Knowledge on Hypertension and Self-Care Practice among Adult Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Ethiopia, 2019

Knowledge and self-care practice among patients with hypertension in tertiary public hospitals of Addis Ababa, Ethiopia: A multicenter cross-sectional study

Introduction

Globally, hypertension is the leading cause of death due to its related complications. Patients' knowledge and self-care practice in hypertension is crucial for achieving optimal blood pressure control and prevention of related complications. This study aimed to evaluate the level of knowledge and self-care practice among hypertensive patients in Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 413 hypertensive patients using simple random sampling methods. A face-to-face interview was administered using a structured questionnaire. Data was analyzed using SPSS version 27.0. Frequency percentage, and mean were calculated. Multivariable logistic regression was used to identify the association between predictors and outcome variables.

Results

Out of 413 respondents, 46.0 % (95 % CI: 40-50 %) and 40.9 % (95 % CI: 36-46 %) had poor knowledge and self-care practice respectively. Being married (AOR = 1.92, 95 % CI:1.19-3.06, P = 0.007), higher education [AOR = 7.38 (95 % CI: 2.29-23.78), P < 0.001); family history (AOR = 3.68, 95 % CI: 2.28-5.94, P < 0.001); getting information from healthcare providers (AOR = 3.17, 95 % CI: 1.46-6.87, P = 0.003) were significantly associated with knowledge of hypertension. Being female (AOR: 0.62,95 % CI: 0.39-0.97, P = 0.033), owing sphygmomanometer (AOR: 4.41,95 % CI: 2.40-8.13, P < 0.001) were associated with self-care practice towards hypertension.

Conclusion

The overall knowledge and self-care practice of respondents was low. Gender, marital status, educational level, family history, source of information, and owing sphygmomanometer were determinant factors. Improving patients' awareness and self-care practice is essential for prevention and control of hypertension.

The effectiveness, feasibility, and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia: A protocol for a randomized control trial study

BACKGROUND

Nowadays, metabolic syndrome has become a major health threat, and affects over one billion people globally. It also plays a great role in the growth of diseases like type 2 diabetes, coronary diseases, stroke, and other chronicity. It increases the risk of cardiovascular disorder and stroke by three to ten times and diabetic mellitus by ten times. The prevalence of metabolic syndrome is increasing globally as a result of epidemiological shift. Low and middle-income countries are facing an increasing burden of metabolic syndrome. There is a need for concerted efforts to modify behavioral risk factors that significantly contribute to the prevalence of the syndrome. This can be done by developing and implementing appropriate interventions that can bring behavior change after testing for effectiveness, feasibility, and acceptability. Thus, this study aims to develop and test the effectiveness, feasibility and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia.

METHODS AND ANALYSIS

This randomized controlled trial will be implemented with 226 bank employees (age ≥18 years) with metabolic syndrome from government and private banks in Bahir Dar City, Ethiopia. Participants will be randomized to intervention (education) and control (general health advice) groups. The intervention group will be given one-on -one base education about healthy diets, physical exercise, stress management, avoidance of harmful alcohol consumption and smoking cessation by experts on health promotion. Text messages will be sent every two weeks and reading materials will also be provided. Additionally, a review meeting will be held at the 3rd and 6th month of the intervention. The primary outcomes of interest will be change in metabolic parameters (obesity levels, blood pressure, fasting blood glucose, total cholesterol, high density lipoprotein, low density lipoprotein, and triglycerides). Secondary outcomes will be knowledge, attitudes and practice of the participants towards lifestyle and cardiovascular risk factors, feasibility, acceptability, implementation fidelity, and cost-effectiveness of the intervention. Data will be collected at three time points: at baseline, at the 6th month of the intervention and at the end of the intervention (9 months). Generalized linear mixed models will be utilized to compare the desired outcome between the trial arms, after accounting for baseline variations. Cost-benefit analysis and a qualitative process evaluation of the intervention will also be conducted.

DISCUSSION

This randomized control trial study will provide information on the effectiveness, feasibility, and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia, where the burden of metabolic syndrome is high among office workers.

