Our Lady of Fatima University – QC

College of Nursing

Healing me Softly with this Leaf: The Effectiveness of Gynura Leaves in

Controlling Hypertension

By:

Warley B. Fajardo III

Gretzen Joy B. Sarenas
Mary Jane E. Atibagos
Princess C. Bantucan
Ma. Jessica T. Fuentes
Lindsey Nena H. Meimban
John Karl C. Solomon

College of Nursing, Our Lady of Fatima University

March 2015

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TABLE OF CONTENTS

Page

Title Page 1

Table of Contents 2

Abstract 4

Introduction 5

Review of Related Literature

Theoretical Framework 7
Literature Review 9

Research Methodology

Research Design 17

Research Locale 17

Population and Sampling 18

Research ethics 19

Research Instrument 20

Data Collection 20

Data Analysis 21

Results 22

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Discussion

Demographic Profile 24

Blood Pressure of the Participants 24

Limitations 26

Conclusion 27

Reference 28

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ABSTRACT

It is apparent nowadays that the prevalence of the number of people having

hypertension is increasing. Highest contributing factor for this is noncompliance with
pharmacological treatment regimen as brought by economic deprivation. To address
this problem, this study aims to find an alternate way to control hypertension without
needing a surmount of money - and it is through the use of Gynura procumbens.
Gynura has a lot of antihypertensive properties such as angiotensin converting
enzymes inhibitors and calcium channel blockers, and it activates release of bradykinin
and nitric oxide wherein all of those have effects to lower blood pressure. This study
utilized experimental design, and used random sampling in assigning 15 participants for
experimental group and another 15 for control group for the pool of 30 non-compliant
hypertensive participants residing at Sitio Junji, Barangay Kaligayahan, Novaliches,
Quezon City as data were gathered from the Kaligayahan Health Center. Participants
were chosen regardless of gender, must be 35-60 years old, known hypertensive but
noncompliant with medications, and no known underlying diseases. Among 30
participants involved, it was reduced to 28 in the middle of the experiment due to some
limitations of the study. Results showed based on the comparison of blood pressure
(BP) on the last day of the experiment, the mean BP of the experimental group (n=13) is
118.46/82.31 mmHg while 156.00/100.67 mmHg for control group (n=15), giving now to
conclusion that there is significant difference in the systolic and diastolic blood pressure
between hypertensive patients taking and not receiving gynura for 4 weeks with p<
0.001 results, Hence, Gynura leaves is proven effective in controlling hypertension.

Keywords: Experimental, Gynura procumbens, Gynura, Hypertension, Non-compliant,

Leaves, Bloods pressure.

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1.0 INTRODUCTION

The increasing prevalence of hypertension in developing countries is of great concern.

This is especially in developing countries with high illiteracy rates) and a drastic shift in
the increase from communicable diseases to non-communicable diseases.
Hypertension is a term used to describe high blood pressure. Flow of blood is based on
the beat at which the heart pumps blood. Hypertension occurs as a result of a long
duration of abnormal pressure on the arteries. High blood pressure generally does not
express any visual symptoms, putting individuals at risk for hypertension unknowingly. It
affects 95% of persons suffering from the disease and usually starts at the ages of 35 to
40 affecting both genders. A simple blood pressure test using a sphygmomanometer
determines if an individual is hypertensive. Normal blood pressure readings are 110
mmHg SBP and 70 mmHg DBP. Consistent high blood pressure can lead to heart
diseases, such as heart attack or stroke. Hypertension develops over time and several
factors can contribute to it, including lack of physical activity, poor diet (high in sodium),
overconsumption of alcohol, tobacco use, certain medications, adrenal gland tumors,
kidney problems, and other factors. This is due to the fact that the success of controlling
hypertension through pharmacologic means is only 7.5-12 cause of the costly prices of
antihypertensive drugs. To address this, alternatives for anti-hypertensive drugs may be
used like herbal medicines and Gynura is one of these, it originated in continental
South-East Asia, Malaysia, and also western and central Africa, but is now widely
cultivated anywhere in the world since its health properties have been discovered. The
leaves of this plant are traditionally used for the treatment of kidney diseases, eruptive
fever, rash, hypertension, diabetes mellitus, and hyperlipidemia. Gynura has been
widely used as an herbal medicine for different kinds of illnesses like hypertension by
eating 4-7 raw leaves after washing them with salted water or just with clean water.

