The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study

Abstract

Patients and Methods: A cross-sectional study was conducted using BP readings from three consecutive months. A structured interviewer-administered and pretested questionnaire with components derived from the World Health Organization Stepwise Survey was employed to extract information from 350 purposively selected participants. Measurement of BP was based on the Eighth Joint National Committee Guidelines. Bivariate and multivariate logistic regression analyses were computed using the SPSS package. Results: The mean age of the 350 participants was 67±11.38 years. Males made up 35% of the participants and BP control was achieved in 41.4% of the patients. Only 5.1% of the participants reported adherence to all the recommended lifestyle behaviors. Low adherence rates were reported for diet, medication, and physical activity. Bivariate analysis showed that participants who adhered to antihypertensive treatment and alcohol recommendations had reduced odds of having uncontrolled hypertension, while consuming deep-fat fried foods ≥3 times a week was associated with higher odds of uncontrolled BP (p<0.1). Logistic regression analysis revealed that participants who ate traditional whole-grain "sadza" or porridge were more likely to have controlled BP [adjusted odds ratio (AOR): 1.6; 95% confidence interval (CI): 1.0-2.5] while those who did not add salt at the table had reduced odds of having uncontrolled BP by 40% (AOR: 0.6; 95% CI: 0.4-0.9). Conclusion: Overall, adherence to the recommended lifestyle behaviors which are known to be effective in controlling BP in Mutare was poor. Health workers should include comprehensive health education messages on the importance of compliance with dietary, medication, and physical exercise recommendations when counseling patients. The intervention crafting process should focus on identifying enablers of the recommended lifestyle behaviors in the community and the health delivery system.

The prevalence and determinants of blood pressure control among hypertension patients in eastern Zimbabwe: A cross-sectional study

“…The result showing 41.3% prevalence of controlled BP among hypertensive patients was consistent with other similar studies conducted in LMICs such as Ethiopia (42%) [42,43], South Africa (41.9%) [44], Iran (38.3%) [45], and India (46.9%) [46], and Zimbabwe (41.4%) [31]. However, this was low when compared to other similar studies in Kenya (48.6%) [47] and Zimbabwe (52%) [32].…”

“…WHO estimates that 50% of essential drugs in SSA are counterfeit [ 52 ]. Another possible explanation for the low rate of BP control is poor adherence to lifestyle modification behaviors and medication in Mutare [ 31 ]. More intensive efforts are required to enhance BP control among hypertension patients.…”

“…Research studies conducted in Mutare, Zimbabwe revealed poor adherence to recommended lifestyle medication and hypertension treatment, high rates of uncontrolled BP, and poor hypertension patient management [31][32][33]. These studies were all conducted at a local tertiary referral hospital, and evidence specific to hypertension patients seen at the primary health level is lacking.…”

Effectiveness of the Protection Motivation Theory-based Education Program among People at Risk of Stroke: A Randomized Controlled Trial

“…1 blood sugar control. Adherence to prescribed medications and lifestyle modifications, such as healthy eating, quitting smoking, exercising, and reducing alcohol consumption, efficiently lowers blood pressure 39 and HbA1C. 40 However, it should be noted that we did not collect data on the participants' current medication regimens, which might have contributed to the changes in their blood pressure and HbA1C.…”