Effect of life style modification on adherence to diet and hypertension in hypertensive patients

authors:

avatar Atharalsadat Mirkarimi , avatar Homeira Khoddam , avatar Mohammad Ali Vakili , avatar Mohammad Bagher Sadeghi , avatar Mahnaz Modanloo ORCID , *

Koomesh: Vol.20, issue 2; 192-202
article type: issue_documents_importer
received: August 08, 2017
accepted: January 03, 2018

how to cite: Mirkarimi A, Khoddam H, Vakili M A, Sadeghi M B, Modanloo M. Effect of life style modification on adherence to diet and hypertension in hypertensive patients. koomesh. 2024;20(2):e152949. 

Abstract

Introduction: Hypertension is one of the most important health problems which cause significant morbidity and mortality and it can be affected by social factors. Life style modification is an effective strategy to manage blood pressure. This study aimed to determine the effect of educational program of lifestyle modification on adherence to diet and hypertension in hypertensive patients. Materials and Methods: This randomized clinical trial study was done on patients with hypertension referred to Heart clinic at Sayyad hospital of Gorgan in 2015. Patients recorded adherence to diet daily (including 5 subgroups salt consumption, fatty foods, fruits, fresh vegetables, and low fat dairies), based on the obtained scores they were considered as poor, average and complete adherence. 98 eligible patients with average and low adherence was chosen via convenience sampling and allocated into control and intervention groups using stratified random allocation (n=49). For modifying life style, face to face education took place for intervention group twice a week, over a 2-week period. Each session lasted about 2 hours. Patients in the control group received routine care without any intervention. Educational content relevant to hypertension was including description of hypertension, modifying life style (daily exercise and physical activity, smoking cessation, weight control, improving sleep pattern, decreasing anxiety and stress management), use of prescribed drugs, attend to follow-up appointments, and following recommended diet. Then, adherence to diet was recorded daily for two weeks in both groups. Results: Result showed that education of life style modification was effective on diet adherence (P

References

  • 1.

    Fattahi F, Zarrati M. Relation of body mass index, abdominal obesity, some nutritional habits and hypertension in 25-65 year old population of Tehran. Koomesh 2011; 12: 229-235. (Persian).

  • 2.

    Vongpatanasin W, Victor RG. Vascular diseases and hypertension. Benjamin I, Griggs RC, Wing EJ, Fitz JG. Andreoli and Carpenter's Cecil Essentials of Medicine. 9th ed. Philadelphia, PA: Saunders/Elsevier; 2015, P. 167-68.

  • 3.

    Muszbek N, Brixner D, Benedict A, Keskinaslan A, Khan ZM. The economic consequences of noncompliance in cardiovasculardisease and related conditions: a literature review. Int J Clin Pract 2008; 62: 338-351.

  • 4.

    Khosravi A, Jozan M, Gharipour M, Rowzati M, Khosravi E, Sarrafzadegan N. The impact of workplace intervension on controling hypertension. J Birjand Univ Med Sci 2013; 19: 10-16. (Persian).

  • 5.

    Azizi, Mirmiran, Azadbakht. Predictors of cardiovascular risk factors in Tehranian adolescents: Tehran Lipid and Glucose Study. Int J Vitam Nutr Res 2004; 74: 307-312.

  • 6.

    Azizi F, Ghanbarian A, Madjid M, Rahmani M. Distribution of blood pressure and prevalence of hypertension in Tehran adult population: Tehran Lipid and Glucose Study (TLGS), 1999-2000. J Hum Hypertens 2002; 16: 12-30.

  • 7.

    Bahrami H, Sadatsafavi M, Pourshams A, Kamangar F, Nouraei M, Semnani S, et al. Obesity and hypertension in an Iranian cohort study; Iranian women experience higher rates of obesity and hypertension than American women. BMC Public Health 2006; 6: 158.

  • 8.

    Bahrami Nejad N, Hanifi N, Moosavi Nasab N. Comparing the effect of two family- and individual-based interventions on blood pressure and lifestyle. J Qazvin Univ Med Sci 2008; 12: 62-79. (Persian).

  • 9.

