Lifestyle modifications in hypertension : an assessment of reported adherence knowledge and attitudes at Mankayane Hospital, Swaziland

Thesis (MFamMed)--Stellenbosch University, 2013.ENGLISH SUMMARY : Background: Lifestyle modifications have been shown to lower blood pressure. Many guidelines recommend lifestyle modifications in the management of hypertension. Comprehensive adoption of the relevant lifestyle modifications has the greatest benefit. Methods: This was a cross-sectional descriptive study with a qualitative component. Information on adherence was collected from 227 participants, using a structured questionnaire utilising Likert scales. In-depth interviews to assess knowledge and attitudes were conducted. Interviews were recorded, transcribed verbatim and analysed. Results: Reported adherence to salt intake reduction and increased consumption of fruits and vegetables were 81.1% and 90.7% respectively. Reported adherence to exercise and weight reduction were 4.0% and 6.2% respectively. Reported adherence to alcohol intake reduction and smoking cessation were 50.6% and 56.5% respectively. The lifestyle modifications known by most participants were consumption of local vegetables, salt reduction, weight reduction and reduction of fats in the diet. The attitudes towards the recommended lifestyle modifications were mostly positive. Exercise in any form was reported as beneficial but time to exercise was a major limiting factor. Weight reduction was reported as difficult but possible. Salt reduction emerged as the most important lifestyle modification. Alcohol and smoking were reported to be addictive and difficult to stop. Increasing consumption of fruits and vegetables emerged as the easiest to adhere to. Conclusion: Reported adherences to exercise and weight reduction were very low whilst increased consumption of fruits and vegetables and salt reduction had fairly high reported adherences. Participants had more knowledge about increased intake of fruits and vegetables, salt reduction and weight reduction when compared to the other recommended lifestyle modifications. The attitude to the recommended lifestyle modifications was positive with the participants acknowledging that they are important in controlling blood pressure. Greater emphasis may be required on some lifestyle modifications where knowledge is lacking and different approaches may be required for each lifestyle modification so as to improve adherence.AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar