Background and Objective: Hypertension is a major health issue worldwide, with primary schoolteachers possessing several lifestyle risks of the disease. There have not been any health promotion programs yet for primary schoolteachers in Indonesia, especially for blood pressure control. A school-based model of workplace wellness program for teachers was developed. It focused on using screening as feedback in controlling blood pressure by eating a healthy diet, doing physical activity, and having regular checks. This study aimed to assess its clinical and behavioral effects. Methods: This trial was a one group pre- and post-test study design without control. It was implemented purposively in three public primary school locations in Jakarta to 44 eligible teachers for approximately three months from January to March 2022. The workplace wellness program included on-site screening (blood pressure, body mass index/BMI, spot urine sodium-creatinine ratio), knowledge, motivation, and ongoing health behavior (physical activity and the dietary approach to stop hypertension/DASH), online education/training, consultation/counseling sessions with a family doctor, and self-monitoring. All screening measurements were repeated at the end of the program. A paired t-test or Wilcoxon analysis was performed using SPSS 20.0. Results: Both systolic and diastolic blood pressure decreased by 5.05 mmHg (p = 0.018) and 6.41 mmHg (p < 0.001), respectively. The spot urine sodium-creatinine ratio and BMI decreased slightly but not significant (p = 0.707; p = 0.761). Knowledge and motivation increased slightly but not significant (p = 0.529; p = 0.175). The DASH behavior significantly increased by 25% (p < 0.001). Though the overall physical activity did not change, the walking activity increased twofold significantly (p = 0.006). This study also showed that the outcome would be achieved when the participant followed the recommendations obediently. Conclusion This school-based workplace wellness program was found to have a potential effect on controlling blood pressure by changing health behaviors. A randomized controlled trial is recommended to provide stronger evidence on its effectiveness before doing a large-scale implementation in primary schools in Indonesia.
Health Promotion ; Hypertension ; Exercise ; DASH diet ; Dietary Approaches To Stop Hypertension

Background and Objective: Premature ventricular complex (PVC) burden exhibits one of three circadian types, classified as fast-type, slow-type, and independent-type PVC. It is unknown whether PVC circadian types have different heart rate variability (HRV) parameter values. Therefore, this study aimed to evaluate differences in HRV circadian rhythm among fast-, slow-, and independent-type PVC. Methods: This cross-sectional observational study consecutively recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as five control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and HRV. HRV analysis included components that primarily reflect global, parasympathetic, and sympathetic activities. Repeated measures analysis of variance was used to compare differences in HRV circadian rhythm by PVC type. Results. The average PVC burden was 15.7%, 8.4%, and 13.6% in fast-, slow-, and independent-type idiopathic PVC subjects, respectively. Global, parasympathetic nervous system, and sympathetic nervous system HRV parameters were significantly lower in independenttype PVC versus fast- and slow-type PVC throughout the day and night. Furthermore, we unexpectedly found that tendency towards sympathetic activity dominance during nighttime was only in independent-type PVC. Conclusion The HRV parameters are reduced in patients with independent-type PVC compared to fast- and slowtype PVC. Future research is warranted to determine possible differences in the prognosis between the three PVC types.
Ventricular Premature Complexes ; Circadian Rhythm ; Autonomic Nervous System