Adherence to hypertension management and lifestyle modifications in patient attending general practice outpatient department in tertiary care hospital of eastern Nepal

Abstract

Background: Hypertension is a huge problem worldwide. It should be managed with a combination of lifestyle modifications and medication. The objective was to find out the level of understanding of hypertensive patients regarding lifestyle modifications; to find their level of application in their daily activities, and to study their effects on the management of hypertension.
Methods: We conducted an observational study with hypertensive patients who presented to GOPD at BPKIHS. We assessed the level of knowledge of those patients with a structured survey. Patients were told about lifestyle modifications following Joint National Committee 7 Guidelines. Patients were reassessed using the same survey at 1 month and 3-month follow-up.
Results: Among the 100 patients included, 6% had prehypertension and 94% had Stage 1 or 2 hypertension. Only 26% of patients knew about lifestyle modifications. After being told about lifestyle modifications, 89% stated that they had adopted them at follow-up. 68 patients came for 1-month follow-up and 51 patients for 3-month follow-up. There was significant weight reduction: Average weight loss 3.54 kg over 3 months (P < 0.001). At 1-month the percentage of subjects with controlled hypertension was 13.2% and at 3 months follow-up it fell to 2% (P < 0.001). 71% patients’ blood pressure (BP) was controlled without medication at 1-month and 77% at 3 months.
Conclusion: A minority of patients knew about lifestyle modifications. After counseling, their implementation was associated with weight reduction and improved control of BP. Good lifestyle counseling is a crucial and effective part of hypertension management.