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Studies show that it lowers blood pressure by increasing nitric oxide (NO) in the body,
which is known as a vasodilator. Gynura also inhibits bodily chemicals and some
neurotransmitters like acetylcholine, phenylephrine, methoxamine, angiotensin II, and
isoprenaline that are major contributors to the process and mechanism of blood
pressure. This paper, therefore, intended to identify the effectiveness of Gynura leaves
in lowering high blood pressure that may contribute as a source of an alternative
modality for controlling hypertension. Through this study, researchers will be able to
show their desire in finding a better way to manage hypertension due to the fact that
hypertension becomes one of the worlds`s most prevalent health conditions as it leads
to significant morbidity and mortality, and also to address the costly antihypertensive
drugs along with its many side effects.

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2.0 REVIEW OF RELATED LITERATURE

2.1 Theoretical Framework

The Self-Care Deficit Theory developed by Dorothea Orem was chosen by the
researchers to illustrate the relationship between the study's key factors. The main
concept of this theory describes the connection between people's capacities for action
and their needs for care. Additionally, it expresses action restrictions, offers guidelines
for selecting assistance techniques, and clarifies patients' duties in self-care.

To see and comprehend the theory's application in this research, certain of its concepts
are defined. One of these is the practice of self-care, which is defined as the activities
that mature and maturing individuals initiate and carry out on their own behalf within set
time limits in the goal of maintaining life, healthy functioning, and well-being. However,
in some instances, a lack of self-care, there is another idea of Orem, and it specifies the
necessity of nursing. This is due to the fact that nursing is necessary when an adult is
unable to provide adequate continuous self-care or has a limited ability to do so. The
seeming high rate of antihypertensive medication non-compliance among hypertension
patients suggests that treatment is inefficient or that ongoing self-care is poor among
these patients. This is posed by a number of variables, including the high cost of
medications, particularly for typical employees, worries about the negative effects of the
prescriptions, a lack of awareness about the advantages, and the lengthy and intricate
nature of the regimen. In terms of monetary volatility, it is really least likely to treat
hypertension pharmacologically.

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Another idea in Orem, the Nursing agency, takes on its responsibility to address these
issues, or at least part of them. It is defined as those nurses who have had the
education and training necessary to act, to be knowledgeable, and to assist others in
meeting their self-care needs. This lines with the principles that a nurse should seek
opportunities to promote health, consider the clients socio-economic status, and assist
clients to identify available resources to address their needs. And to be a better nurse,
application of learned principles must be observed, that is why registered nurses are
incorporating alternative and complementary modalities into their practices outside the
traditional health care setting, like use of herbal medicines, acupuncture, and other
forms of treatment to address deficiency in self-care.

Gynura can be an alternate method of controlling hypertension if the problems with

treating hypertension pharmacologically are taken into account, coupled with the
application of nursing principles and then within the context of this theory. Numerous
research has backed it, and both its features and substance have been analyzed. In this
way, using Gynura procumbens as an additional or alternative nursing technique for
participants meets self-care requirements, socioeconomic issues, and gives another
resource for the control of hypertension.

In accordance with this view, the nurse supports and motivates patients in their quest of
health, which is the ultimate objective of nursing, by acting as an agent of positive
change. In the context of hypertension, "health" is understood as proper care and
control of the condition, which prevents complications.

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2.2 Literature Review

2.2.1 Statistics

Around 330 million individuals in the developed world and 640 million in the developing
world, respectively, suffer hypertension. According to the World Health Organization,
high blood pressure is one of the leading causes of premature death worldwide, and the
problem is getting worse. It is predicted that 1.56 billion adults will have high blood
pressure by 2025.

One in four Filipino individuals, according to a report from the Philippine Daily Inquirer,
have hypertension or high blood pressure. Even worse, the number of hypertensive
Filipinos is growing, particularly those who are dependent on highly salted snacks and
other processed foods. Citing the most recent data from the Food and Nutrition
Research Institute's National Nutrition and Health Survey (FNRI), HEALTHbeat said the
number of hypertensive adults had increased to more than 25.3 percent compared to 22
percent in 2003. The FNRI survey also revealed that at least 11 in every 100 Filipinos
have pre-hypertension, or blood pressure readings of 130 to 139 mmHg (systole), or 85-
89 mmHg (diastole).