CLINICAL TRIAL REGISTRATION

This trial has been prospectively registered at the Australian New Zealand Clinical Trials Registry: ACTRN12623000409673p.

Association between medication literacy and blood pressure control among hypertensive patients

AIM

This study aimed to explore the association between medication literacy and blood pressure control among hypertensive patients.

BACKGROUND

Blood pressure control is a challenge for global health systems. Medication literacy is essential for medication self-management in hypertensive patients and a basis for managers to develop comprehensive intervention strategies for hypertension medication use.

DESIGN

A cross-sectional observational study was conducted.

METHODS

A total of 378 hypertensive patients was selected by convenience sampling from two tertiary hospitals and four community health service centres from December 2021 to January 2022 in Changsha, China. Associations between medication literacy and blood pressure control were identified with chi-square, independent samples t-tests and logistic regression analyses.

RESULTS

The average medication literacy score of the hypertensive patients investigated was low. Over a third of patients had uncontrolled blood pressure. Logistic regression analysis showed that medication literacy was an influencing factor for blood pressure control rate in hypertensive patients.

CONCLUSIONS

Medication literacy and blood pressure control among hypertensive patients was poor. Medication literacy was a facilitator of blood pressure control so improving medication literacy may be of value to improve blood pressure control in hypertensive patients.

Blood Pressure Examination Habit and Its Determinants Among Civil Servants in Arba Minch Town: A Cross-Sectional Study - Using Hurdle Poisson Regression Model

Background

Hypertension is a common non-communicable disease detected through blood pressure measurement that makes periodic health examinations crucial for the detection, prevention, and timely treatment.

Objective

To assess the frequency of blood pressure examination and its determinant among civil servants in Arba Minch Town, south Ethiopia.

Methods

From February to March 2020 an organization-based cross-sectional study design was employed among civil servants in Arba Minch town. Data were collected from 580 randomly selected civil servants using a well-structured questionnaire. Hurdle Poisson regression model was conducted to identify determinants of frequency of blood pressure examination using R version 4.0.2.

Results

A total of 407 (70.2%) civil servants had never examined their blood pressure within a year before the study time. The mean frequency of blood pressure examination was 0.71 with a standard deviation of 1.46. The hurdle Poisson regression analysis indicates age above 40 years (IRR = 6.11, p < 0.001), elevated blood pressure (IRR = 1.48, p < 0.001), no family history of hypertension (IRR = 0.59, p < 0.001) had significant effects on the expected number of non-zero counts blood pressure examination. And education status (OR; 2.39, p < 0.05), poor knowledge about hypertension, not getting advice from health professionals (OR = 8.93, p < 0.001), and age above 40 years had significant effects on not taking blood pressure examination.

Conclusion

The frequency of blood pressure examinations among civil servants was found to be low. This study reveals age, elevated blood pressure, family history of hypertension, getting advice, and knowledge on hypertension were found to be determinants of the frequency of blood pressure examination. Thus, concerned health authorities and medical workers should work on these factors to prevent and detect hypertension among apparently healthy civil servants.

Blood pressure self-monitoring practice and associated factors among adult hypertensive patients on follow-up at South Wollo Zone Public Hospitals, Northeast Ethiopia

BACKGROUND

Hypertension is a silent killer that causes serious health issues in all parts of the world. It is risk factor for cardiovascular disease, stroke and kidney disease. Self-monitoring practice has been identified as an important component of hypertension management. Hence, this study aimed to assess blood pressure (BP) self-monitoring practice and associated factors among adult hypertensive patients on follow-up in South Wollo Zone public hospitals, Northeast Ethiopia.

METHODS

Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 June 2022, among 336 adult hypertensive patients on follow-up at selected South Wollo Zone public hospitals. Data were collected by using self-administered pretested structured questionnaires; the collected data were entered into Epi-data V.4.6 and then exported to SPSS V.25 software for analysis. Descriptive statistics such as frequency and percentage were used to describe the study participants. Tables and texts were used for data presentation. Binary logistic regression was conducted to test the association between the independent and dependent variables. Adjusted OR (AOR) with 95% CI was estimated to identify the factors associated with BP self-monitoring and the level of significance was declared at p<0.05.

