A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting

Arockiamary Ignasimuthu; Singaram Parimala

doi:10.4103/mgmj.mgmj_132_22

ORIGINAL ARTICLE

Year : 2022 | Volume : 9 | Issue : 3 | Page : 380-382

A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting

Arockiamary Ignasimuthu¹, Singaram Parimala²
¹ Department of Medical-Surgical Nursing, Vinayaka Mission’s Annapoorana College of Nursing, Vinayaka Mission’s Research Foundation, Deemed to be University, Salem 636308, Tamil Nadu, India
² Department of Obstetrics and Gynecological Nursing, Vinayaka Mission’s Annapoorana College of Nursing, Vinayaka Mission’s Research Foundation, Deemed to be University, Salem 636308, Tamil Nadu, India

Date of Submission	09-Aug-2022
Date of Acceptance	30-Aug-2022
Date of Web Publication	29-Sep-2022

Correspondence Address:
Mrs. Arockiamary Ignasimuthu
Department of Medical-Surgical Nursing, Vinayaka Mission’s Annapoorana College of Nursing, Vinayaka Mission’s Research Foundation, Deemed to be University, Salem 636308, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mgmj.mgmj_132_22

Abstract

Background: The goal of hypertension management is to keep blood pressure within normal bounds while also enhancing elderly patients’ quality of life and health. Warm foot baths are a straightforward, affordable, and effective therapy method that can be used in naturopathy to alleviate hypertension. Materials and Methods: This study used a quasi-experimental design that included two groups, the hypertensive intervention group and hypertensive control group, which was studied over 3 months between March 2020 and May 2020. The necessary ethical committee permissions with reference number VMRF/2020/037 and informed consent from all the patients included have been obtained properly before proceeding with the study. Results: Among the 100 individuals involved in the study, 53% were males and 47% were females. The mean age among the intervention group was 53.62 ± 7.26, and 52.84 ± 6.47 among the control group. The majority of the males included in the study were nonsmokers (69.8%). The mean ± standard deviation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the intervention group during the pretest phase was 157.3 ± 13.4 and 88.1 ± 9.4, whereas, after the intervention of foot bath therapy, the measurements of SBP and DBP were reduced significantly to 133.8 ± 9.7 and 76.9 ± 7.2, which was statistically significant with a P value < 0.001. Conclusion: Warm foot bath soak therapy is anticipated to be used as a nonpharmacological treatment for hypertension in older patients.

Keywords: Blood pressure, foot bath therapy, hypertension, nonpharmacological intervention

How to cite this article:
Ignasimuthu A, Parimala S. A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting. MGM J Med Sci 2022;9:380-2

How to cite this URL:
Ignasimuthu A, Parimala S. A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting. MGM J Med Sci [serial online] 2022 [cited 2022 Dec 7];9:380-2. Available from: http://www.mgmjms.com/text.asp?2022/9/3/380/357489

Introduction

The aging population is the one that is expanding the fastest worldwide. Data gathered over 30 years have shown that hypertension is more common as people get older.^[1],[2] In this subgroup of hypertensives, there is an increased risk of coronary artery disease, dementia, congestive hemorrhage, chronic kidney failure, congestive heart failure, and stroke. Cardiovascular specialists and other practitioners face a therapeutic conundrum when dealing with hypertension in elderly patients.^[3],[4] The goal of hypertension management is to keep blood pressure (BP) within normal bounds while also enhancing elderly patients’ quality of life and health. In general, pharmacological and nonpharmacological therapies are used to treat hypertension. Pharmacological therapy for the elderly does, however, come with several drawbacks, including side effects that may occur as a result of drug delivery and dependency consequences.^[5],[6] As a result, nonpharmacological treatments can be used in conjunction with pharmaceutical ones. Nonpharmacological management techniques include foot-soak therapy, which uses warm water to relax blood vessel muscle tissue and improve blood flow.^[7],[8],[9] Warm foot baths are a straightforward, affordable, and effective therapy method that can be used in naturopathy to alleviate hypertension.^{[10],[11],[12]} Hence, this study is aimed to assess the effectiveness of warm foot bath therapy on the reduction of BP among hypertensive patients in a rural tertiary care setting.