2.2.2 Statistics and Perception on Use of Herbal Medicine

A recent global survey conducted by the National Center for Complementary and
Alternative Medicine found that 36% of persons over the age of 18 utilize
complementary and alternative medicine (CAM). The results come from the 2009
National Health Interview Poll (NHIS), a yearly in-person survey that examines

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how various nations handle hypertension. Information on 23,393 persons (36%) who
are 18 years of age or older and use herbal medications was collected in the CAM area.

Gynura is frequently used in South-east Asian nations like Malaysia and China to treat
and prevent illnesses, promote good health, and lengthen and improve the quality of
life. The most common reasons for using it is that it is affordable, more closely
corresponds to the patient's ideology for safer usage, allay's concerns about the
adverse effects of chemical (synthetic) medicines, and satisfies a desire for more
personalized health care. The major use of Gynura is for lowering blood pressure and
for chronic hypertension. Furthermore, it is widely perceived as natural and safe, that is,
nontoxic.

2.2.3 Relationship of Hypertension in terms of the Different Factors

Age, gender, family history, smoking, usage of certain medications, and conditions like
renal failure and issues with the adrenal glands are just a few of the many variables that
can cause or contribute to hypertension as it develops over time.

Growing older is linked to alterations in blood vessel wall structure that reduce the
likelihood of their being elastic. The size and volume of the lining of the arteries are
affected by these changes, which lead to a loss of vascular compliance and, eventually,
hypertension. Men and women have an equal lifetime risk of developing high blood
pressure, according to the National Institutes of Health. However, men are more likely
than women to have high blood pressure before the age of 45. The illness is more likely
to affect women beyond the age of 65.
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Before menopause, women have lower amounts of low-density lipoprotein, or LDL, the
"bad" cholesterol, which is associated with a lower risk of developing heart disease.
However, as women get older, they are predisposed to larger levels of this bad
cholesterol. Men, meanwhile, start to have higher amounts of "bad" cholesterol when
they hit adolescence. In addition, they have lower amounts of HDL, or "good"
cholesterol, high-density lipoprotein. Along with this fact, high amounts of LDL
cholesterol build up along the inner arterial walls as cholesterol plaque, a hard, thick
substance that restricts blood flow and raises blood pressure.

High levels of estrogen during a woman's reproductive years minimize the risk of high
blood pressure and high cholesterol level. It appears to have a preventive impact
against illnesses affecting the body's vasculature. LDL cholesterol may rise as a result
of declining estrogen levels throughout menopause and the perimenopausal stage. The
risk of developing hypertension rises as a result of the decline in HDL cholesterol and
rise in LDL cholesterol.

Women had a three to five times lower risk of heart attack than men, according to a
study by Dr. Kolovou and colleagues published in their May 2010 paper in "Current
Vascular Pharmacology." The blood vessel plaques that lead to atherosclerosis and
high blood pressure are most likely prevented from forming by estrogen. For a variety of
causes, high blood pressure frequently runs in families. Many of the genes that can
predispose a person to high blood pressure, heart disease, or stroke tend to be shared
among blood relatives. Genes are genetic building blocks that parents pass on to their
offspring. Additionally, relatives could have similar routines like smoking, exercising, and
drinking that can influence risk.

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In comparison to men whose parents did not have high blood pressure, men whose
parents developed high blood pressure at age 55 or younger were seven times more
likely to experience adult-onset hypertension than those without a parent with high
blood pressure, and men whose parents both experienced early-onset high blood
pressure were twenty times more likely to experience it.

Despite the other factors contribute in the development of hypertension like cigarette
smoking, diseases such as renal failure and adrenal problems, and medications,
researchers intend to exclude participants with conditions like these. Thus, this study
advances the following inquiries:

Research Question 1. What is demographic profile of the participants in terms of

1.1 Age

1.2 Gender, and;

1. 3 Family history of hypertension?

As a result, the researchers proposed that participants who are older have a higher risk
of having high blood pressure; Male clients are more prone to develop hypertension;
Participants who have a family history of hypertension are more likely to experience
high blood pressure.

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2.2.4 Gynura as antihypertensive

Gynura procumbens has been demonstrated to lower blood pressure and produce a
hypotensive effect by inhibiting the angiotensin-converting enzyme. It has also been
demonstrated that this plant has beneficial effects on the cardiovascular system,
lowering blood pressure by blocking calcium channels and suppressing the activity of
the angiotensin-converting enzyme. They function by reducing the rate at which calcium
enters the heart's and blood vessels' cells, widening blood vessels and facilitating better
heart pumping. Although components are formed naturally and do contain ACE
inhibitors and calcium channel blockers, no negative effects have been documented
according to tests. As a result, the heart doesn't have to work as hard, and blood
pressure lowers This effect is also accomplished by the plant's activation of the release
of nitric oxide and bradykinin.

