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

Abstract

Background: Lifestyle modifications (LSMs) are indispensable in blood pressure control among hypertensive patients. However, the extent to which patients lifestyles (LS) coincide with clinical prescriptions has become an important management challenge in primary care. Aim: To describe adherence to LSMs among adult hypertensive Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in resource-poor environment of Eastern Nigeria. Study Design: A primary care clinic-based descriptive cross-sectional study carried out on 140 adult patients with essential hypertension who were on treatment for at least 6 months at the primary care clinic. Place and Duration of Study: The study was carried out at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria between April 2011 and November 2011. Methodology: Data was collected using pretested, structured and interviewer-administered questionnaire. Each item of LS was scored on a five points Likert scale ordinal responses of always, most times, sometimes, rarely and none. Adherence to LSMs was assessed in the 30 days preceding the study and measured from the following domains: physical activity, alcohol and tobacco use, dietary fruits, vegetables, salt and fat consumptions. Each of the domains of LS was given a score of one point for healthy LS and zero point for unhealthy LS. Operationally, patients who scored 7 points in all the assessed domains were considered adherent. Specific adherence to LS factors was also determined. Results: The overall adherence rate was 16.4%. Specifically, adherence was highest with the uses of tobacco (100.0%) followed by dietary salt (94.3%) and alcohol (90.7%). Other adherence rates were consumptions of dietary vegetables (75.7%), dietary fruits (66.2%), dietary fat and oils (64.2%) and physical activity (16.4%). Adherence was significantly associated with the female gender (p=.036). Conclusion: This study has shown that adherence to LSMs was 16.4% with no smoking rated highest and physical activity the lowest. Female gender was significantly associated with adherence. There is need to sustain the current level of adherence on smoking while efforts should be made to improve on identified domains of inadequate adherence.