Adherence to Lifestyle Modification among Hypertensive Clients: A Descriptive Cross-Sectional Study (original) (raw)
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Clinical Hypertension, 2017
Background: Hypertension is one of the leading causes of disability and death in both developed and developing countries that need urgent strategies to implement interventions that control it. Appropriate lifestyle changes often called non-pharmacological approaches that often overlooked are the corner stone of the prevention and control of hypertension. The aim of this study is to assess the practice of lifestyle modifications and associated factors among diagnosed hypertensive patients in Durame and Nigist Elleni Mohamed Memorial General Hospitals in southern Ethiopia. Methods: Facility-based cross-sectional study was conducted among 205 hypertensive patients in Durame and Nigist Elleni Mohamed Memorial General Hospitals in Sothern Nation and Nationality People Representative (SNNPR), from March 1-30 2016. Simple random sampling was used to select study subjects. Data were entered to Epidata 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20.0 for analysis. A binary Logistic regression model was fitted to determine independent predictors of lifestyle modifications among hypertensive patients. Adjusted odds ratio at 95%CI was used to declaring the independent effect of each variable on the outcome variable. Result: The study revealed that only 56(27.3%) of the patients practiced recommended lifestyle modifications. The study found that age (Adjusted Odds Ratio [AOR] = 0.27, 95% Confidence Interval [CI]:0.13-0.61), educational status (AOR = 2.00,95% CI:1.33-6.75), monthly income (AOR = 2.46, 95% CI:1.32-4.63), years since diagnosis (AOR = 2.48, 95%CI: 1.32-4.69), and co-morbidity (AOR = 0.28,95% CI: 0.13-0.61) were factors significantly associated with lifestyle modification practice (p < 0.05). Conclusion: Generally, lifestyle modification practices among hypertensive patients were low in this study. Therefore, Patients should be educated on the recommended lifestyle modifications that may help patients to control f their blood pressure.
Journal of Lumbini Medical College, 2015
Introduction: Lifestyle modifications is an important aspect of hypertension therapy. However, studies on this nonpharmacological approach of hypertension management and its impact is very limited in a developing country like Nepal. The objective of the present study was to determine the life style of patients after diagnosis of hypertension. Methods: A descriptive cross sectional study design was conducted in Lumbini Medical College Teaching Hospital (LMCTH). A total of 63 patients attending Medical outpatient clinic of Lumbini Medical College who were diagnosed as hypertensive at least two months before the interview were included. Data were collected from 22 nd February 2015 to 21 st March 2015 by interview method using a questionnaire consisting of a combination of structured and semistructured questions. Results: This study revealed that non-vegetarian decreased from 95.2% to 74.6% after diagnosis. Lifestyle modification criteria like amount of salt intake, smoking, and alcohol consumption were significantly reduced whereas physical exercise and stress reduction activity were significant increased. Conclusion: Majority of respondents has changed their lifestyle after diagnosis of hypertension.
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.
Public Health – Open Journal
Background: Hypertension (HTN) is the major risk factor of cardiovascular diseases. Despite the increasing trends suggesting that HTN is a growing public health problem in developing countries; studies on its prevalence, associated risk factors, and extent of blood pressure control have been mostly done in communities in these countries. In Cameroon, there exists few data on the prevalence of hypertension in hospital area. Aim of the study: To determine the prevalence of hypertension and identifying the cardiometabolic risk factors associated with HTN of the patients attending to Deido District Hospital. Methodology: Descriptive and cross sectional survey was carried out at the Deido District Hospital. For this, 805 cameroonians male and female aged 20 years above were recruited on their arrival at the hospital. After filling a questionnaire related to their lifestyle (cigarette, food consumption frequency, practice of physical activity), the following parameters were recorded: age, gender, weight, height and glycemia. HTN was defined according to 2017 American College of Cardiology and the American Heart Association (ACC/AHA) guidelines. Hyperglycemia was diagnosed with Intermediate distribution frame (IDF) criteria. Body mass index was calculated and physical activity was defined according to World Health Organization (WHO) recommendations. Results: The prevalence of hypertension was 28.4%. Concerning subtypes of HTN, the prevalence of subdural hematoma (SDH) was 27.1%, that of ISH was 15.7% and that of intradialytic hypotension (IDH) was 17.8%. Women were more affected than men (63.8% vs 36.2%). The prevalence of hyperglycemia was 16.2%, obesity was 40.2% and overweight was 30.6%. Adults aged 40-59, 60-79 and 80 and above were 1.99, 4.21 and 4.71 times more exposed to HTN (OR=1.99; p=0.002), (OR=4.21; p=0.000) and (OR=4.71; p=0.014). Concerning marital status, individuals "Divorced", "widowed" and "married" individuals were more exposed (OR=5.40; p=0.006), (OR=2.17; p=0.000) and (OR=2.10; p=0.006). Monthly Wages influences the onset of HTN. Individuals having high (OR= 4.40; p=0.000), middle (OR=2.92; p=0.000) and minimum (OR=2.08; p=0.015) monthly wages were more exposed to HTN than none. Concerning educational level, it appears that those with University education were 3.32 times exposed to HTN following by those with secondary education (OR=2.98; p=0.004) and primary education (OR=2.49; p=0.010). In the case of physical activity, those who don't practice physical activity were 0.24 times exposed than others (OR=0.24; p=0.050). Conclusion: Around one-third of the subjects were hypertensive. Age, sedentarity (physical inactivity), monthly wages, marital status and education level were cardiometabolic risk factors associated to hypertension.