A peptide called bradykinin is present in the body and aids in expanding or opening
blood arteries. As a result, blood can circulate more easily throughout the body and
blood pressure can be reduced. Many types of anti-hypertensive drugs aid in boosting
bradykinin synthesis or preventing it from occurring within the body when certain
conditions exist. Medical experts have observed that bradykinin aids in enhancing the
permeability of soft muscle tissue, such as blood vessels, allowing it to contract and
open.

The body naturally produces nitric oxide, which serves as a messenger between cells.
One of its primary purposes is to widen blood arteries, which is why it is occasionally
administered to heart patients in supplement form orally and intravenously.

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Kaur also conducted a phytochemical analysis of Gynura and found that it contains
several different groups of natural chemicals, including chlorogenic acid, kaempferol,
quercetin, and rutin. According to studies, quercetin has a significant vasodilatory effect
on noradrenaline-precontracted arteries and affects sodium and water absorption in the
renal tubules, which may help regulate blood pressure. Dietary chlorogenic acid has
been shown to lessen hypertension by reducing oxidative stress and increasing nitric
oxide bioavailability. Gymura procumbens leaf crude water extracts contain a high
flavonoid concentration and have in vitro cardiorelaxing and vasodilating effects.

The flavonol kaempferol is reasonably common in many plants, including several

berries that can be eaten. These substances have anti-inflammatory, anti-oxidative, and
antihypertensive properties. Quercetin, one of the most prevalent flavonoids found in
fruits and vegetables, has been proven to cause a gradual, dose-dependent, and long-
lasting decrease in blood pressure. It also has lipolytic and anti-cancer actions.
Additionally, it stopped the beart's morphological and functional modifications. Rutin is a
polyphenolic bioflavonoid that is highly potent molecule due to its strong antioxidant
characteristics. It increases generation of reactive oxygen species linked with
hypertension and damages blood vessels and kidney. According to Baboota et al., it
has broad-spectrum pharmacological benefits that include the treatment of numerous
chronic illnesses like cancer, diabetes, hypertension, and hypercholesterolemia.
Chlorogenic acids (CGAs) are strong antioxidants that can be found in a variety of foods
and beverages. Consumption of chlorogenic acid can have an anti-hypertension effect.
Mechanistically, the metabolites of CGAs attenuate oxidative stress (reactive oxygen
species), which leads to the benefit of blood-pressure

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reduction through improved endothelial function and nitric oxide bioavailability in the
arterial vasculature.

Gynura was the subject of a study by Mendelson to determine its antihypertensive

potential in rats with spontaneous hypertension (SH). Gynura procumbens water extract
(GPWE) was administered repeatedly to SH rats using gastric irrigation for 4 weeks,
and the results demonstrated long-lasting effects on blood pressure as well as an
increase in urine flow rate. Gynura blocks several neurotransmitters and physiological
substances that play a significant role in the process and mechanism of blood pressure,
including acetylcholine, phenylephrine, methoxamine, angiotensin II, and isoprenaline.
These findings suggest that Gynra procumbens lowers blood pressure through a non-
selective pathway that is mediated by promotion of vasodilation, stability of the heart,
and diuretic action.

Gynura should be taken in the morning before breakfast; 4-7 mature leaves, with length
of 2-3 inches per leaf, medium sized, and should be washed thoroughly. Then it will be
chewed in until they turn into a thick paste before swallowing. Drinking a glass of warm
water will be helpful. Consistency of eating the leaves everyday should be maintained
until improvement.

After studies and research done about the contents and properties of Gynura as an
antihypertensive, the following questions were raised:

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Research Question 2. What is the blood pressure of the hypertensive participants after
taking Gynura for 4 weeks?

Research Question 3. Is there a significant difference in the systolic and diastolic blood
pressure of the participants taking Gynura leaves before and after the intervention?

Research Question 4. Is there a significant difference in the systolic and diastolic blood
pressure between hypertensive patients taking and not racerving Gynura for 4 weeks?

Accordingly, the researchers hypothesized that eating Gynura leaves leads to lower
blood pressure.There is no significant difference in the systolic and diastolic blood
pressure of the participants taking Gynura leaves before and after the intervention, and
between taking and not taking Gynura.