Materials and methods

This study used a quasi-experimental design that included two groups, the hypertensive intervention group and hypertensive control group, which was studied over 3 months between March 2020 and May 2020. The necessary ethical committee permissions with reference number VMRF/2020/037 and informed consent from all the patients included have been obtained properly before proceeding into the study. Through the purposive sampling method, 100 individuals were recruited for the study: 50 hypertensives in the intervention group and 50 hypertensive individuals in the control group. A pretest and posttest procedure was followed after dividing the 100 respondents into two groups: 50 respondents in the treatment group and 50 respondents in the control group. Age- and gender-matched participants included in this study must meet certain criteria, such as having grade I hypertension, receiving independent care, and consenting to the treatment regimen. Elderly people with complicated hypertension, people with diabetes, and dropouts were excluded from the study. Before and after the 15-min intervention of warm foot bath therapy, the subjects’ BP was measured and recorded before and after the intervention over 5 days for 1 month. Without any interventions between pretest and posttest, BP in the control group was recorded, measuring both systolic (SBP) and diastolic (DBP) BP. Before receiving foot-soak therapy in the intervention group, the pretest score was determined, and the posttest was conducted after the therapy was completed.

Statistical analysis

All the data were recorded in Microsoft Excel, and SPSS v.24 was used for statistical analysis. A descriptive analysis was performed, and the mean and standard deviation (SD) were calculated. The statistical significance of the quantitative data in terms of mean distribution variations was determined using an unpaired Student’s t-test. With a 95% confidence interval, a P value of 0.05 was judged statistically significant.

Results

Among the 100 individuals involved in the study, 53% were males and 47% were females. The mean age among the intervention group was 53.62 ± 7.26, and 52.84 ± 6.47 among the control group. The majority of the males included in the study were nonsmokers (69.8%) [Table 1]. BPs were recorded pre and posttest among both the groups with intervention and without intervention in one group and without any intervention in the other (control) group. The mean ± SD of SBP and DBP in the intervention group during the pretest phase was 157.3 ± 13.4 and 88.1 ± 9.4, whereas, after the intervention of foot bath therapy, the measurements of SBP and DBP reduced significantly to 133.8 ± 9.7 and 76.9 ± 7.2, which was statistically significant with a P value of less than 0.001. The mean ± SD of SBP and DBP in the intervention group during the pretest phase was 151.7 ± 7.2 and 88.2 ± 9.1, whereas, during the posttest, the measurements of SBP and DBP remained almost similar to the pretest at 149.9 ± 7.4 and 90.4 ± 8.6, which was also significant with P value less than 0.001 [Table 2].

Table 1: Sociodemographic characteristics of respondents

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Table 2: Blood pressure in the intervention and control groups

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Discussion

The mean age of respondents in the foot-soak intervention group was 53.6 years, compared with 52.84 years in the control group. One of the risk factors for hypertension is age, where the likelihood of developing hypertension rises with age.^[13] This is brought on by alterations in blood vessel structure and functions brought on by aging, wherein the blood vessels lose their elasticity and reduce blood vessel strain.^[14] Warm water foot-soak therapy uses the application of heat to the body as an intervention to improve blood flow, revitalize the body, and promote more relaxation. Hot water activates the baroreceptor nerves, which drive the impulse to the vasomotor center and causes the dilatation of the veins and arterioles, producing the relaxing effects of foot-soak therapy. Vasodilation that takes place in the arterioles lowers peripheral resistance, which lowers venous return and lowers cardiac output.^[15] Additionally, foot-soak therapy stimulates the production of endorphin chemicals from the pituitary gland, which activates the parasympathetic nervous system and decreases activity rather than the sympathetic nerves. This causes generalized vasodilation, which lowers BP and decreases peripheral resistance.^[16] The outcome of the statistical test indicated that, among older people with hypertension who had had foot-soak therapy, there was a significant difference between the pretest and posttest BP values (P = 0.001). The findings of this study are in line with earlier research that discovered a 30-min, 3-day foot bath significantly reduced BP, with mean systolic and diastolic readings falling by 3.994 mmHg and 2.722 mmHg, respectively.^[17]

Conclusion

Warm water foot-soak therapy has a substantial impact on lowering BP in older people with hypertension. Warm foot bath soak therapy is anticipated to be used as a nonpharmacological treatment for hypertension in older patients.

