A comparative study to assess the effectiveness of foot soak on decreasing blood pressure for hypertension clients with and without hypertensive medication

Hypertension is one of the primary source of death and incapacity among grown-ups. Hypertension is an inert issue in numerous individuals as it has a long asymptotic stage. The dif icult itself has no clinical signs and indications until organ harm has occurred. Hypertension is the most well-known condition requiring deep-rooted medicate treatment in the western world. The National Heart, Lung and Blood Institute of USA has assessed that half of the individuals with hypertension are unconscious of the condition. The present study aims are to assess the effectiveness of foot soak on decreasing blood pressure for hypertension clients with and without hypertensive medication in a selected community area. The quasi-experimental designwas used as a research design. Convenient sampling technique was used to select samples. A semi-structured interview was used to collect demographic data, and the BP chart was used to monitor the blood pressure of the patients. For the patients in the experimental group, foot soakwas given. After 20mins, BPwas checked and noted in BP graph. The investigation results show that after the organization foot soak there was a noteworthy decrease in the post-test level of systolic BP and diastolic BP among hypertensive patients with and without hypertensive drug was highly signi icant at p<0.001 level. Foot soak is the simple and inancially savvy approach to decrease pulse among hypertensive patients with and without hypertensive prescription.

Blood pressure, Hypertension, Hypertensive medication ABSTRACT Hypertension is one of the primary source of death and incapacity among grown-ups. Hypertension is an inert issue in numerous individuals as it has a long asymptotic stage. The dif icult itself has no clinical signs and indications until organ harm has occurred. Hypertension is the most well-known condition requiring deep-rooted medicate treatment in the western world. The National Heart, Lung and Blood Institute of USA has assessed that half of the individuals with hypertension are unconscious of the condition. The present study aims are to assess the effectiveness of foot soak on decreasing blood pressure for hypertension clients with and without hypertensive medication in a selected community area. The quasi-experimental design was used as a research design. Convenient sampling technique was used to select samples. A semi-structured interview was used to collect demographic data, and the BP chart was used to monitor the blood pressure of the patients. For the patients in the experimental group, foot soak was given. After 20 mins, BP was checked and noted in BP graph. The investigation results show that after the organization foot soak there was a noteworthy decrease in the post-test level of systolic BP and diastolic BP among hypertensive patients with and without hypertensive drug was highly signi icant at p<0.001 level. Foot soak is the simple and inancially savvy approach to decrease pulse among hypertensive patients with and without hypertensive prescription.