Risk Factors Associated with Hypertension among Adults in the Hohoe Municipality, Ghana
British Journal of Medicine and Medical Research, 2016
Hypertension plays a persistent role in the causation of coronary heart disease, stroke, and vascular problems. Many factors like dietary, behavioral, psychological, environmental, genetic, etc have a direct or indirect influence on hypertension. The available evidences shows a higher prevalence of hypertension in Nepal. The objective of this study was to assess the prevalence and risk factors associated with hypertension among adults of Nagarjun Municipality. A descriptive cross-sectional study was conducted among adults of age 18 and above in Nagarjun municipality. A structured questionnaire was used to assess the risk factors and observation was done to determine blood pressure and anthropometric measurement. The data were entered and analyzed by (SPSS) software version 20. Chi-square test was used to identify the association. The overall prevalence of hypertension was 22.8% and prehypertension was 14.5%. More males were found to have hypertension (28.09%) compared to females (16.67%). Age, sex, religion, socioeconomic status, ciggrate smoking, alcohol consumption, BMI, diabetes, family history of hypertension and cardio vascular disease was found to be significantly associated with hypertension. The preventive and intervention measures should be adopted to reduce the behavioral and biological risk factors which are directly related with the causation of hypertension.
Journal of Hypertension and Cardiology, 2013
Background: Hypertension is a public health problem with high mortality and morbidity globally. A rapid assessment of hypertensive patients at Harare Central Hospital Outpatients Department (OPD) in June 2013 revealed that 41% of patients had uncontrolled hypertension. We, therefore, explored the factors associated with uncontrolled hypertension among hypertensive patients at Harare Hospital. Methods: A one-on-one unmatched case-control study was conducted among 118 cases and 118 controls. A case was a person aged 18years and above on hypertensive treatment for ≥6months with mean Blood Pressure (BP) ≥ 140/90mmHg while a control was 18years and above on hypertensive treatment ≥6 months with mean BP<140/90mmHg. Interviews were used to collect information on socio-demographic, treatment, health system, condition, and patient-related factors. Written informed consent was obtained from all study participants. Medication adherence was measured with Morisky medication adherence scale-8. Results: The median ages for cases were 49 years (IQR: 41-63) and 48 years (IQR: 42-62) for controls. Almost 57% were women with 23% living in rural areas. Most cases (94%) and controls (78%) added salt to meals. Rural women were less likely to have uncontrolled BP compared to urban women (OR=0.7; 95%CI: 0.35, 1.37). Lack of exercise, adding salt to meals and eating fruits/vegetables less than three times/week were associated with uncontrolled BP. Independent factors associated with uncontrolled BP were low adherence to medication, aOR 22.03 (95%CI: 9.10,53.5), receiving health education, aOR 0.24 (95%CI: 0.11 , 0.53), exercises aOR 0.33 (95% CI: 0.15,0.73) and on medical insurance aOR 2.69 (955CI: 1.12,6.44). Conclusions: Common risk factors for hypertension were associated with uncontrolled BP. Since these are modifiable factors there is a need to implement interventions that will encourage healthy living in this population to improve treatment outcomes.