RESULTS

The proportion (95% CI) of BP self-monitoring practice among hypertensive patients in South Wollo Zone Public Hospitals was 8.93% (95% CI 6.3% to 12.5%). In the multivariable analysis, urban residence (AOR 3.97, 95% CI (1.11 to 14.20)), comorbidity (AOR 4.80, 95% CI (1.23 to 18.69)), regular healthcare professional visit (AOR 4.64, 95% CI (1.02 to 21.14)), advice on the type of devices used for BP self-monitoring (AOR 5.26, 95% CI (1.49 to 18.58)) and knowledge on hypertension self-care (AOR 13.13, 95% CI (4.21 to 40.99)) were positively associated with BP self-monitoring practice.

CONCLUSION

The proportion of BP self-monitoring practice was low. Living in urban areas, comorbidity, regular healthcare professional visits, advice on the type of devices used for BP self-monitoring, and knowledge of hypertension self-care were positively associated with BP self-monitoring practice.

Level of self-care practices and associated factors among hypertensive patients in Addis Ababa, Ethiopia

OBJECTIVES

The study assessed the level of self-care practice and its predictors among hypertensive patients in the health centers of Bole Sub-city, Addis Ababa, Ethiopia.

METHODS

A multi-Center-based cross-sectional study that employed 370 hypertensive participants at the conveniently selected Health Centers in Bole Sub-City; from August 01-30, 2020. The researchers selected the participants based on a simple random sampling method after applying for a pre-tested interviewer-administered questionnaire and secured for informed consent. All the statistical analyses were SPSS 22.0 software based. The authors used binary logistics regression to identify the presence and strength of association; with its respective 95%CI and p-value less than five percent as a significant level.

RESULTS

The overall level of good self-care practice among hypertensive patients was 53.0% (95% CI: 47.2-58.8%) whereas 61.4%, 63.8%, 92.7%, 82.7%, and 18% of the study participants were adherent to medication, good weight management, non-smokers, alcohol abstainers and physical activity consecutively. Being illiterate had 2.347 and 2.084 times higher odds of having had good self-care practice compared to secondary school and a diploma or above consecutively. Being a merchant, civil, and retired were associated with good self-care practice than being unemployed.

CONCLUSION AND RECOMMENDATION

The study reported a lower level of self-care practice in the study settings. Educational level and occupation were factors identified for self-care practice. The authors recommended policymakers, healthcare workers, and researchers work on the identified factors of self-care practice of hypertensive participants in the study settings.

Self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City administration, Eastern Ethiopia: A multi-center cross-sectional study

Introduction

Hypertension is a silent killer that causes serious health issues in all parts of the world. Hypertension is a risk factor for cardiovascular disease, stroke, and kidney disease. Self-care practices have been identified as an important component of hypertension management. Despite the government's commitment and the interventions of various stakeholders, the burden of hypertension and its sequel remain unabated. A recent study showed that hypertension self-care practices play a vital role in controlling and managing high blood pressure, even though there is poor self-practice among hypertensive patients in Ethiopia. Therefore, this study assessed the level of self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City Administration, Eastern Ethiopia.

Methods

Hospital-based cross-sectional study was conducted from June 15 to July 15/2021 among 415 adult hypertensive patients on follow-up. The participants were selected using systematic sampling. Hypertension Self-Care Activity Level Effects (H-SCALE) was used to collect data through face-to-face interviews. The SPSS version 24 was used for analysis. Logistic regression analyses were done to determine the association between the outcome and independent variables. For multivariate logistic regression models, variables having a P < 0.25 during bivariate analysis were candidates. The strength of the association was estimated using AOR and 95% CI. The level of statistical significance was declared at a p < 0.05.