INTRODUCTION
In many places of the world, non-communicable diseases have gotten a signi icant pestilence. This is because of quick progress in ways of life driving diminished physical movement, changing eating regimens and expanded tobacco use. This pattern is available in all classi ications of social orders rich, poor, created and creating nations. Destitution, brutality, fast social and inancial changes, absence of instruction, lacking or all-out missing of wellbeing administrations add to much increment in instances of cardiovascular sicknesses, diabetes, malignancy as they do in AIDS and malaria. Hypertension is one of the primary source of death and handicap among grown (Stokes et al., 1989;Macmahon et al., 1990).
Hypertension is an idle issue in numerous individuals as it has a long asymptotic stage. The dif icult itself has no clinical signs and indications until organ harm has occurred (O'Brien et al., 2003). Hyperten-sion is the most widely recognized condition requiring deep-rooted sedate treatment in the western world. The National Heart, Lung and Blood Institute of USA has assessed that half of the individuals with hypertension are unconscious of the condition (Frisoli et al., 2011). 'Silent killer, it is said that they are deep and dangerous. High blood pressure somewhat a kind to such a situation and if left undetected and untreated, it results in stroke, heart attack and heart failure, retinal damage and Nephrosclerosis (Wassink et al., 2007).
Indian Journal of Medical Research reported that approximately one billion people worldwide have high blood pressure, and this number is expected to increase to 1.56 billion by the year 2025. That translates to about one out of every four adults being affected with hypertension. Now India is the country which has most people with high blood pressure in the world. Over ten crores of Indian adults presently suffer from hypertension (Masriadi and Eha, 2019). American Heart Association (2017) has stated that 28.6% of the US population and hypertension. Hypertension prevalence has also been increasing in other countries and estimated that 972 million people in the world were suffering from this problem. Incidence rates of hypertension range between 3% and 18%, depending on the age, gender, ethnicity, and body size of the population studied. Despite advances in hypertension treatment, control rate continue to be suboptimal. Programs that improve hypertension control areas and prevent hypertension and urgently needed. Thompson estimated that 60 million Americans have hypertension and an additional 25 million have borderline hypertension. Half of those affected by borderline hypertension due to unawareness of it. Death rates because of cardiovascular diseases are 45% higher in black men than a white man and 67% higher for black women than for white women among hypertensives (Dahlöf et al., 1991).
Foot soak treatment is a non-invasive, inancially savvy technique utilized for the decrease of circulatory strain. It is promptly accessible, easy method that can be applied to any individual without thought of time and spot. This type of treatment requests no unique gadgets or requirements. After the individual involved with the network territory and in the wake of checking on the related writing, the agent wanted to lead an investigation to assess the adequacy of foot douse on circulatory strain among hypertensive patients with and without drugs. Examiner was keen on the rami ications of foot soak among hypertensive patients to diminish the raised circulatory strain. Such mediations will assist with decreasing hypertension in some patients (WHO, 2000). A purpose of the study (1) to assess the level of blood pressure among hypertensive clients with and without hypertensive drugs.
(2) To ind the effectiveness of foot soak on decreasing blood pressure among hypertensive clients. (3) To compare the post-test level of blood pressure among hypertensive clients with and without medication. (4) To ind an association of the level of blood pressure with selected demographic variables.

MATERIALS AND METHODS
A quantitative methodology with quasiexperimental research design research was utilized to lead the investigation in Sevvapet town, Thiruvallur.60 tests were chosen by convenience sampling technique. The inclusion criteria for test choice was patients with hypertension beneath the age gathering of 60 years, with the determination for a time of under ive years, who were happy to take part in the study, who are on with and without oral antihypertensive medications, who can understand English or Tamil. The exclusion criteria for the samples are patients with hypertension who are following some other unwinding methods, who are mentally unstable, who having hypertension with other related diseases. Informed consent was obtained before the investigation. The purpose of the study was explained to the samples with written informed consent was obtained from them. The demographic data were collected using a structured questionnaire. The blood pressure was checked using a sphygmomanometer and recorded in the BP chart before the intervention. Then clients in experimental group 1 and experimental group 2 were given foot soak. After 20 mins, the blood pressure was assessed among both experimental groups. This was continued for ive days, and BP was recorded in the BP chart. The data were analyzed using descriptive and inferential statistics. The sample characteristics were described using frequency and percentage. Pearson's co-relation coef icient was used to assess the effectiveness of foot soak. Chi-square used to associate the post-test level of blood pressure with the selected demographic variables.
Section B: To assess the level of blood pressure among hypertensive clients with and without hypertensive drugs.