Ethical consideration

Clearance/approval from the Institutional Ethics Committee/Review Board of Vinayaka Mission’s Research Foundation, Salem, Tamil Nadu, India, was taken for undertaking the research study entitled: “A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting,” with vide letter no. VMRF/2020/037 dated 24.01.2020.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Buford TW Hypertension and aging. Ageing Res Rev 2016;26:96-111.
2.	Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M Hypertension in the elderly. World J Cardiol 2012;4:135-47.
3.	de Bruijn RF, Ikram MA Cardiovascular risk factors and future risk of Alzheimer’s disease. BMC Med 2014;12:130.
4.	Wu CY, Hu HY, Chou YJ, Huang N, Chou YC, Li CP High blood pressure and all-cause and cardiovascular disease mortalities in community-dwelling older adults. Medicine (Baltimore) 2015;94:e2160.
5.	Park S Ideal target blood pressure in hypertension. Korean Circ J 2019;49:1002-9.
6.	JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res 2008;31:2115-27.
7.	Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al; SPRINT Research Group. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: A randomized clinical trial. JAMA 2016;315:2673-82.
8.	Ogihara T, Saruta T, Rakugi H, Matsuoka H, Shimamoto K, Shimada K, et al; Valsartan in Elderly Isolated Systolic Hypertension Study Group. Target blood pressure for treatment of isolated systolic hypertension in the elderly: Valsartan in elderly isolated systolic hypertension study. Hypertension 2010;56:196-202.
9.	Kimm H, Mok Y, Lee SJ, Lee S, Back JH, Jee SH The J-curve between diastolic blood pressure and risk of all-cause and cardiovascular death. Korean Circ J 2018;48:36-47.
10.	Vyas SC, Mooventhan A, Manjunath NK Effect of hot arm and foot bath on heart rate variability and blood pressure in healthy volunteers. J Complement Integr Med 2019;17:/j/jcim.2019.17.issue-1/jcim-2018-0181/jcim-2018-0181.xml.
11.	Goley A, Mooventhan A, Manjunath NK Comparative study on the effect of neutral spinal bath and neutral spinal spray on blood pressure, heart rate, and heart rate variability in healthy volunteers. J Complement Integr Med 2018;16:/j/jcim.2019.16.issue-2/jcim-2018-0118/jcim-2018-0118.xml.
12.	Maheshkumar K, Sivakumar AV, Maruthy KN, Padmavathi R Hot arm and foot bath on heart rate variability and blood pressure in healthy volunteers—Needs to be verified with the standard device? J Complement Integr Med 2020;17:20190318.
13.	Pinto E Blood pressure and ageing. Postgrad Med J 2007;83:109-14.
14.	Xu X, Wang B, Ren C, Hu J, Greenberg DA, Chen T, et al. Age-related impairment of vascular structure and functions. Aging Dis 2017;8:590-610.
15.	Saeki Y The effect of foot-bath with or without the essential oil of lavender on the autonomic nervous system: A randomized trial. Complement Ther Med 2000;8:2-7.
16.	Sheng Y, Zhu L The crosstalk between autonomic nervous system and blood vessels. Int J Physiol Pathophysiol Pharmacol 2018;10: 17-28.
17.	Yun S-Y, Kwon M The effect of foot bath therapy on post-operation pain, stress, HRV in hand replantation patients. Korean J Occup Health Nurs 2011;20:105-12.