Lifestyle practices among hypertensive patients attending the Family Medicine Clinic in a tertiary hospital in Nigeria

Alali Dan-Jumbo; Paul  O. Dienye; Nnenna O. Nnadi; Simon Uriah

doi:10.30574/gscarr.2021.6.2.0021

Authors

Alali Dan-Jumbo Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt Nigeria.
Paul O. Dienye Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt Nigeria.
Nnenna O. Nnadi Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt Nigeria.
Simon Uriah Department of Family Medicine, Rivers State University Teaching Hospital, Port Harcourt Nigeria.

DOI:

https://doi.org/10.30574/gscarr.2021.6.2.0021

Keywords:

Lifestyle modification, Practices, Hypertension, Nigeria

Abstract

Introduction: Hypertension is a major modifiable cause of cardiovascular disease affecting more than one billion people globally. Lifestyle modifications form the corner stone for the mitigation of identified risk factors and the prevention and control of hypertension. Some of these factors include cessation of cigarette smoking, weight reduction, increase in physical activity, moderation of dietary sodium and alcohol intake and following the DASH eating plan. They may also facilitate drug step-down and drug withdrawal in highly motivated individuals. The objective of this study was to determine the extent to which diagnosed hypertensive patients modify their lifestyle.

Methods: This was a cross-sectional study among 230 patients with essential hypertension in the Family Medicine clinic in a tertiary hospital using a structured pretested questionnaire.

Results: Most of the participants (149; 64.8%) were educated on lifestyle practices by health workers. Abstaining from tobacco products (230; 100%) and drinking alcohol (230; 100%) were the most used lifestyle practices. Dietary fruit consumption (93; 40.4%) and engagement in physical activity for thirty minutes per day (35; 15.2%) were the least used lifestyle practices.

Conclusion: Health workers were the main source of education of the participants on lifestyle modification. Use of alcohol and consumption of tobacco products were not practiced by all the study participants. Dietary fruit consumption and engagement in physical activity were not popular lifestyle practices. It is recommended that primary care clinicians inquire about unhealthy lifestyles during clinical consultations as well as motivate hypertensive patients to adopt and adhere to appropriate lifestyle modifications.

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References

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23.

Global, regional, national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. GBD 2015 Risk Factors Collaborators.Lancet. 2016; 388(10053): 1659-1724.

Nicoll R, Henein MY. Hypertension and lifestyle modification: how useful are the guidelines? Br J Gen Pract. 2010; 60(581): 879–880.

Madaki AJK. Lifestyle medicine in primary health care. Nigerian Journal of Family Practice. 2012; 2: 39-41.

Tsuchihashi T. [Lifestyle modification in the management of hypertension]. Nihon Rinsho. Nov 2011; 69(11): 1977-81.

Buda ES, Hanfore LK, Fite RO, Buda AS. Lifestyle modification practice and associated factors among diagnosed hypertensive patients in selected hospitals, South Ethiopia. Clin Hypertens. 2017; 23: 26.

Verma P, Manushi S, Ratan KS. Assessment of extent of lifestyle modification among diagnosed patients of hypertension attending tertiary care hospital. Int J Med Health Sci. 2015; 4(2): 196–201.

Hareri HA, Gedefaw M, Simeng B. Assessment of prevalence and associated factors of adherence to antihypertensive agents among adults on follow up in Adama Referral hospital, east Shoa, Ethiopia-cross sectional study. Int J CurrMicrobiol App Sci. 2014; 3(1): 760–70.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013; 35(2): 121-6.

Iloh GUP, Amadi A N, Okafor GOC, Ikwudinma AO , Odu FU, Godswill-Uko EU. Adherence to Lifestyle Modifications among Adult Hypertensive Nigerians with Essential Hypertension in a Primary Care Clinic of a Tertiary Hospital in Resource-poor Environment of Eastern Nigeria. British Journal of Medicine & Medical Research. 2014; 4(18): 3478-3490,

Powers BJ,Olsen MK, Smith VA, Woolson RF, Bosworth HB, Oddone EZ. Measuring blood pressure for decision making and quality reporting: where and how many measures? Ann Intern Med. 2011; 154: 781–788.

Iloh GUP, Ofoedu JN, Njoku PU, Amadi AN, Godswill-Uko EU. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria. Afr J Prim Health Care Fam Med. 2013; 5(1): 446.