Section C: To ind the effectiveness of foot soak on decreasing blood pressure among hypertensive clients.
The investigation result shows that the pretest means a score of systolic BP among hypertensive customers with hypertensive medications was 144.11 with standard deviation 5.21, and the posttest mean score was 140.15 with a standard deviation of 5.29. The determined matched 't' test estimation of t = 32.916 was seen as highly signi icant at p<0.001 level and portrays that the pretest means a score of diastolic BP among hypertensive customers with hypertensive medications was 89.34 with standard deviation 2.63 and the post-test mean score was 87.38 with standard deviation 2.76. The determined combined 't' test estimation of t = 26.085 was seen highly signi icant at p<0.001 level ( Table 3).
The investigation result shows that the pretest means a score of systolic BP among hypertensive customers without hypertensive medications was 144.47 with standard deviation 4.08, and the posttest mean score was 138.23 with a standard deviation of 4.28. The determined combined 't' test estimation of t = 20.311 was highly signi icant at p<0.001 level and states that the pretest means a score of diastolic BP among hypertensive customers without hypertensive medications was 88.44 with standard deviation 3.13 and the post-test mean score was 84.72 with standard deviation 4.15. The determined matched 't' test estimation of t = 7.898 was highly signi icant at p<0.001 level (Table 1).
Ali Mohammadpour supports the present study, Atefeh Dehnoalian, JavadMojtabavi (2013) led a semi exploratory investigation to decide the impact of warm water foot splash, on systolic and diastolic blood pressures among 68 stroke patients utilizing arbitrary inspecting strategy. Test bunch got foot soak for 30 minutes. The outcomes indicated that the circulatory strain was altogether diminished among the investigation bunch in the wake of accepting the foot drench (P<0.05). Thus it was presumed that there were bene icial outcomes of warm water foot douse on diminishing pulse in patients with stroke and could be utilized as an enhancement treatment (Parker et al., 2018) (Table 2). This infers that after the administration foot soaks on decreasing blood pressure, there was a signi icant reduction in the systolic BP and diastolic BP among hypertensive clients with and without hypertensive drugs.
Section D: To compare the post-test level of blood pressure among hypertensive clients with and without medication.
The study result depicts that the post-test mean score of systolic BP among hypertensive clients with hypertensive drugs was 140.15 with standard deviation 5.29 and the post-test mean score among hypertensive clients without hypertensive drugs    was 138.23 with standard deviation 4.28. The calculated student independent 't' test value of t = 1.539 was not found to be statistically signi icant which infers that there was no signi icant difference in the post-test level of systolic BP between clients with and without hypertensive drugs and also depicts that the post-test mean score of diastolic BP among hypertensive clients with hypertensive drugs was 87.38 with standard deviation 2.76 and the posttest mean score among hypertensive clients without hypertensive drugs was 84.72 with standard deviation 4.15. The calculated student independent 't' test value of t=2.924 was found to be statistically highly signi icant at p<0.01 level ( Table 3).
The present study is supported by Lee, Hyeon-Soon, Kim, Dong-Oak (2012) led a semi exploratory investigation to analyze the impacts of warm water foot soak and foot massage on the circulatory strain, heart rate and blood lipid level among 71 older fundamental hypertensive patients, Korea. The trial bunch I (24 people) experienced warm water foot soak, test bunch II (27 people) experienced foot back massage and control gathering (20 people) followed standard treatment to gauge the impacts. The systolic circulatory strain (p<.05), the diastolic circulatory strain (p<.05), and the beat rate (p<.01) of exploratory gathering I and II after mediating individually with warm water foot soak and foot rub for about a month and a half fundamentally diminished, then the benchmark group, yet the blood lipid level indicated no marked contrast among three gatherings (p>.05). It was inferred that both foot soak and foot massage had bene icial outcomes to diminish the circulatory strain and heartbeat rates among hypertensive patients Malarvizhi (2019). This infers that after the administration foot soak on decreasing blood pressure, there was a signi icant reduction in the post-test level of diastolic BP between hypertensive clients with and without hypertensive drugs.

Section E: Association of the level of blood pressure with selected demographic variables.
The result shows that none of the demographic factors had demonstrated a signi icant relationship with the post-test level of systolic pulse among hypertensive patients with hypertensive medications. It shows that the demographic variable physical action had indicated a measurably critical relationship with the post-test level of diastolic circulatory strain among hypertensive patients with hypertensive medications at p<0.05 level and the other demographic factors had indicated a signi icant relationship with the post-test level of diastolic circulatory strain among hypertensive patients with hypertensive medications (Table 4).

CONCLUSION
This indicates that warm water foot soak is effective among hypertensive clients with or without hypertensive medication and the effectiveness is more signi icant among clients taking hypertension medication. It is one of the cheapest, easy and effective way to reduce blood pressure.

Financial Support and Sponsorship
The authors declare that they have no funding support for this study.