Results

This study revealed that 52% (95% CI, 48.2–58%) had good level of self-care practices. Formal education (AOR = 3.45, 95% CI: 2.1–4.85), good knowledge about hypertension (AOR = 1.5, 95% CI: 1.17–2.1) 1.5, abstain from chewing khat (AOR = 2.01, 95% CI: 1.44–3.94), strong social support (AOR= 1.9, 95% CI: 1.16–3.1), and absence of depression (AOR = 2.03, 95% CI: 1.43–3.92) were statistically associated with a good level of self-care practices.

Conclusions

This study pointed out that about half of the participants had a good level of self-care practices. Formal education, good knowledge about hypertension, abstaining from khat chewing, good social support, and absence of depression showed associations with a good level of self-care practices. Therefore, public health interventions on hypertension self-care practices, and strengthening non-communicable diseases control programs are vital. Moreover, the provision of targeted education to patients can improve disease knowledge and self-care practices.

Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis

Background

Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence.

Methods

This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I² and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity.

Result

A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively.

Conclusion

The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.

Knowledge, Attitude, and Practice Toward Hypertension Among Hypertensive Patients Residing in Lebanon

Background and Objectives

Hypertension (HTN) is a major health concern that leads to cardiovascular disease and premature death. Assessing HTN knowledge, attitude, and practice (KAP) is crucial for controlling HTN. This study aimed to determine HTN KAP among hypertensive patients residing in Lebanon.

Methods

This cross-sectional study involved 342 hypertensive patients. A questionnaire form was used to collect data related to patients' characteristics. SPSS was used to determine KAP scores, descriptive statistics, and correlations.

Results

Data from HTN patients was analyzed of whom 98.2% were Lebanese and 51.2% were males. The median age was 59.15 ± 13.55 years old. A proportion of 40.4% had HTN duration for at least 10 years and 67.3% had HTN family history. Patients had fair HTN knowledge and practice, but good attitude toward HTN. Only 45.3% regularly checked their blood pressure. Positive correlations were observed between HTN attitude and each of knowledge and practice. HTN knowledge and attitude were associated with many studied factors, whereas no relationship was found regarding practice.

Conclusion

Hypertensive patients had fair levels of knowledge and practice, and a good level of attitude concerning their disease. We provided a model for predictors of HTN KAP scores that will allow the development of efficient campaigns related to HTN.

The Effects of Home-Based Self-Care Education on Blood Pressure and Self-Care Behaviors among Middle-Aged Patients with Primary Hypertension in Iran: A Randomized Clinical Controlled Trial

Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management ( p = .06) and smoking cessation ( p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure.

IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351 .

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital

Background

Sustained control of blood pressure, is dependent on degree of self-management, which includes self-integration, self-regulation, self-monitoring and adherence to regimen. We assessed the pattern of self-management of hypertension among adult hypertensive patients in a developing country.

Methods

Cross-sectional study design and convenience sampling, was used to recruit adult hypertensive patients, attending Lagos State University Teaching Hospital, Lagos, Nigeria. Interviewer-administered questionnaire was used to obtain data on self-management components. SPSS version 21.0 was used to analyze data, with p-value set at 0.05.

Result

One hundred and seven (107) respondents, had mean age of 49.0 ± 12.0 years. Mean value for self-management was 3.15 ± 0.55, comprising self-integration (3.06 ± 0.36), self-regulation (3.32 ± 0.63), self-monitoring (3.29 ± 0.84) and adherence to regimen (3.15 ± 0.55). Most components of self-management, had high levels of mean score. Respondents that were less than 40 years, compared with those that were more than 40 years, had greater mean values for self-integration (3.37 vs 3.05), but significantly lesser values for all other components (p < 0.05).

Conclusion

Young hypertensives had poor levels of most components of self-management. There is urgent need for health educational programs on self-management of hypertension among young people in sub-Saharan Africa.

Self-Care Practice and Associated Factors among Hypertensive Patients in Debre Tabor Referral Hospital, Northwest Ethiopia, 2020

Background

Hypertension prevalence is continuously rising and is projected to be 1.56 billion cases by the year 2025. Despite the great progress made in the treatment of hypertension, many patients still do not achieve optimal results and experience devastating complications due to uncontrolled high blood pressure.

