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Successful Strategies in Hypertension Prevention \u0026 ManagementHypertension prevention strategies -
It did not however meet the criteria for different components of the study effectively integrated to answer the research question [ 26 ]. One of the studies was a quantitative study [ 25 ] and met all the criteria questions that are stipulated for this section.
The data analysis method that was adopted is convergent synthesis. The convergent synthesis method was used because of the diversity of study designs that were adopted by the primary studies [ 27 , 28 ].
Prior to the synthesis, there was identification and description of the various health promotion interventions that were used for the prevention of hypertension. To use a convergent synthesis analysis method, the study findings were translated into descriptive qualitative sentences [ 28 ]. There was then a purposeful collation and integration of the findings [ 29 ] into themes from subthemes that were developed from the codes generated.
In the views of Pluye and Hong, while conducting this type of synthesis, the various items identified must be integrated into subthemes and similar or related sub-themes collated to form broad umbrella themes [ 29 ]. The integration of quantitative and qualitative findings mainly occurred in the coding and development of sub-themes stage [ 27 ].
These themes were then described to have meanings that are beyond the originally identified items and hence allow for interpretation and critical analysis. No subgroup analysis and test of the robustness of study finding was conducted as this study was mainly aimed to be a narrative synthesis.
There was an in-depth search of six PubMed, CINAHL, EMBASE, Cochrane library, web of science, google scholar electronic databases that yielded titles and after duplicates were removed, as shown in Fig 1.
The titles, abstracts, and full text were then screened, and ten articles were identified as appropriate for this study. The study designs adopted were survey [ 21 , 25 ], quasi-experimental [ 30 — 32 ], Cohort [ 22 , 24 , 25 ], mixed methods [ 26 ], randomised control [ 20 ], and exploratory uncontrolled pre—post intervention [ 23 ] as shown in Table 1.
The studies were conducted in the Faculty of Pharmacy at Rhodes University [ 21 ], the Gugulethu township of Cape Town [ 26 ], Khayelitsha [ 24 ] all in South Africa [ 22 , 25 ], Sousse in Tunisia [ 30 ], Afon and Ajasse Ipo districts in Kwara State in Nigeria [ 31 ], three community pharmacies in the Ashanti Region of Ghana [ 23 ], and the slums of Korogocho and Viwandani in Nairobi [ 30 ].
The target participants for the health promotion interventions had a minimum age of eleven [ 21 ] and a maximum of sixty-five years [ 30 ] and included both sexes. The sampling methods adopted were the convenience [ 21 , 23 , 24 , 26 , 30 ], stratified convenience [ 25 ], random [ 30 ], stratified 2-degree random probability by geographic areas [ 31 ], and the Markov model used as a tool for sampling with the focus on age variability of cardiovascular diseases [ 22 ].
The study duration for each intervention study ranged from a minimum of a day health education programme [ 21 ] to a maximum of 36 months health promotion for behaviour change [ 30 ]. The other studies were 3months [ 25 ], 4 months [ 20 , 26 ], 5 months [ 23 ], 9 to 10 months [ 25 ], 12 months [ 22 ], 18months [ 32 ] and 24 months [ 24 , 31 ] health promotion interventions.
Health promotion interventions were noted to have a positive impact on the prevalence of hypertension [ 30 — 32 ] as shown in key findings in Table 2. The health promotion interventions led to a remarkable decrease in the prevalence of hypertension in the intervention compared to the control groups [ 30 , 31 ].
It was reported that the prevalence of hypertension decreased in the treatment group globally from After stratification for age, for participants younger than 40 years old, a significant decrease in the prevalence of hypertension from A significant decrease in the prevalence of hypertension from The number of respondents with controlled blood pressure increased from 3.
In instances where there were improvements for hypertension prevalence in both the intervention and the control groups, the changes in the intervention groups were noted to be remarkable [ 30 , 32 ]. Mean blood pressure was said to reduce remarkably in intervention groups than in the control groups [ 31 , 32 ].
There was a significant reduction in mean SBP between baseline and end-line measurements in the intervention 2. It was statistically significant that systolic blood pressure decreased by Diastolic blood pressure decreased by 4.
Health promotion interventions that sought to increase community knowledge on hypertension yielded positive outcomes as knowledge levels were noted to increase [ 21 , 23 , 25 ].
In a post-intervention quiz, there was a significant increase in the scores from Most of the respondents with hypertension were unaware of their status during the baseline survey but showed significant awareness upon implementation of the intervention [ 31 ].
