Tozivepi Samantha N, Takawira Simon, Chikaka Elliot, Mundagowa Paddington, Chadambuka Elizabeth M, Mukora-Mutseyekwa Fadzai
Clinical Research Centre, Africa University, Mutare, Manicaland Province, Zimbabwe.
Department of Health Sciences, Africa University, Mutare, Manicaland Province, Zimbabwe.
Patient Prefer Adherence. 2021 May 18;15:1027-1037. doi: 10.2147/PPA.S306885. eCollection 2021.
To determine the association between the achievement of blood pressure (BP) control and adherence to recommended lifestyle behaviors among hypertensive patients seen at Mutare Provincial Hospital, Zimbabwe.
A cross-sectional study was conducted using BP readings from three consecutive months. A structured interviewer-administered and pretested questionnaire with components derived from the World Health Organization Stepwise Survey was employed to extract information from 350 purposively selected participants. Measurement of BP was based on the Eighth Joint National Committee Guidelines. Bivariate and multivariate logistic regression analyses were computed using the SPSS package.
The mean age of the 350 participants was 67±11.38 years. Males made up 35% of the participants and BP control was achieved in 41.4% of the patients. Only 5.1% of the participants reported adherence to all the recommended lifestyle behaviors. Low adherence rates were reported for diet, medication, and physical activity. Bivariate analysis showed that participants who adhered to antihypertensive treatment and alcohol recommendations had reduced odds of having uncontrolled hypertension, while consuming deep-fat fried foods ≥3 times a week was associated with higher odds of uncontrolled BP (p<0.1). Logistic regression analysis revealed that participants who ate traditional whole-grain "sadza" or porridge were more likely to have controlled BP [adjusted odds ratio (AOR): 1.6; 95% confidence interval (CI): 1.0-2.5] while those who did not add salt at the table had reduced odds of having uncontrolled BP by 40% (AOR: 0.6; 95% CI: 0.4-0.9).
Overall, adherence to the recommended lifestyle behaviors which are known to be effective in controlling BP in Mutare was poor. Health workers should include comprehensive health education messages on the importance of compliance with dietary, medication, and physical exercise recommendations when counseling patients. The intervention crafting process should focus on identifying enablers of the recommended lifestyle behaviors in the community and the health delivery system.
确定在津巴布韦穆塔雷省医院就诊的高血压患者中，血压（BP）控制的实现与坚持推荐的生活方式行为之间的关联。
采用连续三个月的血压读数进行横断面研究。使用一份由结构化访谈员实施且经过预测试的问卷，该问卷的组成部分源自世界卫生组织的逐步调查，从350名经过目的性选择的参与者中提取信息。血压测量基于美国国家联合委员会第八版指南。使用SPSS软件包进行双变量和多变量逻辑回归分析。
350名参与者的平均年龄为67±11.38岁。男性占参与者的35%，41.4%的患者实现了血压控制。只有5.1%的参与者报告坚持了所有推荐的生活方式行为。在饮食、药物治疗和体育活动方面，报告的依从率较低。双变量分析表明，坚持抗高血压治疗和酒精摄入建议的参与者患未控制高血压的几率降低，而每周食用油炸食品≥3次与未控制血压的几率较高相关（p<0.1）。逻辑回归分析显示，食用传统全麦“萨扎”或粥的参与者血压更有可能得到控制[调整后的优势比（AOR）：1.6；95%置信区间（CI）：1.0 - 2.5]，而不在餐桌上加盐的参与者患未控制血压的几率降低40%（AOR：0.6；95%CI：0.4 - 0.9）。
总体而言，在穆塔雷，对已知对控制血压有效的推荐生活方式行为的依从性较差。医护人员在为患者提供咨询时，应纳入关于遵守饮食、药物治疗和体育锻炼建议重要性的全面健康教育信息。干预措施制定过程应侧重于确定社区和卫生服务系统中推荐生活方式行为的促进因素。