Objective

The aim of this study is to assess self-care practice and associated factors among hypertensive patients.

Methods

An institution-based cross-sectional study was conducted at Debre Tabor Referral Hospital, Northwest Ethiopia, from October to November 2020. A single population proportion formula and systematic random sampling technique was used to recruit 392 study participants. The data were entered to Epi-Info software version 7.1 and then exported to SPSS version 23 for analysis. A descriptive statistic was expressed as percentage, frequency, and mean. Finally, multivariable logistic regression was used to identify factors associated with dependent variable using a p value of <0.05.

Results

A total 392 eligible hypertensive patients participated in the study. The self-care practice among hypertension patients was found to be 54.1%. Urban residency (AOR = 2.17; 95% CI, 1.2-3.9), social support (AOR = 2.12; 95% CI, 1.13-3.39), good knowledge (AOR = 1.83; 95% CI, 1.15-2.91), age between 40 and 64 (AOR = 3.15; 95% CI, 1.19-8.3), age ≥65 (AOR = 3.81; 95% CI, 1.35-10.7), and stress control (AOR = 1.6; 95% CI, 1.06-2.67) were predictors of hypertension self-care practice. Conclusion and Recommendation. The study revealed that almost one out of two hypertension patients had good hypertension self-care practice. Good social support, age greater than 40 years, urban residency, good basic knowledge, and having stress control were positively associated with hypertensive self-care practice.

Self-care practice among hypertensive patients in Ethiopia: systematic review and meta-analysis

BACKGROUND

In high-income and low-income countries, including Ethiopia, hypertension (HTN) is a serious public health concern. As a consequence, a massive self-care practice (SCP) is necessary, and the domains of SCP, including adherence to medication, physical activity, weight management, low-salt diet, non-smoking, moderate alcohol usage, and dietary management, are required. However, there is no nationwide study on HTN SCPs in Ethiopia. This meta-analysis, therefore, aimed to estimate the pooled level of HCP among individuals living with HTN in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was used to report this systematic review and meta-analysis. We systematically searched the databases PubMed/MEDLINE, Embase, Google Scholar and Science Direct for studies conducted in Ethiopia. All observational studies published until July 2020 were included. Data were analysed using R V.3.5.3 software, and the pooled prevalence with 95% CIs was presented using tables and forest plots. The presence of statistical heterogeneity (I ²) within the included studies was evaluated. We used a funnel plot to identify evidence of publication bias. The random-effects meta-analysis model was employed to estimate the pooled proportion of good HTN SCPs.This was submitted for registration with the International Prospective Register of Systematic Reviews in March 2020 and accepted with the registration number CRD42020175743 (https://www.crd.york.ac.uk/PROSPERO).

RESULTS

Our search databases produced 356 papers. Twelve of these papers fulfilled the inclusion and were found suitable for the review. The total population in this study was 3938. Off these hypertensive populations, 44% (95% CI 34 to 53) had good SCP. The subgroup analysis for each component of SCP was done. The subgroup analysis of good adherence to low-salt diet, alcohol abstinence, medication adherence, non-smoking, physical exercise and weight management was 52% (95% CI 39% to 66%), 77% (95% CI 69% to 88%), 65% (95% CI 45% to 85%), 92% (95% CI 88% to 95%), 43% (95% CI 30% to 56%) and 51% (95% CI 32% to 69%), respectively. In conclusion, nearly half of patients with HTN had good SCPs.

Quality of Life and Awareness of Hypertension Among Hypertensive Patients in Saudi Arabia

Background and aim

Hypertension possesses significant public health challenges for both developing and developed economies. Therefore, it is crucial to evaluate the awareness of hypertension and health-related quality of life (HRQoL) among patients with hypertension. This study aims to evaluate the knowledge of hypertension and HRQoL among hypertensive patients.

Materials and methods

A cross-sectional study using an anonymous questionnaire was conducted over a period of 4 months (November 2020 to February 2021) in Riyadh, Kingdom of Saudi Arabia (KSA). This study included 437 questionnaires submitted by the hypertensive population.