    Esteghamati A, Abbasi M, Alikhani S, Gouya MM, Delavari A, Shishehbor MH, et al. Prevalence, awareness, treatment, and risk factors associated with hypertension in the Iranian population: the national survey of risk factors for noncommunicable diseases of Iran. Am J Hypertens 2008; 21: 620-626.

  • 10.

    Haghdoost AA, Sadeghirad B, Rezazadehkermani M. Epidemiology and heterogeneity of hypertension in Iran: a systematic review. Arch Iran Med 2008; 11: 444-452.

  • 11.

    Malekzadeh MM, Etemadi A, Kamangar F, Khademi H, Golozar A, Islami F, et al. Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population. J Hypertens 2013; 31: 1364.

  • 12.

    Abdollahy A, Bazrafshan H, Salehi A, Behnampour N, Hosayni S, Rahmany H, et al. Epidemiology of hypertension among urban population in Golestan province in north of Iran. J Gorgan Univ Med Sci 2007; 8: 37-41. (Persian).

  • 13.

    World Health Organization. A global brief on hypertension: silent killer, global public health crisis. World Health Organization 2015.

  • 14.

    Sung SK, Lee SG, Lee KS, Kim DS, Kim KH, Kim KY. First-year treatment adherence among outpatients initiating antihypertensive medication in Korea: results of a retrospective claims review. Clin Ther 2009; 31: 1309-1320.

  • 15.

    Golzarand M, Bahadoran Z, Mirmiran P, Azizi F. The association of dairy products consumption and the risk of hypertension in Tehranian adults: Tehran lipid and glucose study. Pajoohandeh J 2015; 19: 287-293. (Persian).

  • 16.

    Law M, Morris J, Wald N. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009; 338: b1665.

  • 17.

    Kwan MW, Wong MC, Wang HH, Liu KQ, Lee CL, Yan BP, et al. Compliance with the Dietary Approaches to Stop Hypertension (DASH) diet: a systematic review. PloS One 2013; 8: e78412.

  • 18.

    Arrieta A, Qiao N, Woods JR, Jay SJ, Veledar E, Nasir K. Cost of cardiovascular disease episodes among patients with hypertension. circulation: cardiovascular quality and outcomes. 2015; 8: A144-A.

  • 19.

    Moran A. Treating hypertension based on 2014 guidelines cost saving. Pharmaco Economics Outcomes News 2015; 721: 24-14.

  • 20.

    Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). Eur Heart J 2013; 34: 2159-2219.

  • 21.

    Khan NA, Hemmelgarn B, Herman RJ, Rabkin SW, McAlister FA, Bell CM, et al. The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 therapy. Can J Cardiol 2008; 24: 465-475.

  • 22.

    Park JH, Shin Y, Lee SY, Lee S, III. Antihypertensive drug medication adherence and its affecting factors in South Korea. Int J Cardiol 2008; 128: 392-398.

  • 23.

    Khan NA, Hemmelgarn B, Herman RJ, Bell CM, Mahon JL, Leiter LA, et al. The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 therapy. Can J Cardiol 2009; 25: 287-298.

  • 24.

    Siadat ZD, Hasandokht T, Farajzadegan Z, Paknahad Z. Effects of multicomponent lifestyle modification on blood pressure control in health centers: Design of the study. J Res Med Sci 2013; 18: 308-313.

  • 25.

    Mirkarimi A, Khoddam H, Vakili MA, Sadeghi MB, Modanloo M. Assessment of dietary adherence in hypertensive patients referred to Shahid Sayyad Shirazi teaching hospital in Gorgan. J Res Dev Nurs Midwifery 2016; 13: 39-46. (Persian).

  • 26.

    Delamater AM. Improving patient adherence. Clin Diabetes 2006; 24: 71-77.

  • 27.

    van Dulmen S, Sluijs E, van Dijk L, de Ridder D, Heerdink R, Bensing J. Patient adherence to medical treatment: a review of reviews. BMC Health Serv Res 2007; 7: 55.

  • 28.

    Campbell NC, Thain J, Deans HG, Ritchie LD, Rawles JM. Secondary prevention in coronary heart disease: baseline survey of provision in general practice. BMJ 1998; 316: 1430-1434.

