Improving Hypertension: Engagement in a Walking Exercise Program in a Primary Care Setting

Background: Hypertension (HTN) is a very common, undertreated, and costly disease. Despite effective treatment strategies available, uncontrolled hypertension remains a persistent problem in the primary care setting.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to assess the effectiveness of a walking exercise program (WEP) on blood pressure in adults diagnosed with uncontrolled hypertension in a primary care setting. Goals were targeted to decrease blood pressure, decrease BMI, and increase physical activity.
Methods: Using Bandura’s Social Cognitive theory as a framework, a walking exercise was offered at a primary care clinic, to assess the effectiveness of exercise in reducing blood pressure. Fourteen (N=14) participants enrolled and completed the 8-week program. Blood pressure and body mass index (BMI) were measured prior to intervention (pre), 4-weeks after (mid), and at 8 weeks (post). Participants were given a pedometer to calculate steps walked daily, and a paper log for blood pressure and steps recording.
Results/Interpretations: Systolic blood pressure (SBP) was significantly reduced (p=.001). Diastolic blood pressure (DBP) also had a statistically significant reduction (p=.049). BMI was also significantly reduced (p=.037) when compared to pre intervention.
Implication: This quality improvement (QI) project showed that the implementation of a walking exercise program in a primary care setting can lead to significant improvements in blood pressure management.