Results

A total of 437 participants were included in this study, with 55.4% being males (n=242). The majority (85.1%) were aware of the normal values of blood pressure. Many participants had no problems with mobility, personal care, usual activities, pain or discomfort, and anxiety or depression. Age groups showed a significant association with mobility and usual activities. The knowledge of hypertension was significantly associated with HRQoL.

Conclusion

This study found that majority of the hypertensive patients were aware of the standard values of blood pressure. HRQoL concerning physical functioning and general health is found to be good based on the EuroQol visual analogue scale (EQ VAS) in the hypertensive population who are aware of their condition. This study reported a weak yet significant association between hypertension-related knowledge and HRQoL scores. Several factors can affect the HRQoL of the hypertensive population including gender, education, occupation, and income status.

Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

Hypertension is one of the leading causes of morbidity and mortality in developing countries including Ethiopia. Self-care practice has been provided as one of the most important preventive mechanisms of hypertension and is considered as a basic treatment for hypertension. There is no national-level study that assesses hypertensive self-care practice in Ethiopia. Therefore, this study aimed to assess the pooled level of hypertensive self-care practices and associated factors in Ethiopia.

METHODS

This study was carried out using published and unpublished articles accessed from databases: PubMed/MEDLINE, HENARI, Google Scholar, Web of Science, Scopus, African Journals, and university repositories. Data were extracted using a standard data extraction format. Data analysis was carried out using STATA version 11. Heterogeneity across the included studies was assessed using Cochrane's Q statistics and I 2 test with its corresponding p values. Publication bias was determined using Egger's test and presented with a funnel plot. The pooled level of hypertensive self-care practice was estimated using a random-effects meta-analysis model.

RESULTS

This systematic review included 17 cross-sectional studies with 5,248 study participants. The overall pooled level of self-care practice among hypertensive patients in Ethiopia was 41.55% (95% CI 33.06, 50.05). Participant formal education (AOR = 2.82; 95% CI 2.18, 3.64) and good knowledge of hypertension (AOR = 4.04; 95% CI 2.19, 7.44) were significantly associated with self-care practice among hypertensive patients in Ethiopia.

CONCLUSION

In this study, more than half of hypertensive patients had poor hypertensive self-care practice in Ethiopia. Participant's formal education and good knowledge of hypertension were significantly associated with self-care practice among people living with hypertension in Ethiopia. Therefore, based on the evidence of this study, we recommended that programmers and policymakers should enhance the awareness of hypertensive patients on self-care practice domains and strengthen local programs working on noncommunicable diseases.

Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan

Background

Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.

Methods

This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.

Results

Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.

Conclusion

Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.

Dietary Salt-Related Determinants of Hypertension in Rural Northern Thailand

Hypertension and its connection to high salt consumption have been observed in the Thai population. This study mainly contributed to the literature to examine the dietary-salt-related determinants associated with the risk of hypertension in rural northern Thailand, which exhibited the highest prevalence of hypertension. A total of 376 adults residing in San Pa Tong District, Chiang Mai province, were face-to-face interviewed using a structured questionnaire assessing dietary-salt-related knowledge, attitudes, consumption, sources, and habits. The subject’s blood pressure (BP) was measured twice before and after the interview. Hypertension was defined as a systolic BP ≥ 130 mmHg or a diastolic BP ≥ 80 mmHg. The dietary-salt-related knowledge, attitude, and habits toward salt reduction were positively correlated; however, knowledge and attitudes were not significantly correlated with consumption. Multivariate logistic regression results indicated subjects who frequently bought ready-to-eat food, ate out, or used bouillon cube/monosodium glutamate (MSG) during food preparation were likely to have hypertension (OR = 2.24, 95% CI: 1.36–3.69, p = 0.002). MSG was heavily consumed and used as a flavor enhancer in northern Thai cuisine; however, a few subjects realized it contains sodium due to no salty taste. The deficiency of specific dietary-salt-related knowledge illustrated the need for tailored educational intervention strategies.