  • 29.

    Sanaie N, Nejati S, Zolfaghari M, Alhani F, Kazemnezhad A. The effects of family-based empowerment on family cooperation in following patient treatment regime after coroner arteries bypass surgery. Modern Care J 2014; 11: 19-27.

  • 30.

    Chien WT, Chiu Y, Lam LW, Ip WY. Effects of a needs-based education programme for family carers with a relative in an intensive care unit: a quasi-experimental study. Int J Nurs Stud 2006; 43: 39-50.

  • 31.

    Ebrahimi S, Zakerimoghadam M, Shahsavari H, Gholizadeh B, Naboureh A. Effects of self-management program and telephone follow up on medical adherence in patients with ischemic heart disease. Koomesh 2017; 19: 213-219. (Persian).

  • 32.

    Hadi N, Nostami GN. Determinant factors of medication compliance in hypertensive patients of Shiraz, Iran. Arch Iran Med 2004; 7: 292-296. (Persian).

  • 33.

    Abbasi M, Salemi S, Fatemi NS, Hosseini F. Hypertensive patients, their compliance level and itsrelation to their health beliefs. Iran J Nurs 2005; 18: 61-68. (Persian).

  • 34.

    Jafari F, Hashemi N, Reisi M. The effect of diet training on variations in blood pressure, weight, and some biochemical factors in hemodialysis patients: a clinical trial. J Clin Nurs Midwifery 2015; 3: 13-19. (Persian).

  • 35.

    Pourshaban M, Parsayekta Z, Gholamnezhad M, Peyravi HA. The effect of nutrition training on food diet adherence in non-dialysis chronic kidney patients. J Nurs Educ 2014; 2: 23-32. (Persian).

  • 36.

    Masror Roudsari D, Dabiri Golchin M, Haghani H. Relationship between adherence to therapeutic regimen and health related quality of life in hypertensive patients. Iran J Nurs 2013; 26: 44-54. (Persian).

  • 37.

    He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 2002; 16: 761-770.

  • 38.

    He FJ, MacGregor GA. Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension 2006; 48: 861-869.

  • 39.

    Mafutha GN, Wright SC. Compliance or non-compliance of hypertensive adults to hypertension management at three primary healthcare day clinics in Tshwane. Curationis 2013; 36: 1-6.

  • 40.

    Baljani E, Rahimi Z, HeidariS, Azimpour A. The effect of self management interventions on medication adherence and life style in cardiovascular patients. Sci J Hamadan Nurs Midwifery Facul 2013; 20: 58-68. (Persian).

  • 41.

    Gajewska D, Niegowska J, Kucharska A. Compliance to DASH diet by patients with essential hypertension. Polish J Food Nutr Sci 2010; 60: 71-76.

  • 42.

    Mansoorian M, Qorbani M, Shafieyan N, Asayesh H, Shafieyan Z, Maghsodloo D. Association between life style and hypertension in rural population of Gorgan. J Health Promotion Manag 2012; 1: 23-28. (Persian).

  • 43.

    Ghasemifard N, Fallahi E, Barak F, Saneei P, Hassanzadeh KA, Yazdannik A, et al. The association between dietary approaches to stop hypertension diet and metabolic syndrome in women. Sci J Hamadan Univ Med Sci Health Serv 2014; 21: 112-121. (Persian).

  • 44.

    Khan MS, Bawany FI, Mirza A, Hussain M, Khan A, Lashari MN. Frequency and predictors of non-compliance to dietary recommendations amonghypertensive patients. J Commun Health 2014; 39: 732-736.

  • 45.

    Taddeo D, Egedy M, Frappier JY. Adherence to treatment in adolescents. Paediatr Child Health 2008; 13: 19-24.

  • 46.

    Wu JR, Moser DK, Chung ML, Lennie TA. Predictors of medication adherence using a multidimensional adherence model in patients with heart failure. J Card Fail 2008; 14: 603-614.

  • 47.

    Berben L, Bogert L, Leventhal ME, Fridlund B, Jaarsma T, Norekvl TM, et al. Which interventions are used by healthcare professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice. Eur J Cardiovasc Nurs 2011; 10: 14-21##.