A descriptive study of adherence to lifestyle modification factors among hypertensive patients (original) (raw)
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International Journal of Pharmacy and Pharmaceutical Sciences, 2015
All adult patients (>18 year) diagnosed with essential hypertension were recruited. A convenience method of sampling was adopted. Data was processed using the software Statistical Package for Social Science (SPPS). P values of<0.05 were considered as statistically significant. Results: Overall, 144 patients were included. Of them 92 (63.9%) were recruited from Princess Mansour Hospital and 52 (36.1%) others from Al-Hada Hospital. Rates of adherence to exercise, a healthy diet and medications were 20.1%, 11.8% and 34.7% respectively. The level of monthly income was found to be strongly associated with adherence to both a healthy diet (* P =0.046) and regular exercise (* P = 0.004). Presence of other co-morbidity was found to be an important factor in the commitment to a healthy diet (* P = 0.012), regular exercise (* P = 0.028) and medications (* P = 0.002). Patients of ages <65 year were found to be more adherent to a healthy diet compare to elderly ones (* P = 0.007). Only 6 (4.2%) patients were found to be adherent to all studied domains. Adherence to all domains increased significantly with educational level (* P Conclusions: Adherence to all studied domains was sub-optimal. Well-organized and individualized patient-oriented education is needed. = 0.002).
Assessment of blood pressure control in adult hypertensive patients in eastern Sudan
BMC Cardiovascular Disorders, 2018
Background: The rate of blood pressure (BP) control in adult hypertensive patients is poor and the reasons for poor control of BP pressure are not fully understood globally. This study aimed to assess the rate and factors associated with BP control in adult hypertensive patients in Sudan. Methods: A hospital-based cross-sectional study was conducted in adult hypertensive Sudanese patients at Gadarif Hospital in eastern Sudan from November 2016 to March 2017. Information on sociodemographic characteristics of the participants, comorbidities, antihypertensive medication, and adherence to antihypertensive medication was gathered from patients using a questionnaire. Fasting cholesterol and triglyceride levels were measured. Results: A total of 380 patients were enrolled. Of them, 234 (61.6%) were women. The mean (SD) age of the participants was 57.8 (11.1) years (range: 25-93 years). Over one-third (n = 147, 38.7%) of the participants were taking more than one antihypertensive medication. Approximately one-third (29.5%) of the participants were nonadherent to medication. The rate of BP control was 45.3%. In binary logistic regression analyses, age, sex, physical inactivity, adding salt to food, drinking coffee, body mass index, and the lipid profile were not associated with uncontrolled BP. However, non-adherence to medication was the main factor associated with uncontrolled BP (odds ratio = 5.29, 95% confidence interval = 3.16-8.83, P < 0.001). Conclusions: Almost half of hypertensive patients in follow-up have uncontrolled BP, mainly due to non-adherence to medicine. We recommend further research on drug adherence to improve the rate of BP control in this setting (Gadarif) of the Sudan.
The World Health Organization defines adherence to medication as the degree to which the person's behaviour corresponds with the agreed recommendations from a healthcare provider. The WHO describes poor adherence as the most critical cause of uncontrolled blood pressure and estimates that 50-70% of people do not take their antihypertensive medication as prescribed. Aim: To determine the level of adherence to antihypertensive medications and blood pressure control among patients attending primary health care centres. Methodology: The study was a cross-sectional and carried for three weeks on 5 PHCC in Jeddah targeting hypertensive patients over the age of 18 and excluded younger than 18 and pregnancy associated hypertension. By using a special designed questionnaire, the Hill-Bone Compliance to High Blood Pressure Therapy Scale in Arabic language. Results: This study included 432 participants; male constitutes 31.2% while females were found to be 68.8%. Age group between 55-60 years were found to be most prevalent in our study (37.6 %). More than 95% of participants were Saudi citizens. Patients with hypertension less than 1 year were 16.24%, between 1-5 years were about 30%. More than 61% of study participants were adherent to their medications while 38.46% were not adherent to medications of hypertension. Conclusion: Non-adherence to the therapeutic regimen remains a major limiting factor of hypertension management in Saudi Arabia. Overall the medication adherence was poor in hypertensive patients. Poor adherence to therapy is largely unrecognized in clinical practice. Our study suggests that, improving medication adherence in hypertensive patients can help to achieve optimal blood pressure goals and prevent further hypertension related complications. Adherence to therapeutic regimens is an important factor for optimal clinical benefits; therefore, efforts should be made by the physicians to identify the reasons for non-adherence and initiate steps to improve it.