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3.0 RESEARCH METHODOLOGY

3.1 Research Design

This research study entitled, "Healing me Softly with this Leaf: The Effectiveness of
Gynura Leaves in Controlling Hypertension", made utilization of a quantitative,
experimental research. Quantitative research is a formal, objective, rigorous, systematic
process for engendering numerical information about the world, and supplementally to
decide the efficacy of treatments. This has been culminated via test whereby the
researchers do randomization, manipulation of prerequisites for the motive of deciding
their impact on conduct by administering no remedy to the manage group and a
treatment to the experimental crew (e.i. they will be given Gynura leaves). It is
structured in terms of independent, and structured variables. The impartial variable is a
manipulated environmental stimulus dimension and the predicated variable is a
behavioral dimension that exhibits the influence of the independent variables. The
customary objective in experimental research is to outline the relationship between the
impartial and dependent variables. In line with this, the researchers reflect
onconsideration on this kind of format for this unearth information regarding betokened
to have a visual examination of the effect of Gynura procumbens on blood pressure of
hypertensive participants.

3.2 Research Locale

The researchers carried out the study in Sitio Junji, Barangay Kaligayahan, Novaliches,
Quezon City. It is placed alongside nook of Rockroll Street, alongside Quirino Highway
with adjoining places namely, Incipient Haven on its East, Kaypian on its north and

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Malapaka on its Northwest. It has a whole land region of about 10, 313 rectangular
meters or about 1.1 hectares, and it is often underdeveloped and most of the houses
are gently built. The consummate populace of Sitio Junji is about 358 inhabitants
(omitting renters) and about 128 households in accordance to statistical information
amassed from the Barangay The researchers considered the region as their attainable
locale of learn about because approximately 38% of the total populace are a while forty-
five and above, and 54% of them are hypertensive as per report of the Barangay Health
Center. Withal, monetary repute of the denizens frequently falls along the
penuriousness line and economic assets have been their principal quandary. The
researchers additionally discovered that there are plenty of denizens in the vicinity who
have planted Gynura which was genuinely subsidiary to the study.

3.3 Population and Sampling

This unearths information regarding viewed a population of 30 participants: living in Sitio

Junji regardless of gender, a while 35-60 years old, kenned hypertensive but non-
compliant with medications, no regarded underlying diseases such as renal failure and
adrenal quandary.

The researchers utlized the approach of facile desultory sampling Sumple desultory
sampling is defined as a subset of a statistical populace in which every member of the
subset has an equal probability of being opted for. A simple desultory pattern is
supposed to be an independent illustration of a group.

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3.4 Research Ethics

The researchers discovered the precept of autonomy, cognizant consent, confidentiality.
beneficence, and non-maleficence in the conduction of the study. The researchers
made positive that the contributors had been no longer force to take section in the
study. For this to be sustained, a letter of sanction was once given designating the
cause of the study. This is the place the precept of autonomy applied-defined by way of
Baul as the non-public rule of the self that is liberate from both controlling, interferences
with the avail of ours, and from private boundaries that forestall paramount cull, is
implemented.

Another moral principle utilized which anses from principle of autonomy is the precept of
erudite consent. It is about people's grasp and melination to participate in the analyze
about and now no longer about simply signing a shape (UNC Charlotte, 2014). This
used to be utilized with the avail of making positive that the attainable men and women
have understood the purport procedures, viable risks and beaisons of their involution,
and their alternatives to participation, and that they have been no longer pressured to
take part in the study

Principle of confidentiality used to be once moreover optically canvassed. According to

Burns and Grove (2013), confidentiality is the safety of non-public data and restrict on
efficacious sorts of information. The researchers put this into exercise by way of
ascertaming that the identification of the contributors will no longer be made viewed to
all of us in any betokeus. In line with the principle of confidentiality is the principle of
anonymity which is when a participant's identification can't be linked with his man or girl
replications as described.
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Researchers withal discovered the standards of beneficence and non-maleficence

together and goal at engendering internet obtam over harm. According to Ford and
Reutter (2011), beneficence relates to the advantages of the research, whilst non-
malificence relates to the plausible risks of participation. Hence, the researchers did
rigorous and magnificent inculcation earlier than and in the direction of the leam about
and ascertain to furnish each participant net advantage and that is to manipulate
hypertension. In this context, non-maleficence was additionally utilized via stringent
monitoring of the participants' blood stress and bodily contrast whilst taking Gynura
leaves to stop any damage such as hypotension.