International Journal of Medicine and Biomedical Research, 2014
Background: Hypertension ranks first among the non-communicable diseases in Nigeria and globally. Interventions like lifestyle modifications, with its advantages, are often overlooked. Awareness and practice of these measures will aid in blood pressure control. Aim: To assess the level of awareness and practice of lifestyle modification among hypertensive adults in a semi-urban community of Olokoro in Umuahia South local government area of Abia state, Nigeria. Methods: A crosssectional study involving adult hypertensive patients who presented during a medical screening exercise. Structured pre-tested researcher administered questionnaire was used for data collection. Results: A total of 101 individuals were recruited; 58 (57.4%) males and 43 (42.6%) females. Mean age was 56.7±12 years with a range of 27 to 84 years. Mean systolic and diastolic BP were 143±17mmHg and 80±12mmHg respectively. Up to 87.1% were unaware that regular exercise is part of lifestyle modification while 60% are unaware of the need for moderation of alcohol intake. More than 80% are unaware of the roles of vegetables, fruits, unsaturated oil and reduction in diary food intake in the control of BP. Among 88 participants with some knowledge of salt restriction, 68.2% practiced it. This also applied to 8.6%, 7.5%, 32.3%, 12.9% and 6.5% of those with knowledge of regular exercise, weight reduction, alcohol moderation, fruit intake and cigarette smoking respectively. There was a negative correlation between the level of practice and both systolic and diastolic blood pressures. Conclusion: Awareness level and practice of lifestyle modification in blood pressure control among the studied cohort is poor. Concerted strategies need to be taken to improve these.
Sage Open Medicine, 2021
Introduction: Adherence to lifestyle modification in addition to medication adherence is very important in preventing complications. Nevertheless, lifestyle modification guidelines are not widely followed by patients with hypertension. The objective of the study was to explore the predictors of compliance with lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019. Method: A descriptive cross-sectional study design was used. A total of 384 patients with hypertension were included in this study. A systematic sampling method was used to select study participants. The data were collected through an interview method by using a structured questionnaire. The data were entered and analyzed using SPSS. Each variable was summarized using summary statistics. To measure the association between lifestyle modification and its predictors, bivariate and multivariate logistic regression model was used. P-value < 0.05, odds ratio (OR), and 95% confidence interval (CI) were used to determine statistical significance, direction, and strength of association. Results: Two hundred six (53.6%) patients with hypertension had poor adherence to the recommended lifestyle modification. Male patients with hypertension were more adherent to lifestyle modification compared with female patients (adjusted OR (AOR) = 0.60, 95% CI: 0.39–0.92). The rate of poor adherence was 1.86 times higher among patients with hypertension diagnosis of <5 years compared with patients with hypertension diagnosis of ⩾5years(AOR = 1.86, 95% CI: 1.19–2.89). Patients who were adherent to their medication were 2.13 times to have poor adherence to lifestyle modification compared with medication non-adherent patients (AOR = 2.13, 95% CI: 1.38–3.27). Conclusion: High proportions of patients with hypertension were non-adherent to lifestyle modification. Sex, age, duration of the disease, and medication adherence were significantly associated with lifestyle modification adherence. Close follow-up of female patients, the elderly, and patients with a short duration of hypertension is recommended. Keywords: Hypertension, lifestyle modification, adherence, factors affecting.
The Journal of Medical Research, 2017
Background: Hypertension is the most common of the risk factors for cardiovascular and renal disease affecting approximately 1 billion people worldwide, with more than 25% prevalence in Nigeria. Adherence to medications and life style changes are important to achieve desired therapeutic goal. This study was designed to evaluate the perception, knowledge and practices of life style modification measures among Northwestern Nigerian hypertensive patients. Methods: This was a cross-sectional study conducted at the Hypertensive clinic of Murtala Muhammad Specialist Hospital, Kano, NorthWestern Nigeria.Structuredpre-tested interviewer administered questionnaire was used for data collection.Questions werecategorized to elicit participants' demographic characteristics, knowledge, perception and practice of various lifestyle-modification measures. Chi square tests were performed.Reliability and validity of the dimensional structure of the questionnaire were assessed in factor analysis with principal component extraction using varimax rotation. Results: A total of 104 participants were recruited; 51 (49%) males and 53 (51%) females. Mean age was 56±11.7 years, with a range of 24 to 90 years. Mean systolic and diastolic BP were 151±25.7mmHg and 90±14.3mmHg respectively. Up to 92% were aware that regular exercise is part of lifestyle modification while 81% are aware about salt restriction. Only 9% and 13% of the participants are aware of the roles of unsaturated oil and reduction in diary food intake in the control of BP. Overall, 33(31.7%) of the patients had good knowledge, 40(38.5%) average knowledge and 31 (30%) poor knowledge. Despite the positive attitude towards lifestyle measures, only 59(56.7%) had good adherence. Questions in the knowledge domain had the best reliability index (alpha Cronbach 0.79) compared to attitude and practice domains. Conclusion: The level of knowledge and practice of lifestyle modification in blood pressure control among the studied population is low. Concerted strategies are required to increase the awareness, knowledge and practice of the lifestyle-modification measures in this part of the world.