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Effect Of A Training Programme On Knowledge And Practice Of Lifestyle Modification Among Hypertensive Patients Attending Out-patient Clinics
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The recommended lifestyle modification such as, moderate alcohol intake,
weight loss of 3% to 9% of body weight, the DASH diet, regular aerobic
exercise, and reduced dietary salt are lifestyle modification that
controls blood pressure. Depending on the type of intervention, blood
pressure reduction of 3 to 11 mm Hg systolic and 2.5 to 5.5 mm Hg
diastolic, are believed to have great influence on blood pressure
reduction and ability to potentiate antihypertensive drugs. The
recommended diet called DASH diet is low in total and saturated fat,
sugar, sugary drinks, refined carbohydrates, and red meat but high in
vegetables, fruits, whole grains, poultry, fish and low-fat dairy
products. This DASH diet has long been documented to lower weight, risk
of type 2 diabetes, heart rate, apolipoprotein B, homocysteine,
C-reactive protein, and is accompanying by a lower incidence of stroke,
heart failure, and all-cause mortality (Lochner, Rugge & Judkins,
2006).
In a premier trial, it was also documented that a reduction of
14.2/7.4 mmHg in blood pressure is attained when DASH diet is accompany
by salt reduction and alcohol, aerobic exercise and weight loss, which
also reduces the prevalence of hypertension from 38% to 12% over the
period of six months. Reduce salt consumption by hypertensive patents,
possibly the single most important hypotensive measure, entails
regularly checking food labels for salt content, staying away from
processed foods, and using spices and herbs for flavour. It is generally
acceptable that personal efforts from the patients and reinforcing and
enabling environment from health personnel will lead to a great success
in diet and behavioural modification (Nicoll & Henein 2010).
Knowledge
and practice of lifestyle modification among patients with high blood
pressure has however been showed to be inadequate in some studies. In
UK, Nicoll and Henein (2010) in their study revealed that many
hypertensive patients are unwilling to accept that their lifestyle
practices or choices have made a worthwhile contributed to their
condition and may refuse advice to change, this may be true of other
hypertensive patients. Therefore, health education about hypertension,
its consequences and lifestyle modification is been advocated to begin
as early as possible in population identified to be at risk (American
Heart Association, 2010).
1.1 Statement of the problem
Despite the
treatment guideline and numerous drugs available for the treatment of
hypertension, having patients bringing their blood pressure under
control has always been a mirage. Part of the guidelines for the
treatment of hypertension is lifestyle modification. In terms of
economic burden, morbidity, mortality, poorly controlled blood pressure
is a considerable important public health concern among older adult in
the world. High blood pressure is the leading and most significant
modifiable risk factor for, stroke, heart diseases, renal diseases and
retinopathy. Recent recommendations for the prevention and treatment of
hypertension has placed importance on modifying lifestyle. It has been
proven that lifestyle modifications that is capable of lowering
hypertension include increased physical activity, weight loss, reduced
sodium intake. This include, a diet rich in fruit, vegetables, and
low-fat dairy products reduced in total and saturated fat (Al-wehedy,
Abd Elhameed, & Abd El-Hammed, 2015).
Despite the above fact,
it’s been documented in several studies that most hypertensive patients
don’t have enough knowledge about lifestyle modification. In a study
carried out among 101 participants on perception and practice of
lifestyle modification in South-East Nigeria, it was revealed that about
87.1% of the participant were not aware that exercising regularly is
part of lifestyle modification while 60% were not aware that alcohol
intake should be of moderate consumption. The roles of unsaturated oil
and reduction in diary food intake, vegetables, and fruits in the
control of blood pressure were not aware by 80% and above. A little
above 60% practiced salt restriction among 88% that has some knowledge
of salt restriction. This is also applicable to the few with knowledge
of weight reduction, regular exercise, fruit intake, cigarette smoking
and alcohol moderation, respectively. The study shows there was a
negative relationship between diastolic and systolic blood pressures and
the level of practice. This typifies that knowledge level and practice
of lifestyle modifications were poor among the studied participants.
(Okwuonu, Emmanuel & Ojimadu, 2014).
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