In another health promotion intervention, it was observed that overall knowledge about blood pressure and hypertension increased among those who received treatment [ 20 , 26 ]. It was noted that Health promotion on text messaging to hypertension participants on medication adherence was also noted to have a remarkable impact as the treatment arm demonstrated a significantly higher knowledge for an extended duration [ 26 ].
In instances where the intervention group was given diaries to use, After a media campaign, participants were identified to adopt positive lifestyle modifications weight loss and no salt or alcohol intake that reduced their risk of hypertension [ 25 ].
After a media campaign for the reduction in salt intake, It was noted that the community pharmacy is a feasible setting for screening and detection of hypertension if the right structures are put in place [ 23 ].
The use of this intervention strategy is also appropriate due to easy accessibility for providing information on lifestyle practices to prevent hypertension [ 23 ]. During community intervention programs, newly identified people who have hypertension are referred to the health facility to seek and use professional care [ 31 ].
The use of these intervention strategies has led to an increase in the antihypertensive drug treatment from 4. Most of the indicators of knowledge, attitudes, and behaviour change showed a statistically significant relationship for the reduction in salt consumption, smoking, alcohol use, and increased physical activity after the administration of an intervention [ 23 , 25 ].
Significantly more participants reported that they were taking steps to control salt intake especially adding salt while cooking and at the table [ 25 ]. Given the message that was communicated during the health promotion intervention, the participants could readily remember the key messages that are likely to improve the chance of behaviour change.
Among patients with hypertension in the control group, smoking and alcohol use were also reduced significantly [ 32 ]. It was also noted in Ghana that physical activity levels increase significantly among intervention than in the control groups [ 23 ].
It was also noted that there was a significant decrease in the numbers of those reporting inadequate physical activity among the intervention compared with the control group at the population level and among hypertension people at baseline [ 32 ].
Community health worker intervention was noted to be cost-effective as it led to a remarkable reduction in the cost of care for hypertension patients [ 22 ]. After text messaging, the intervention group had positive increases in self-reported behaviour changes [ 26 ].
Health promotion interventions were also noted to produce an improvement in health insurance coverage as the intervention group had a Self-reported general use of health care resources increased in the program area and decreased in the control area [ 31 ].
This systematic review synthesis the health promotion interventions that are critical in the control of hypertension in Africa.
Hypertension health promotion interventions are mostly targeted to those factors that can be altered through individual efforts-largely referred to as modifiable risk factors [ 33 — 36 ]. These targets of health promotion intervention incorporate those environmental and social determinants of health that include lifestyle factors like heart-healthy diet [ 37 , 38 ], reduction in sodium and adequate potassium [ 35 — 38 ], increased physical activity [ 37 ], reduction in overweight and obesity [ 39 — 42 ] as well as increased knowledge on hypertension risk factors [ 11 , 35 — 38 , 43 ].
The specific target of these modifiable risk factors, especially among the entire population, has been shown in this study to be critical if significant gains are going to be made in the total control of hypertension.
To ensure sustained hypertension control among those diagnosed and reduce the incidence, several barriers are identified to be implicated. These barriers included cultural norms, insufficient attention to education, lack of resources for interventions for hypertension control. Other barriers associated with population-based hypertension control included poor health education, lack of physical activity culture and space to engage in same, urbanisation and its attendant increased in restaurants and the consumption of fast foods rich in calorie and fat, consumption of large amounts of sodium and lower potassium, and inadequate information on how to control hypertension [ 11 , 43 , 44 ].
Health promotion interventions that specifically target mitigation or the elimination of these barriers have been shown through the various studies in Africa to be cardinal. It is important that in a resource-limited setting like Africa, health promotion interventions specifically target these barriers and identify means to mitigate the same.
Other factors incorporating wealth and income levels and social determinants like employment, access to health care, social inequalities are noted to influence individual ability to adapt to measures that prevent hypertension [ 45 , 46 ].
These factors are identified to hinder the early detection, awareness creation, control, and management of hypertension in Africa. It is therefore imperative that multi-pronged approaches are adopted to target all populations at work, school, and industries and not only those at risk.
In developed countries, there have been many health promotions programs for hypertensive patients to change modifiable factors [ 45 — 47 ].
There are several limitations in implementing health promotion programs in developing countries compared to developed countries.
