Direct Costs of Hypertension Treatment in Iran

Facilitators of medication adherence in patients with hypertension: a qualitative study

Hypertension has been identified as the most important risk factor for disability and premature death worldwide. This study aimed to explain the factors that facilitate medication adherence from the perspective of patients with hypertension in southeastern Iran. This qualitative study used conventional content analysis and purposive sampling methods to achieve data saturation, involving 25 participants. Facilitating factors were categorized into two main categories: individual and family factors and organizational support. Individual factors included motivational fears, disease acceptance, healthy lifestyle, disease monitoring, and follow-up. Family factors included family support, while organizational support included governmental support to provide inexpensive medicines, comprehensive healthcare team support, health insurance access, and media training. These factors were identified as essential facilitators that significantly influence appropriate adherence to hypertensive drugs. This study revealed that various factors affected medication adherence in these patients, and efforts should be made to improve hypertension treatment and increase medication adherence. Measures taken to control hypertension are cost-effective to reduce the burden associated with this disease. The findings of this study can be valuable in formulating policies for the treatment and care of hypertension.

Effect of Educational Intervention by Application of PRECEDE-PROCEED Model on Lifestyle Change in Hypertensive Patients

Background: One of the most important causes of cardiovascular disease is hypertension. Lifestyle modification has been emphasized in preventing and controlling blood pressure. This research aimed to determine the effect of educational intervention by application of PRECEDE-PROCEED model on lifestyle change in hypertensive patients in the villages of Fasa City, Fars Province, Iran. Methods: This research is a quasi-experimental study that was conducted on 300 hypertensive patients in 2020-2021. Data gathering tools were a demographic information questionnaire, a questionnaire based on the PRECEDE-PROCEED model, and a lifestyle questionnaire (LSQ). The educational intervention consisted of ten sessions lasting 45 or 50 min. Before and 6 months after the educational intervention, the two groups each completed a questionnaire. The systolic and diastolic blood pressure (DBP) levels, as well as physical exercise and health variables, nutrition and weight control, mental health, and spiritual health were measured before and 6 months after the educational intervention. Results: The results showed that there was no significant difference between the two groups before in cues of PRECEDE-PROCEED model; however, the experimental group had a significant increase in cues of PRECEDE-PROCEED model 6 months after the intervention. The results showed that the experimental group had a significant increase 6 months after the intervention in terms of physical exercise and health variables, nutrition and weight control, mental health, and spiritual health. The mean blood pressure (both diastolic and systolic) in the experimental group was significantly reduced after the intervention. Conclusions: The study's results showed the effectiveness of an educational intervention based on the PRECEDE-PROCEED model on lifestyle change in hypertensive patients. It also highlights the need to pay further attention to the education aimed at controlling hypertension through a healthy lifestyle and correct behavioral habits.

To what extent the weight changes impact the risk of hypertension among menopausal women: insights from Tehran lipid and glucose study

BACKGROUND & AIM

The association between weight change and incident hypertension (HTN) in menopausal women has not been well characterized. This study aimed to determine whether weight changes after menopausal years make a difference in incidents of hypertension.

MATERIALS & METHODS

This population-based study was performed using data collected from Tehran Lipid and Glucose Study cohort (1999-2018). Women who had natural and early menopause were followed up every 3 years. Data gathering was performed through the standard protocol of the study. Statistical analysis was performed using multivariable Cox hazard regression analysis. We used the 'survival' package in the R software version 3.6.0 to fit survival models.

RESULTS

A total of 487 menopausal women met the inclusion criteria; 62.6% had natural menopause and remained had early menopause. Among the participants, 65.5% experienced HTN. The highest proportion of participants had > 5% weight gain, while the lowest had 3-5% weight gain. Either losing body weight (lost > 5%: HR: 0.44; CI 95%, 0.32, 0.62; p < 0.001), (lost 3-5%; HR: 0.47; CI 95%, 0.26, 0.84; p = 0.01), and weight gain > 5% (HR: 0.69; CI 95%, 0.51, 0.91; p = 0.01), were associated with decreased risk of HTN after adjustment for confounders. In this study, weight loss and gain have a protective impact on the development of HTN in subjects. For incident HTN, age (HR: 1.04 (1.01, 1.08), p = 0.004), fasting blood glucose (HR: 1.01, CI 95%:1.00, 1.01; p < 0.001), body mass index (1.02 (1.00, 1.05), p = 0.03) and smoking (1.70 (1.11, 2.58), p = 0.01) were positively associated with HTN.

CONCLUSIONS

Our study indicates the significant association of weight change with hypertension risk in later life among menopausal women.