3.5 Research Instrument

The researchers utilized the following techniques and implements in amassing data;
Questionnaire method. The researchers used questionnaire indited on paper that was
once validated with the avail of a cardiologist, naturopathic medico, rural health medical
medico and statistician which individually administered by way of the researchers to the
participants Mechanical contrivances. The researchers used mechanical contrivances
like sphygmomanometer and stethoscope to quantify and reveal the blood stress of the
participants. They withal used records accumulation sheet to document their blood
pressures, demographic profile, and past and current illness

3.6 Data Collection

The researchers made a letter and signed by the dean of Our Lady of Fatima Univesity,
College of Nursing Quezon City to ask permission to the authorized health officer of
Quezon City Health Department to conduct the study.

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3.7 Data Analysis

The researchers subjected the gathered statistics in a licensed statistical software

program for evaluation and computation, called stata S.E. Version 12, with the aid of
their statistician, whereby quantitative variables have been summarized and presented
as suggest and popular deviation, whilst qualitative variables were tabulated and
presented as frequency and percentage distribution. Comparison of blood pressure
between experimental and control agencies were determined and tested using an
impartial t-test, while contrast of blood stress between before and after follow-up had
been in contrast using structured t-test. The degree of value (alpha) was once set at
0.05.

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4.0 RESULTS
This section offers the presentation, analysis, and interpretation of data. The
researchers made use of tables to show the frequency counts and percentage. The
presentation used to be as soon as additionally supported.

4.1 Age

Table 1 indicates the distribution of hypertensive individuals in terms of age. Among the
15 contributors assigned in experimental group, there is one (1) participant comprising
6.67% belonging from a long time 35-39, four (4) participants or 26.67% from a long
time 40-44, three (3) individuals or 20% from a while 45-49, 5 (5) members or 33.33%
from ages 50-54, while two (2) participants or 13.33% from 55-59, and no participants
for age 60. As to the 15 participants of the control group, 4 (4) contributors belong to a
long time 35-39 which consists of 26.67% of the total, three (3) contributors or 20%

from ages 40-44, two (2) participants or 13.33% from a long time 45-49, three (3)
individuals or 20% from a while 50-54, three (3) individuals or 20% from a while 55-59
and no participant for age 60.

4.2 Gender

Table 2 suggests the distribution in terms of gender. Participants in the experimental

group are more ladies comprising 9 (9) of them or (6) or 40% with the participants
assigned in the control group, females are ten (10) or 66.67% whilst the remaining 5 (5)
which 33.33% of complete are males.

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4.3 Family History

Table three shows the distribution of participants in terms of presence of family history
of hypertension. For experimental group, there are six (6) participants or 40% who has
regarded family history of hypertension; five (5) or 33% of the contributors has no family
history of hypertension and 4 (4) individuals does no longer recognize if they have
family records of hypertension due to distinctive motives (e.g they were not able to with
their parents). For the managed group, there are seven (7) contributors or 47.67% who
have household records of hypertension, three (3) contributors or 20% have no family
history of hypertension, and 5 (5) participants or 33.33% have unknown household
history of hypertension.

4.4 Summary Result of The Systolic and Diastolic Blood Pressure between
Experimental and Control Group

Based on the result of the blood pressure on the last day, day 28, of the experiment
timeline course, Table four shows that the imply systolic blood pressure (SBP) and
diastolic blood strain (DBP) of the team with Gynura intervention is 118.46 mm Hg and
82.31 mm Hg respectively. While the team without Gynura intervention has a suggested
SBP and DBP of 156.00 mm Hg and 100.67 mm Hg respectively. The computed t for
SBP is 10.044 with a corresponding tabulated t price of 1.7056. While for DBP,
computed t is 4.9172 with a corresponding tabulated t value of 1.7056 also. The P-value
of each SBP and DBP is much less than 0.001. According to Burns and Grove (2013), if
the computed value is higher than the tabulated value then rejects the null hypothesis
and receive the alternative hypothesis. As the rule states, then the null hypothesis is
rejected concluding there is enormous distinction in the systolic blood strain between
hypertensive sufferers taking and now not receiving Gynura for four weeks; likewise,
there is a massive difference in the diastolic blood pressure between hypertensive
patients taking and not receiving Gynura for 4 weeks.

