Effectiveness of Daily intake of lemon juice along with walking decrease the level of Blood Pressure among Hypertensive Clients

Health is the level of functional or metabolic ef iciency of a living organism. In humans, it is the ability of individuals or communities to adopt and selfmanaged, when facing physical mental or social changes. Hypertension is called as the ”Silent Killer” because it is a disease that usually occurs without any symptoms. Lemon juice is also an excellent source of Arginine, the essential Amino acids that help lowering blood pressure. The present study aims to assess the effectiveness of Daily intake of lemon juice along with walking decrease the level of blood pressure among hypertensive clients between 4070years. A quantitative quasi-experimental research design was conducted among 30 hypertensive clients who were selected by using non-probability convenience sampling technique. A structured interview was used to collect demographic data and hypertension was assessed by observational checklist. Pre-test was conducted before administering the lemon juice by observing the blood pressure level using Observed Checklist method among the hypertensive clients. The time for assessment varied from 15 20minutes. The Lemon juice of 250mlwas administered alongwithwalking to the samples and immediately after 1 hour, post-test was conducted by observation checklist. The study inding clearly infers that there was a signi icant reduction in the level of hypertension in the post-test which clearly infers that intake of lemon juice alongwithwalking proves to be effective in reducing the level of hypertension and improves the quality of life of the hypertensive clients.

Health is the level of functional or metabolic ef iciency of a living organism. In humans, it is the ability of individuals or communities to adopt and selfmanaged, when facing physical mental or social changes. Hypertension is called as the "Silent Killer" because it is a disease that usually occurs without any symptoms. Lemon juice is also an excellent source of Arginine, the essential Amino acids that help lowering blood pressure. The present study aims to assess the effectiveness of Daily intake of lemon juice along with walking decrease the level of blood pressure among hypertensive clients between 40-70years. A quantitative quasi-experimental research design was conducted among 30 hypertensive clients who were selected by using non-probability convenience sampling technique. A structured interview was used to collect demographic data and hypertension was assessed by observational checklist. Pre-test was conducted before administering the lemon juice by observing the blood pressure level using Observed Checklist method among the hypertensive clients. The time for assessment varied from 15 -20 minutes. The Lemon juice of 250ml was administered along with walking to the samples and immediately after 1 hour, post-test was conducted by observation checklist. The study inding clearly infers that there was a signi icant reduction in the level of hypertension in the post-test which clearly infers that intake of lemon juice along with walking proves to be effective in reducing the level of hypertension and improves the quality of life of the hypertensive clients.

INTRODUCTION
Great nutrition is an essential segment of well being. Through hundreds of years, food has been perceived as signi icant for individuals in well being and disease. (Hara, 1990) The historical backdrop of man has been to a huge degree, a battle to acquire food. (Kamiwaki et al., 1994) It has been accounted for that food materials, for example, tea catechins, cacao lignin, and wheat grain hemicellulose were found to suppressively affect circulatory strain. (Kodama et al., 1996) A few investigations featured lemon as a signi icant well being advancing organic product plentiful in phenolic mixes just as nutrients, minerals, dietary ilaments, basic oils, and carotenoids (González-Molina et al., 2010). The suppressive impact of lemon juice and its unre ined lavonoid on circulatory strain has been accounted for in SHR (Miyake et al., 1998). The water concentrate of lemon strips additionally suppressively affected circulatory strain in SHR (Kumamoto et al., 1984;Mat-subara et al., 1985). Late examinations uncovered that the impact of day by day lemon admission on boundaries identi ied with metabolic condition in sound ladies and indicated that the measure of lemon consumption had a huge negative connection with systolic blood pressure (Domoto et al., 2010). Daily strolling improves the circulatory strain in humans (Lee et al., 2010;Kato et al., 2014).
Therefore, the aim of this study was to assess the effectiveness of Daily intake of lemon juice along with walking decrease the level of blood pressure among hypertensive clients between 40-70years. The purpose of the study, 1. To assess the level of blood pressure level among hypertensive clients.
2. To evaluate the effectiveness of daily intake of lemon juice along with walking in reducing the blood pressure level among hypertensive clients 3. To determine the association between the level of blood pressure and selected demographic variables.

MATERIALS AND METHODS
A quantitative approach with quasi-experimental research design was used to conduct the study at Kondencheri Village, Chennai. 30 samples were selected by using a non-probability convenient sampling technique. The criteria for sample selection are clients who have only hypertension, willing to participate and are able to converse in Tamil. The exclusion criteria for the samples are who are willing to participate and clients who are not present at the time of data collection. The data collection period was done with prior permission from the Principal of Saveetha College of Nursing and an authorized setting permission was obtained from Kondencheri Village, Chennai. The purpose of the study was explained to the hypertensive clients and consent was obtained from them. The con identiality of the data collected was assured to the samples. Structured interview was used to collect demographic data and observation checklist was used to assess hypertension. On an average 5 samples was assessed per day. The time for assessment varied from 15 -20 minutes. The Lemon juice of 250ml was administered along with walking to the samples and immediately after 1 hour, post-test was conducted by observation checklist. The data were analyzed using descriptive and inferential statistics. The sample characteristics were described using frequency and percentage. Student paired 't' test was used to assess the effectiveness of lemon juice with along with walking between the pretest and post-test. Chisquare was used to associate the post-test level of hypertension with the selected demographic variables. Regarding systolic BP after the administration of lemon juice along with walking in the post-test, 18(60%) had pre-hypertension and 12(40%) had stage -I hypertension and with regard to diastolic BP 16(53.33%) had pre-hypertension and 14(46.67%) had stage-I hypertension. (Table 2) Section C

Effectiveness of evaluating the effectiveness of daily intake of lemon juice along with walking in reducing the blood pressure level among hypertensive clients
The present study depicts that with regard to systolic blood pressure the pretest mean score was 144.94±12.35 and the post-test mean score was 132.22±11.53. The mean difference score was 12.72. The calculated paired 't' value of t = 13.796 was found to be statistically signi icant at p<0.05. (Table 3) The present study also shows that with regard to diastolic blood pressure the pretest mean score was 94.25±8.85 and the post-test mean score was 86.83±10.85. The mean difference score was 7.42.    The calculated paired 't' value of t = 5.492 was found to be statistically signi icant at p<0.05. (Table 4) Another study was also supported by (Geleijnse et al., 2003). Blood pressure response to changes in sodium and potassium intake: a meta regression analysis of randomized trials. The indings show that reduced intake of sodium and increased intake of potassium could make an important contribution to the prevention of hypertension, especially in populations with elevated blood pressure. (Geleijnse et al., 2003) The study inding shows that, none of the demographic variables had not shown statistically significant association with blood pressure among hypertensive clients.

CONCLUSIONS
The present study assessed the effectiveness of Daily intake of lemon juice along with walking decrease the level of blood pressure among hypertensive clients between 40-70years. The results revealed that lemon juice provided to hypertensive clients along with walking was proved to be effective and there was signi icant reduction in the level of hypertension among hypertensive clients thereby improving their quality of life.