Health promotion interventions are mostly messages that are communicated and, in some instances, will require the extensive reading of health information material. In Africa, literacy levels remain low, coupled with the relative lack of a common language that is usually locally accepted and understood by all.
The contents of most health education programs in developing countries are often difficult to read and understand by most people because of relatively low educational levels [ 48 ].
This makes the training method for health promotion interventions to be rather tedious and inefficient, and hence the implementation of health promotion interventions in these low resource settings relatively difficult. However, the use of culturally friendly, easily understandable, and the use of local resources was seen as one of the best means of health promotions interventions and has the propensity to mitigate the difficulty associated with language.
It was realised that the use of community-based pharmacy, health education granted in local languages, and use of next of keen as reminders on medication adherence has been keen in early detection, increased knowledge, and appropriate medication adherence among hypertension patients, respectively.
There has been increasing interest in using diverse strategies for measures that can curtail hypertension prevalence. The use of telecommunication is gaining widespread popularity in African countries and leveraging of such means promises to be one positive means of health promotion for persons at risk.
The use of cell phones and short messaging services, and mobile notifications have been shown to have positive effects in several Human immunodeficiency virus infection intervention studies [ 49 , 50 ] and hypertension patients [ 26 ] in Africa. In response to the changing African environment, useful and accessible methods of disseminating health-promoting knowledge, especially for the prevention of chronic diseases like hypertension, must be developed and implemented.
Several studies have shown health promotion interventions for people with hypertension particularly yield positive outcomes. This has even been the case over two decades ago when it was reported that a sustained 5years campaign for the implementation of measures to reduce the incidence of hypertension resulted in a 2.
Similarly, other health promotion interventions that target physical activity resulted in a significant decrease in the prevalence of hypertension among the intervention group after five years of implementation [ 52 ]. Various health promotion interventions have resulted in a significant decrease in the number of obese participants, increased physical activity, and decreased salt intake [ 23 , 42 ], which are particular risk factors to hypertension [ 7 , 52 , 53 ].
It is also important that significant health promotions intervention that target hypertension risk factors focus on salt intake, a significant risk factor for hypertension [ 54 ]. Since reducing salt intake reduces blood pressure [ 53 ], it is often used as an intervention strategy.
Salt reduction strategies based on improving individual and group health, increasing awareness, and changing behaviour should be relatively easy to implement and have a high probability of hypertension risk reduction.
For a salt reduction of less than 3g, the mean population systolic blood pressure decreased by 1. It must be noted that these are cost-effective and useful interventions that can produce tremendous results for poor resource settings.
This study provides a comprehensive overview of the health promotions interventions that are used for the control of hypertension in Africa. It is important to note that all the researchers worked as a team in all the phases of this study, and where there was a disagreement, a consensus was built.
This reduced the likelihood of subjectivity that is usually associated with study selection, data extraction, and analysis in systematic reviews.
The study is not without limitations as only English-based articles were included in the study, creating the possibility of some salient articles in other languages left out. The protocol for this study did not receive prior registration. Also, the quality assessment of the included studies was minimal as it was largely limited to assessment for only the risk of bias.
This study showed the role of health promotion interventions in the control of hypertension in poor settings in Africa. It was realized that health promotion interventions that focus on increasing education, information dissemination, and promoting behaviour change were seen as useful in the control of the entire hypertension incidence and prevalence.
Interventions that use local resources and are largely community-based also showed positive health outcomes. It is imperative that to sustain health promotion interventions and achieve control of hypertension, especially in the long term, interventions must be culturally friendly and incorporate locally available resources.
These types of intervention need to be further tested in various cultures of Africa and to ensure sustained prevention of hypertension risk factors. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field.
Article Authors Metrics Comments Media Coverage Peer Review Reader Comments Figures. Abstract Background A proportion of hypertension patients live in developing countries with low awareness, poor control capabilities, and limited health resources.
Methods An in-depth search of PubMed, CINAHL, EMBASE, Cochrane library, web of science, google scholar yielded titles and after duplicates were removed.
Results Health promotion interventions led to a remarkable decrease in the prevalence of hypertension, increased knowledge and awareness in the intervention compared to the control groups. Conclusion To sustain health promotion interventions and achieve control of hypertension especially in the long term, interventions must be culturally friendly and incorporate locally available resources in Africa.
