ABSTRACT
Background: Lifestyle modifications (LSMs) are indispensable in blood pressure control among hypertensive patients. However, the extent to which patients lifestyles (LS) coincide with clinical prescriptions has become an important management challenge in primary care. Aim: To describe adherence to LSMs among adult hypertensive Nigerians with essential hypertension in a primary care clinic of a tertiary hospital in resource-poor environment of Eastern Nigeria. Study Design: A primary care clinic-based descriptive cross-sectional study carried out on 140 adult patients with essential hypertension who were on treatment for at least 6 months at the primary care clinic. Place and Duration of study: The study was carried out at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria between April 2011 and November 2011. Methodology: Data was collected using pretested, structured and intervieweradministered questionnaire. Each item of LS was scored on a five points Likert scale ordinal responses of always, most times, sometimes, rarely and none. Adherence to LSMs was assessed in the 30 days preceding the study and measured from the following domains: physical activity, alcohol and tobacco use, dietary fruits, vegetables, salt and fat consumptions. Each of the domains of LS was given a score of one point for healthy LS and zero point for unhealthy LS. Operationally, patients who scored 7 points in all the assessed domains were considered adherent. Specific adherence to LS factors was also determined. Results: The overall adherence rate was 16.4%. Specifically, adherence was highest with the uses of tobacco (100.0%) followed by dietary salt (94.3%) and alcohol (90.7%). Other adherence rates were consumptions of dietary vegetables (75.7%), dietary fruits (66.2%), dietary fat and oils (64.2%) and physical activity (16.4%). Adherence was significantly associated with the female gender (p=.036). Conclusion: This study has shown that adherence to LSMs was 16.4% with no smoking rated highest and physical activity the lowest. Female gender was significantly associated with adherence. There is need to sustain the current level of adherence on smoking while efforts should be made to improve on identified domains of inadequate adherence.
ABSTRACT
Background: Abdominal obesity once considered an aesthetic rather than a pathological condition is now recognized as a principal risk factor for metabolic syndrome and magnifies the risk of cardiovascular diseases. As the case detection rate of abdominal obesity increases in Nigeria determining its predictors remain relevant for proactive control intervention. Aim: This study was designed to determine the predictors of abdominal obesity among adult Nigerians in a resource-poor environment of a rural hospital in Eastern Nigeria. Study Design: A hospital based case-control study carried out on 700 adult patients aged 18-91 years who were screened for abdominal obesity using the third report of National Cholesterol Education Panel (NCEP) in adult (ATP III) criterion and 350 patients who had waist circumference (WC) ≥102cm and ≥88cm for men and women respectively and met the inclusion criteria were matched for age and sex with 350 non-obese, non-hypertensive and non-diabetic control. Place and Duration of Study: The study was carried out at a rural hospital in Eastern Nigeria between June 2008 and June 2011. Methodology: Predictor variables were assessed using a pretested, structured and interviewer-administered questionnaire. Hypertension and diabetes mellitus were defined using JNC 7 and American Diabetic Association criteria respectively. Results: Abdominal obesity was significantly associated with physical inactivity (p=.002) and family history of obesity (p=.036). The most significant predictor of abdominal obesity was physical inactivity (OR=4.19, p=.001). The abdominally obese patients were four times more likely to be physically inactive compared to their non-abdominally obese counterparts. Conclusion: This study has shown that the predictors of abdominal obesity among the study population were physical inactivity and family history of obesity. The interventional control programs for abdominal obesity should consider these predictive variables alongside the complex of other cardiovascular risk factors.