BackgroundHypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria.MethodsThis was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication.ResultsA total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants.ConclusionPoor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study.
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.
Conclusions: Quality of sleep in patients with ESRD on hemodialysis is considerably impaired. Exercise regimen is an effective non-pharmacological and economic way of improving quality of sleep in this population.
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