Funding: The authors received no specific funding for this work. Introduction Worldwide, hypertension causes significant morbidity and mortality, contributing to 57 million 3. Materials and methods Design Primary research articles published between to were reviewed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis PRISMA framework [ 16 — 18 ].
Search strategy We searched six PubMed, CINAHL, EMBASE, Cochrane library, web of science, google scholar electronic databases for eligible studies after making scoping searches through manual search guided by the reference list of the selected studies. Search results In searching from the six electronic databases, titles were identified from using the keywords and titles after duplicates removal.
Inclusion and exclusions criteria The selection of each study depended on predefined inclusion and exclusion criteria. Data collection and extraction To extract data, a matrix was first developed, discussed, and agreed on by all the researchers.
Quality appraisal The tool used for quality appraisal is the Mixed Methods Appraisal Tool MMAT version Data analysis The data analysis method that was adopted is convergent synthesis.
Results There was an in-depth search of six PubMed, CINAHL, EMBASE, Cochrane library, web of science, google scholar electronic databases that yielded titles and after duplicates were removed, as shown in Fig 1. Download: PPT. Study characteristics The study designs adopted were survey [ 21 , 25 ], quasi-experimental [ 30 — 32 ], Cohort [ 22 , 24 , 25 ], mixed methods [ 26 ], randomised control [ 20 ], and exploratory uncontrolled pre—post intervention [ 23 ] as shown in Table 1.
Reduction in prevalence of hypertension after health promotion interventions Health promotion interventions were noted to have a positive impact on the prevalence of hypertension [ 30 — 32 ] as shown in key findings in Table 2.
Knowledge increase after health promotion intervention Health promotion interventions that sought to increase community knowledge on hypertension yielded positive outcomes as knowledge levels were noted to increase [ 21 , 23 , 25 ].
Health promotion interventions reduced hypertension risk factors Most of the indicators of knowledge, attitudes, and behaviour change showed a statistically significant relationship for the reduction in salt consumption, smoking, alcohol use, and increased physical activity after the administration of an intervention [ 23 , 25 ].
Cost of health promotion interventions Community health worker intervention was noted to be cost-effective as it led to a remarkable reduction in the cost of care for hypertension patients [ 22 ]. Discussion This systematic review synthesis the health promotion interventions that are critical in the control of hypertension in Africa.
Strengths and limitations This study provides a comprehensive overview of the health promotions interventions that are used for the control of hypertension in Africa. Conclusions This study showed the role of health promotion interventions in the control of hypertension in poor settings in Africa.
Supporting information. S1 Checklist. PRISMA checklist. s DOCX. S1 File. MMAT appraisal of individual studies. References 1. Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organisation, Geneva: WHO, Kissela B, Schneider A, Kleindorfer D, Khoury J, Miller R, Alwell K, et al.
Stroke in a biracial population: the excess burden of stroke among blacks. Walker R, Whiting D, Unwin N, Mugusi F, Swai M, Aris E, et al.
Stroke incidence in rural and urban Tanzania: a prospective, community-based study. The Lancet Neurology. Ibrahim MM, Damasceno A. Hypertension in developing countries. The Lancet. Preventing chronic diseases: a vital investment.
Geneva: Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global Burden of Hypertension and Systolic Blood Pressure of at Least to mm Hg, — Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, et al.
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, — a systematic analysis for the Global Burden of Disease Study Padmanabhan S, Caulfield M, Dominiczak AF.
Genetic and molecular aspects of hypertension. Circ Res. Lane M, Robker RL, Robertson SA. Parenting from before conception. Whelton PK, Carey RM. JAMA Cardiol. Carey RM, Muntner P, Bosworth HB, Whelton PK.
Prevention and Control of Hypertension: JACC Health Promotion Series. J Am Coll Cardiol. pmid; PubMed Central PMCID: PMC Hinderliter AL, Sherwood A, Craighead LW, Lin PH, Watkins L, Babyak MA, et al. The long-term effects of lifestyle change on blood pressure: One-year follow-up of the ENCORE study.
Am J Hypertens. Rose GA, Khaw KT, Marmot M. Oxford University Press, USA. Emberson J, Whincup P, Morris R, Walker M, Ebrahim S. Evaluating the impact of population and high-risk strategies for the primary prevention of cardiovascular disease.
Eur Heart J. Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Archives of internal medicine. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.
J Clin Epidemiol. Moher D, Altman DG, Liberati A, Tetzlaff J. PRISMA statement. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols PRISMA-P elaboration and explanation. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al.