An Arabic instrument to Measure Medication Adherence in Saudi Hypertensive Patients
World Family Medicine Journal/Middle East Journal of Family Medicine, 2013
Objectives: To estimate the prevalence of depression and identify associated risk factors among elderly attendants of primary health care centers in Abha City, KSA. Methodology: A cross-sectional approach was carried out among a representative random sample of registered patients, who are 65 years of age or more, at the randomly selected three PHCCs in Abha, KSA. The tool used for data collection consisted of two parts; the first part was about personal information of the participants, while the second part was a validated geriatric depression scale-short form. Results: The study included 400 elderly patients (200 males and 200 females). Their age ranged between 65 and 80 years with a mean of 71.9 years and a standard deviation of 4.2 years. Depression, regardless of its severity, was recorded among 63.7% of elderly patients. Mild and moderate depression was reported by 47.5% and 14.5% of elderly patients respectively while severe depression was reported by only 1.8% of them. Elderly patients of the following characteristics showed more significant depression according to multivariate logistic regression analysis results; females, singles or divorced, smokers, diabetics, cancer patients, osteoarthritis patients, patients with end-stage renal disease, hepatic patients and those having visual impairment. Conclusions: Depression constitutes a health problem among Saudi geriatrics in Abha, especially among women, those having history of chronic diseases and those having sensory impairment. These results provide insight for all physicians and nurses caring for the elderly, researchers in the field of Geriatrics, and health educators into the particular care needs of elderly patients in Abha, KSA.
Arterial hypertension is a leading risk factor for cardiovas-cular disease and stroke. This study aimed to assess the predictors of uncontrolled systolic and diastolic blood pressure (BP) in Lebanon among treated hypertensive individuals. The authors included 562 participants 40 years and older. The potential predictors included sociodemo-graphic characteristics, self-reported health information, and medication adherence. Prevalence of uncontrolled systolic and diastolic BP reached 43.1% and 24.9%, respectively. Independent predictors of uncontrolled systolic BP were older age, male sex, and low and medium medication adherence level. Predictors of uncontrolled diastolic BP were younger age, obesity, and low medication adherence level. Married individuals and patients taking statins had better diastolic BP control. Uncontrolled BP is a major public health problem in Lebanon. The authors identified low adherence as a major modifiable risk factor for systolic and diastolic BP control and obesity as a major modifi-able risk factor for diastolic BP control. J Clin Hypertens (Greenwich). 2016;1-7. ª 2016 Wiley Periodicals, Inc. Arterial hypertension (AH) is a leading risk factor for cardiovascular disease (CVD) and stroke. 1 Approximately 30% of the general population has AH, and this proportion increases to two thirds in older individuals. 2 A meta-analysis of 61 prospective studies including one million adults showed that the cardiovascular risk increases continuously and consistently without evidence of a threshold, down to blood pressures (BPs) as low as 115/75 mm Hg. 3 Audits conducted in patients with AH showed insufficient BP control, despite availability of effective antihypertensive treatments and guidelines. 4 The prevalence of uncontrolled AH varies between countries. 5 In the United States, analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2003-2010 indicated that more than 45% of treated individuals did not have their BP controlled at the 140/ 90 mm Hg threshold. 6 Meanwhile, within Europe, BP control reached 40%, 30%, 28%, 19%, and 21% among treated patients in England, Germany, Italy, Spain, and Sweden, respectively. 5 Similarly, within the Middle East, BP control reached 34.4% and 37% among treated patients in Jordan and Saudi Arabia, respectively. 7,8 Two recent studies evaluated BP control in the Lebanese population. On one hand, Matar and colleagues 9 reported a prevalence of 46% of uncontrolled BP in treated individuals; however, their study population was not representative of the whole population and they could not identify any predictor of uncontrolled BP. On the other hand, the I-PREDICT 10 study found that diabetes was associated with uncontrolled BP while predictors of good BP control were the early control of BP and the prescription of combination therapy at baseline; however, participants in this study were outpatients from hospitals and private clinics, thus they are not representative of the Lebanese population. Both studies conducted in Lebanon 9,10 did not tackle the relationship between advancing age and uncontrolled BP and did not assess medication adherence in treated hypertensive individuals. Furthermore, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) 11 suggests that systolic BP (SBP) is the main risk factor for CVD and stroke after 50 years of age and accounts for most cases of uncontrolled AH in individuals 60 years and older. In contrast, diastolic BP (DBP) is a more potent CVD risk factor than SBP until age 50. 11 Thus, the aim of our study was to assess sociodemo-graphic, self-reported, and clinical predictors of uncontrolled SBP and DBP among treated hypertensive individuals in a nationally representative sample of the Lebanese population. METHODS Study Design and Population In the framework of the study assessing the prevalence of CVDs and their risk factors among Lebanese
Tropical Journal of Pharmaceutical Research, 2013
A cross-sectional observational study was conducted in cardiology outpatient clinics at two hospitals in Amman, Jordan. Outcomes studied were prevalence of cardiovascular risk factors, patterns of antihypertensive medication use, rate of blood pressure control and factors associated with such control. Results: The number of concomitant medical conditions was high: diabetes mellitus (51 %), dyslipidemia (82 %), coronary artery disease (71 %), history of acute coronary syndrome (37 %) or coronary revascularization (64 %). Hypertension was controlled in 44 % of patients. Average number of antihypertensive medications was 2.38 ± 1.21. The most commonly prescribed monotherapy medications were beta-blockers (48 %), followed by angiotensin-converting enzyme inhibitors (ACEIs) with 28 % and angiotensin II receptor blockers (ARBs) with 23 %. Among all patients, beta-blockers (67 %) were also the most prescribed, followed by ACEIs (47 %) and ARBs (41%). Multivariate logistic regression analysis revealed inverse association between BP control and the presence of diabetes mellitus. Conclusion: There is inadequate cardiovascular risk assessment and control of blood pressure in hypertensive patients in Jordan. Several practical measures need to be taken urgently to mitigate these deficiencies.