Chow CK, Jolly S, Rao-Melacini P, Fox KA, Anand SS, Yusuf S. Association of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromes. Circulation. 2010; 121(6): 750-758.

Nolan RP, Liu S, Feldman R, Dawes M, Barr S,Lynn H, et al. Reducing risk with e-based support for adherence to lifestyle change in hypertension (REACH): protocol for a multicentred randomised controlled trial. BMJ Open. 2013; 3: e003547.

Ike SO, Aniebue PN, Aniebue UU. Knowledge, perceptions and practices of lifestyle- modification measures among adult hypertensives in Nigeria. Trans R Soc Trop Med. 2010; 104(1): 55–60.

Arora NK. Interacting with cancer patients: the significance of physicians' communication behavior. SocSci Med. 2003; 57(5): 791-806.

Hadiza S, Yakasai AM, Yau JA, Adamu FI, Mijinyawa MS. Factor analysis of knowledge, attitude and practice of life style modification measures among hypertensive patients in North – Western Nigeria. JMR. 2017; 3(2): 74-78.

Iyalomhe GBS, Iyalomhe SI. Hypertension related knowledge, attitudes and life style practices among hypertensive patients in sub – urban Nigerian community. Journal of public health and epidemiology. 2010; 2(4): 71 – 77.

Heymann AD, Gross R, Tabenkin H, Porter B, Porath A. Factors associated with hypertensive patients' compliance with recommended lifestyle behaviors. Isr Med Assoc J. 2011; 13(9): 553-7.

Durai V, Muthuthandavan AR. Knowledge and practice on lifestyle modifications among males with hypertension. Indian J Community Health. 2015; 27(1): 143–9.

Katibi IA, Olarinoye JK, Kuranga SA. Knowledge and practice of hypertensive patients as seen in a tertiary hospital in the middle belt of Nigeria. Niger J ClinPract. 2010; 13: 159–162.

Salako BL, Ayodele OE, Kadiri S, Arije A. Assessment of blood pressure control in a black African population. Trop Cardiol. 2002; 28: 3-6.

Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future national results on adolescent drug use: Overview of key findings, 2005. Bethesda, MD: National Institute on Drug Abuse; NIH Pub. No. 2006; 06-5882.

Jiang H, Livingston M, Room R, Gan Y, English D, Chenhal R. Can public health policies on alcohol and tobacco reduce a cancer epidemic? Australia's experience. BMC Med. 2019; 17: 213.

Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. Lancet. 2010; 376(9748): 1261–1271.

Jha P, Peto R. Global effects of smoking, of quitting, and of taxing tobacco. N Engl J Med. 2014; 370(1): 60–8.

Burns DM. Epidemiology of smoking-induced cardiovascular disease. Prog Cardiovasc Dis. 2003; 46(1): 11-29.

Azagba S, Sharaf MF. Disparities in the frequency of fruit and vegetable consumption by socio-demographic and lifestyle characteristics in Canada. Nutr J. 2011; 10: 118.

Rolls BJ, Ello-Martin JA, Tohill BC: What Can Intervention Studies Tell Us about the Relationship between Fruit and Vegetable Consumption and Weight Management? Nutr Rev. 2004, 62(1): 1-17.

Zhuang YL, Gamst AC, Cummins SE, Wolfson T, Zhu SH. Comparison of smoking cessation between education groups: findings from 2 US National Surveys over 2 decades. Am J Public Health. 2015; 105(2): 373-9.

Kimani S, Mirie W, Chege M, Okube OT, Muniu S. Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study. BMJ Open. 2019; 9(1): e023995.

Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep. 2014; 129(2): 19‐31.

Maksimović MZ, Vlajinac HD, Radak DJ, Maksimović JM, Marinković JM, Jorga JB. Association of socioeconomic status measured by education and risk factors for carotid atherosclerosis: cross-sectional study. Croat Med J. 2008; 49(6): 824‐831.

Hasenegger V, Rust P, KönigJ, Purtscher A E, Erler J, Ekmekcioglu C. Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria. Nutrients. 2018; 10(3): 311.

Sacks FM, Svetkey LP,Vollmer WM. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344: 3-10.

Hooper L, Bartlett C, Daveysmith G, Ebrahim S. Systematic review of long term effects of advice to reduce dietary salt for prevention of cardiovascular disease. Br Med J. 2002; 325: 628-636.