The association between hypertension self-management and stroke event in male patients at the Badung District Hospital, Bali

Abstract

Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.

Self-Care Management for Hypertension in Southeast Asia: A Scoping Review

“…In the quantitative and mixed-method studies, body weight management (29 studies 20 , 24 , 25 , 29 , 30 , 33 , 36 , 39–50 , 52 , 53 , 56–62 , 64 ) and physical exercise (22 studies 21 , 22 , 24 , 30–33 , 35 , 38 , 40–43 , 45 , 47 , 52 , 53 , 56 , 57 , 60 , 61 , 75 ) were the most reported, whereas in the qualitative studies, medication adherence and diet intake was the most reported self-care practice. In addition, a few studies described alternative self-care management methods such as stress-relieving methods (6 studies 35 , 40 , 60 , 66 , 68 , 75 ), sleep and rest (2 studies 68 , 74 ), and spiritual fulfilment was described in one study.…”

“…In the quantitative and mixed-method studies, studies indicated that traditional self-care management, such as body weight management, physical exercise, dietary intake, and medication adherence were poorly practiced. Respectively, studies showed unaddressed risk factors for heart disease and stroke with a 50% incidence or more being reported for overweight/obese (8 studies 20 , 30 , 33 , 50 , 52 , 56 , 57 , 61 ), low level physical exercise (8 studies 21 , 24 , 31 , 32 , 45 , 56 , 57 , 61 ), poor/low-quality dietary intake (9 studies 21 , 23 , 30 , 34 , 40 , 56 , 57 , 60 , 75 ), and poor adherence to medication (4 studies 27 , 32 , 52 , 56 ).…”

“…The design of the studies was varied. Forty-five were cross-sectional studies, ten were qualitative, [65][66][67][68][69][70][71][72][73][74] one case control, 75 and one mixed-method design. 76 The findings of quantitative and mixed-method studies are displayed in Table 3 and qualitative studies in Table 4.…”

“…A study with the largest sample (313,714) was conducted by Nurdiantami et al 24 Sample sizes ranged from 5 to 30 participants in the qualitative studies reviewed. For study settings, in quantitative and mixed-method studies, 10 studies took place nationally, 24,41,[47][48][49][50][51]53,63,64 19 in the urban areas, 20,21,23,[31][32][33][36][37][38]40,42,[44][45][46]52,54,55,58,76 16 in rural areas, 22,[25][26][27][28][29]34,39,43,56,57,[59][60][61][62]75 and two studies in multiple settings. 30,35 For quantitative studies, four of them were conducted in urban settings, …”

“…In the quantitative and mixed-method studies, body weight management (29 studies 20,24,25,29,30,33,36,[39][40][41][42][43][44][45][46][47][48][49][50]52,53,[56][57][58][59][60][61][62]64 ) and physical exercise (22 studies 21,22,24,[30][31][32][33]35,38,[40][41][42][43]45,47,52,53,56,57,60,61,75 ) were the most reported, whereas in the qualitative studies, medication adherence and diet intake was the most reported se...…”