Hypertension in Jordan: Prevalence, Awareness, Control, and Its Associated Factors
International Journal of Hypertension
Objectives. Determine the prevalence, awareness, and control rates of hypertension and their associated factors among Jordanian adults. Methods. A multistage sampling technique was used to select a nationally representative sample of adults from the population of Jordan. Trained interviewers collected data using a comprehensive structured questionnaire, measured anthropometric parameters, and collected blood samples. Results. This study included a total of 1193 men and 2863 women aged ranged from 18 to 90 year with a mean (SD) of 43.8 (14.2) year. The age-standardized prevalence was 33.8% among men and 29.4% among women. Of those with hypertnsion, 57.7% of men and 62.5% of women were aware of hypertension. Only 30.7% of men and 35.1% of women who were on antihypertensive medications had their blood pressure controlled. From 2009 to 2017, there was nonsignificant decrease in hypertension prevalence of 2.7% among men and 1.1% among women. However, the rate of hypertension awareness in...
2013
Copyright © 2010 N. Al-Hamdan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To determine the prevalence, risk factors, characteristics, and treatment practices of known adult hypertensives in Saudi Arabia. Methods. Cross-sectional community-based study using the WHO stepwise approach. Saudi adults were randomly chosen from Primary Health Care Centers catchment areas. Data was collected using a questionnaire which included sociodemographic data, history of hypertension, risk factors, treatment practices, biochemical and anthropometric measurements. Collected data was cheeked, computer fed, and analysed using SPSS V17. Results. Out of 4719 subjects (99.2 % response), 542 (11.5%) subjects were known hypertensives or detected by health workers in the past 12 months. Hypertension was significantly associ...
Integrated Blood Pressure Control
Background: Large segments of the hypertensive population in the world are either untreated or inadequately treated. The incidence of heart failure and mortality from cardiovascular complications of hypertension is high among patients with uncontrolled blood pressure (BP). But BP control status of hypertensive patients has not been investigated in the study area. The study aimed to assess BP control status and determinant factors among adult hypertensive patients on antihypertensive medication attending outpatient follow-up at University of Gondar Referral Hospital, northwest Ethiopia. Methods: An institution-based retrospective follow-up study was conducted from September 2015 to April 2016. Data were collected using a structured and pretested questionnaire adopted from the World Health Organization STEPwise approach. BP records of 6 months were used, and patients were classified as having controlled BP if their BP readings were <140/90 mmHg for all adults ≥18 years of age and <150/90 mmHg for adults aged ≥60 years. A generalized estimating equation was fitted, and the odds ratio with a 95% confidence level was used to determine the effect of covariates on BP control status. Results: Among 395 participants, 50.4% (95% CI: 45-55) of them controlled their BP in the last 6 months of the survey. Physical activity (adjusted odds ratio [AOR]=1.95, 95% CI: 1.41-2.68), duration on antihypertensive drugs of 2-4 years (AOR=1.70, 95% CI: 1.13-2.56) and 5 years or more (AOR=1.96, 95% CI: 1.32-2.92), and high adherence (AOR=2.18, 95% CI: 1.14-4.15) to antihypertensive drugs were positively associated with BP control, while salt intake (AOR=0.67, 95% CI: 0.49-0.93), overweight (AOR=0.50, 95% CI: 0.36-0.68), and obesity (AOR=0.56, 95% CI: 0.36-0.87) were inversely associated with BP control. Conclusion: In this study, only half of the hypertensive patients controlled their BP. Thus, health care providers need to be made aware about the importance of counseling hypertensive patients on drug adherence, moderate physical activity, and salt restriction to improve BP control.