertensive group according
to the JNC-VII criteria, who were young and needs special attention to avoid early progression to
4
SECTION 2: STUDIES ON CUCUMBER:
Cucumbers are a rich source of Vitamin C which is great in aiding a healthy immune
system. It also is a great source of dietary fiber, which is good for keeping digestive tract
functioning normally. It’s one of the easiest ways to increase fiber and water intake. It has natural
way to prevent water retention. Cucumbers have also been proven through research for DASH
(Dietary Approaches to stop Hypertension) to help in lowering blood pressure. Studies show that
adding foods high in potassium, magnesium and fiber can lower the systolic BP by 5.5 points
Cucumber is a green vine vegetable related to the melon that provides a crisp, grassy
flavor. The nutrients that cucumber provides are closely related with the nutritional requirements
for regulating blood pressure. An 8-inch cucumber provides 444mg of potassium, or 13 percent
of the 3,500mg potassium according to The Food and Drug Administration daily value.
Potassium is a mineral that provides support to the blood pressure system because the body
requires it for regulating fluid and electrolyte levels that regulate the amount of fluid in the
bloodstream. This function directly impacts the blood pressure in the body.13
PRESSURE:
5
In one of the study conducted by professional cardiologist, it’s revealed that cucumbers
can be amazingly useful in controlling high blood pressure. In fact, drinking its juice can help in
Clinical and experimental study of tablet cucumber vine compound was conducted in
with essential hypertension were divided into two groups randomly, 241 patients were treated by
tablet of cucumber vine compound as control. The marked effective rate in decrease of blood
pressure and total effective rate were 52.7%, 90.9% and 58.1%, 92.6% (P greater than 0.05)
respectively.15
“A study to assess the effect of cucumber on blood pressure among Pre-hypertensive adults in a
To assess blood pressure before and after administration of cucumber among pre-
hypertensive adults
adults
To determine the association between the blood pressure and baseline variables after
administration of cucumber
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PRE-HYPERTENSIVE ADULTS:
Pre hypertension is defined as a persistent Systolic blood pressure (SBP) 120-128 mmHg
and Diastolic blood pressure (DBP) 80-89mmHg, according to JNC (Joint National Committee)
classification of hypertension.16
In this study, pre-hypertensive adults refers to adults between age of 35 to 65yrs with
CUCUMBER:
Cucumbers are widely cultivated green fleshy fruit used in salads which is obtained
In this study, 1 cup of cucumber which is approximately 100 grams is administered to pre-
EFFECT:
In this study, effectiveness refers to the changes in the blood pressure level after 30 days
of administration of 1 cup of cucumber (approx 100 grams weighed) for pre-hypertensive clients,
cucumber consumption.
6.6 ASSUMPTIONS
hypertensive clients.
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6.7 DELIMITATIONS
The findings of study will be limited only to the pre-hypertensive clients in the selected
The findings of this study may highlight the effect of cucumber which is local dietary
that cucumber which is easily available in market can be used by the people as primary
6.9 HYPOTHESIS
H1: There will be significant variation in blood pressure before and after
H2: There will be significant association between blood pressure and their baseline
7.1.1RESEARCH DESIGN:
7.1.2SETTING:
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The setting of this study is Kuguru village, which is under Sarjapura PHC, Anekkal
Taluk, Bangalore. In this village there are around 250 families covering a population of around
1000 – 1500.
7.1.3 POPULATION:
The population in this study comprises of all subjects with SBP of 120 to 139 or DBP of
80 to 89 in three consecutive readings both male and female between 35 and 65yrs in Kuguru
All the prospective subjects meeting the inclusion criteria will be selected by purposive
sampling technique.
In this study the sample size is 53, which is calculated from the previous review, Lu.et.al
(reference) as to detect a reduction in blood pressure for 63% of the subjects marked
improvement with 13% precision and 95% confidence interval a sample size of 53 subjects is
required.
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All subjects who are willing to take part in the study.
All subjects who are known case of renal disorders, cardiovascular and
respiratory disorders.
All subjects with known history of hypertension and those under treatment with
7.2.5 INSTRUMENTS:
Semi-structured interview will be used to elicit the baseline variables of selected subjects
of selected subjects.
Formal permission from the Sarjapur PHC will be taken to conduct the study in kuguru
village. The direction for sampling will be obtained in a randomized manner (pen rolling
technique ie., by standing in the center of the village and rolling down the pen and thereby
starting from the direction the pen is pointing). The individual subjects will be selected using
Door to door survey will be done to allocate pre-hypertensive subjects, which will be
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consent will be obtained from the selected subjects. Baseline information will be collected using
All subjects will be given 1 cup (approx. 100grams) of cucumber per day for 30
consecutive days. Log will be maintained by the investigator to assure that all the subjects in the
sample group take cucumber all 30 days. Blood pressure will be checked using caliberated
mercury Sphygmomanometer on the 15th and 30th day of intervention and the BP reading
Data will be analyzed using inferential statistics; paired t test to identify the effect of
cucumber on BP and Chi-square will be employed to determine the association between the
Yes, the study consists of adults with pre-hypertension in Kuguru village. The selected
subjects will be given 1 cup (100grams) of cucumber for 30 consecutive days in order to assess
Yes, administrative and ethical clearance would be obtained from the respective authority.
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7.5 REFERENCES
12
2) Lewis S L. Medical Surgical Nursing. 7th edition. New Delhi:Elsevier
http://www.livestrong.com/article/448171-increased-potassium-blood-
Accessed on 19/7/12
on 12/8/12
13
11) Natures can cure-Herbal health care. Available from URL
http://bnsc52.blogspot.in/2012/05/health-benefits-of-cucumber.html.
Accessed on 3/8/12
13) Carson T, Cucumber for high blood pressure. Available from URL
http://www.livestrong.com/article/422118-cucumber-for-high-
AvailablefromURL:http://www.highbloodpressuremed.com/cucumber-
Accessed on 23/07/12
Accessed on 22/8/12
14
19) Polit and Beck’s. Nursing research principles and methods. 7 th edition.
256
http://www.sciencedirect.com/science/article/pii/5135951130700
2346
http://www.ehow.com/how-8221807-juice-cucumbers.html
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8 SIGNATURE OF CANDIDATE
10.1 GUIDE:
MRS. PADMA PRIYA DEVI. T
SENIOR LECTURER
DEPT OF COMMUNITY HEALTH
NURSING
10.2 SIGNATURE: ST JOHNS COLLEGE OF NURSING
10.3 CO-GUIDE:
11.2 SIGNATURE:
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12 12.1 REMARKS OF THE
CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE:
17