Shim Jee-Seon, Heo Ji Eun, Kim Hyeon Chang
Department of Preventive Medicine, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, 03722 Seoul, Republic of Korea.
Clin Hypertens. 2020 Mar 15;26:5. doi: 10.1186/s40885-020-00138-y. eCollection 2020.
Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension.
We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34-69 years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019.
Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), self-efficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people.
Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.
尽管强烈建议通过饮食调整来预防和治疗高血压，但对于哪些因素与遵循饮食指南相关却知之甚少。我们调查了饮食疗法的知识与态度、感知到的益处、障碍以及自我效能，并确定了患有和未患有高血压的成年人中与饮食依从性相关的因素。
我们收集了497名年龄在34至69岁之间的中年成年人的信息，这些人在2018年12月至2019年2月期间参加了心血管和代谢疾病病因中心（CMERC）队列研究的随访检查，内容包括饮食疗法的知识/态度、感知到的益处，以及饮食依从性方面的障碍和自我效能。
在未患高血压的人群中，95.5%（343/359）和95.8%（344/359）的人分别表示，如果被诊断为高血压，他们会限制钠的摄入量并选择健康饮食。然而，在患有高血压的人群中，分别只有79.7%（110/138）和77.5%（107/138）的人报告他们正在限制饮食中的钠摄入量并保持健康饮食。血压正常组（34.0%）和高血压组（35.5%）的饮食管理频率没有差异。与血压正常者相比，高血压患者的饮食依从性得分更低，更倾向于认为他们需要改变饮食，认为改变饮食是不可能的，并且在遵循饮食指南方面自我效能更低。在血压正常者中，饮食管理与心血管代谢危险因素（比值比：1.63）和饮食教育（比值比：2.19）显著相关，而在高血压患者中，饮食管理仅与意识到无论是否服用降压药都有必要改变生活方式（比值比：6.29）相关。在血压正常者中，良好的饮食依从性与感知到的障碍（比值比：0.71）、自我效能（比值比：3.71）和饮食教育（比值比：1.98）显著相关；在高血压患者中，良好的饮食依从性与感知到的障碍（比值比：0.54）、自我效能（比值比：4.06）和饮食管理（比值比：4.16）显著相关。
许多韩国人对预防和治疗高血压的饮食指南的依从性相对较低。患有和未患有高血压的成年人在知识、饮食习惯以及影响饮食依从性的因素方面存在差异。需要采取有针对性的方法来改善韩国人群的血压控制。