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5.0 DISCUSSION

5.1 Demographic Profile

This study demonstrates that more women than men are diagnosed with hypertension
on a regular basis. Males are substantially less likely to seek primary care services than
women, hence women are more frequently diagnosed with hypertension than men.
Additionally, when unwell, they refuse to consult a doctor and seek treatment. However,
despite the fact that age is a significant risk factor for hypertension and can occur at any
age in both sexes, according to the data presented, there is no age group that
predominately experiences hypertension.

5.2 Blood Pressure of the Participants

The researchers determined that there is a significant difference in the systolic and
diastolic blood pressure between hypertensive subjects taking and not getting Gynura
leaves for 4 weeks based on the study's data, t-Test computation, and interpretation.
Because it aids in the evaluation of the experimental group, using the control group,
which did not receive the intervention, as a comparison group for those who had
received Gynura, increased the stability of the result that there is truly a significant
difference. For instance, the community in which a person lives may be influenced by
favorable societal influences, which may contribute to the decrease of blood pressure

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On the basis of the computed value, researchers also came to the conclusion that there
is a substantial difference between the participants ingesting Gynura leaves before and
after the intervention in terms of their systolic and diastolic blood pressure. The
difference in mean SBP and DBP between days 1 and 28—which decreased from a
mean SBP of 180.00 mmHg and a mean of 101.54 mmHg on day 1 to a mean SBP and
DBP of 118.46 mmHg and 82.31 mmHg, respectively—also supports this result. It can
also be assumed that the experimental group's blood pressures were within a few
millimeters of normal blood pressure, which is defined as values of 110 mmHg SBP and
70 mmHg DBP.

Therefore, consuming 7 gynura leaves every day for a month has been shown to be
useful in managing hypertension based on the aforementioned interpretations. This is
demonstrated empirically by the fact that people assigned to the experimental group
had blood pressure that was lower and closer to normal than participants assigned to
the control group, whose hypertension remained unaffected. This finding is supported
by the study, which found that eating Gynura leaves has a vasodilating effect by
facilitating nitric oxide synthesis in the body and inhibiting certain neurotransmitters and
bodily chemicals that are significant contributors to the process and mechanism of high
blood pressure that causes vasoconstriction. Gynura leaves, an herbal plant having
advantageous cardiovascular properties, also lower blood pressure by blocking calcium
channels and inhibiting angiotensin-converting enzyme activities. They work by slowing
the movement of calcium into the cells of the heart and blood vessel walls, which makes
it easier for the heart to pump and widens blood vessels, thus lowers blood pressure.

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5.3 Limitations

Despite the fact that the hypotensive action of gynura is the only known adverse effect
of eating the leaves, participants were urged to report any discomfort or changes to
normal functioning while taking the leaves in order to prevent any problems. One of the
15 participants in the experimental group withdrew in the middle of the trial due to the
sticky texture and flavor of the gynura. Gynura leaves have a distinctive flavor that is
slightly tangy and slimy in the mouth. They are edible. Even the subject, who accepted
to participate in the study, was initially able to endure the taste of the leaves; but, later
on, the individual began to feel the want to vomit while consuming the leaves.

The third week of data collection saw the researchers giving one participant advice to
stop taking Gynura because the participant's recorded blood pressure did not go down;
instead, it remained static at its hypertensive state. The participant also reported
difficulty urinating, which had started long before the study was conducted. Researchers
thought that a participant in a study might have a renal condition or other comorbidities
based on their observations of beneficence and non-maleficence, so they stopped the
woman's participation and encouraged her to see a doctor for a more thorough
evaluation. Renal artery stenosis and renal failure are two kidney conditions that can
lead to high blood pressure that is difficult to manage with medication or other
treatments. Therefore researchers, conjecture that comorbidities such as renal diseases
interfere to the effectiveness of Gynura to be an antihypertensive.

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College of Nursing

6.0 Conclusion

This research aims to identify the effectiveness of eating Gynura leaves in controlling
hypertension. Results showed that there is significant difference in the systolic and
diastolic blood pressure between hypertensive patients taking and not receiving gynura
for 4 weeks with p-value of less than 0.001 (p<0.001). Also, the comparison of blood
pressure of before and after Gynura intervention showed a result of significant
difference in the systolic and diastolic blood pressure before and after the intervention
with a p-value also of less than 0.001 (0.001). Therefore, the researchers concluded
that taking 7 gynura leaves is proven effective in controlling hypertension.

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College of Nursing

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