The Mixed Methods Appraisal Tool MMAT version for information professionals and researchers. Education for Information. View Article Google Scholar They also encourage people to increase their intake of monounsaturated fats, such as those found in olive and canola oil, nuts, and fatty fish.
Doctors advise reducing your intake of unhealthy fats, such as trans fats, which are found in some processed baked goods and other foods. You should also limit your consumption of saturated fats, found in fatty meats, poultry skin, and full-fat dairy such as butter, cream, and cheese.
Consuming too much of these fats may lead to unhealthy blood cholesterol levels , which can increase the risk of developing hypertension and coronary artery disease. Many experts are also concerned about the increase of sugar in the American diet, which has been linked obesity and type 2 diabetes.
Reducing sugar in the diet can reduce abdominal fat and help with weight loss, which can lead to lower blood pressure. Specific nutrients may be helpful, too. Potassium—found in leafy greens such as spinach, as well as bananas, salmon, mushrooms, squash, white beans, baked potatoes, and avocados—has been shown to help prevent and control hypertension.
Some evidence suggests that magnesium may also lower blood pressure. Your doctor can advise whether magnesium supplements would benefit you. Consuming less sodium helps many people reduce their blood pressure. NYU Langone doctors recommend that most people consume no more than 2, milligrams, or one teaspoon, of salt per day.
Our doctors advise people to carefully read food labels for sodium content. Prepackaged foods, such as canned soups, processed deli meats, frozen dinners, and pizzas can be high in sodium. Drinking alcohol can contribute to high blood pressure, even in healthy people.
If you drink, your doctor may advise doing so in moderation. For women, this means no more than one drink a day, and for men, no more than two drinks a day. A drink is considered to be about an ounce of alcohol, or about one beer, one glass of wine, or one cocktail. If your blood pressure is already high, your doctor may suggest not drinking at all.
The extra calories in each drink can sabotage weight loss efforts as well. If you have difficulty cutting back on alcohol, tell your doctor, who can recommend a treatment program in your community. Stress can contribute to high blood pressure, and can make it difficult to maintain healthy lifestyle habits.
To better manage stress, doctors recommend that adults sleep 7 to 8 hours each night; exercise for 45 minutes, 3 times a week or more; and minimize outside stressors as much as possible. You may also want to consider practicing breathing exercises, yoga, meditation, or other activities that relax body and mind.
Having obstructive sleep apnea —the intermittent, repetitive, and temporary cessation of breathing during sleep—significantly increases the risk of developing high blood pressure.
It also increases the risk of developing other cardiovascular problems, including heart rhythm disorders. People with type 2 diabetes are prone to developing blockages in the arteries, which may lead to hypertension and heart disease.
Strategies include home glucose monitoring, exercising regularly, losing weight, and using insulin. Other medical conditions—including kidney disease, hypothyroidism , adrenal tumors , and related conditions such as Cushing syndrome—can also increase the risk of high blood pressure.
If high blood pressure is caused by one of these conditions, it is called secondary hypertension.
Health and Well-Being Anti-cancer alternatives is the monthly blog of the Antioxidant drinks for hydration and electrolyte balance of strateyies Office of Disease Prevention and Anti-cancer alternatives Promotion. The old adage should always apply: Preventiin Anti-cancer alternatives Hyeprtension and sleep disorders wakefulness the disease. Preventing, identifying, Fish oil supplements treating hypertension sleep disorders wakefulness be about much more than just measuring blood pressure and prescribing medicine. Instead, addressing high blood pressure should be an exemplar of comprehensive, person-centered care — promoting greater overall health, well-being, and personal resilience. During this American Heart Month, we can all boost this idea and support prioritizing high blood pressure prevention and control through a more holistic approach in medical and public health practices. Uncontrolled hypertension is common — affecting nearly half of all American adults.
We use cookies sleep disorders wakefulness similar tools to stfategies Hypertension prevention strategies the best sstrategies experience. By using Anti-cancer alternatives Aerobic exercise benefits, you accept prevnetion Websites Privacy Policy. Hypertensin Langone preventive cardiologists offer tips to prevent high blood pressure, also known as hypertension. These guidelines are also part of the treatment plan for people who have been diagnosed with high blood pressure. While hypertension is very common among American adults, it may cause no symptoms. Over time, however, consistently high blood pressure can cause damage throughout the body. Often, this damage is not apparent until significant harm has been done.
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