To determine the knowledge, attitudes and perceptions of hypertensive patients towards lifestyle modification in controlling hypertension

Rakumakoe, Mmamontsheng Dulcy
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BACKGROUND Worldwide, hypertension is the third leading risk factor contributing to death, surpassed only by malnutrition and smoking. 1 Hypertension is common and treatable and because uncontrolled hypertension has serious consequences, preventive measures and control of blood pressure should be a high priority. A healthy lifestyle remains the cornerstone of the management of blood pressure (BP) for all severities of hypertension. It is possible to prevent the development of hypertension and to lower blood pressure levels by simply adopting a healthy lifestyle. 2 Health care workers can assess and contribute to the management of hypertension with exercise adequately if the patient is educated and convinced that lifestyle changes are essential and indeed the most cost effective method of obviating cardiovascular disease. METHODS Patients with hypertension (N=110) were identified from a cohort of patients attending the outpatients department of Carletonville Hospital, a district hospital situated in the mining town of Carletonville, South Africa, and were then invited to participate in the study. A crosssectional descriptive study design was used to determine the knowledge and attitudes of these patients with respect to the importance of lifestyle modification in the management of hypertension. This was achieved by administering a questionnaire. Descriptive and inferential statistical methods were employed to analyze the data. RESULTS The largest number of respondents fell in the 50-59 year old age groups (28%). Females (62%) made up a significant majority of the study population. The population breakdown included the following: Black respondents were 75%, while 24 % were white and 1% coloured. Body Mass Index was more than 25 in 81% of the respondents and 84% of the population had schooling levels below high school. Fifty seven percent (57%) of the respondents ate fried foods regularly, 70 % cooked with salt, 18% add salt to their food, while 14% ate red meat regularly and 26 % consumed alcohol, with 6 % having more than 3 beers/day. The majority of participants led sedentary lifestyles according to the physical activity score, with 74% having little or no activity. At the time of the study 69% had blood pressure (BP) levels above 140/90 mmHg with only 42% knowing what their normal BP should be. Seventy seven percent (77%) believed that exercise lowers BP, and only 30% reported having received such advice from a medical professional. Ninety five percent (95%) believed that a balanced diet is important in controlling hypertension and fifty one percent (51%) reported having being advised by a medical professional about a balanced diet. Ninety four percent (94%) knew that adding salt to food affects BP and sixty nine percent (69%) reported having being told by a medical professional about the effects of excessive salt intake in their diets. Eighty percent (80%) believed that alcohol affects blood pressure and forty four percent (44%) reported having received such information from a medical professional. Seventy five percent (75%) believed that smoking affects BP and thirty six percent (36%) got this information from a medical professional. DISCUSSION The results indicate that respondents reported having received advice about lifestyle modification from medical professionals. The advice varied between areas of lifestyle change, which included education on diet, alcohol, smoking and exercise. The most frequently given advice was on diet and salt intake, with exercise being the least often information provided to the patients by medical professionals. Reduced salt intake advice was the most frequently reported (69%), followed by a balanced diet (51%), reduced alcohol intake (44%), not smoking (35%) and benefits of exercise (30%).Despite this most of the respondents were leading sedentary lifestyles, were overweight (BMI>25) and had BP`s greater than 140/90 mmHg . The reasons provided for not exercising varied from “not being used to it”, “no- time” to “body pain”. Twenty one percent (21%) were not on a proper diet due to financial reasons, 16% stated lack of information as the reason and 9% just found unhealthy food to be very tempting. CONCLUSION The results of this study suggest that although patients do receive advice on lifestyle modification, it is not effective in changing patient behavior, and may therefore be inadequate and not emphasized enough and also not all patients are advised by medical professionals about lifestyle change. The reason for this is not known. Greeff (2006) in his study emphasized that building a trusting relationship between the healthcare worker and the patient is one of the most important aspects when motivating patients. 2
lifestyle changes