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      Non-pharmacologic hypertension management barriers and recommendations by hypertensive patients at Pentecost Hospital, Madina

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          Abstract

          The number of hypertension cases keeps rising worldwide. Africa is not exempted from the prevalence of hypertension. The Sub-Saharan region over the years has been recording high numbers of hypertension cases due to low consciousness, poor management and lack of control of urbanization. However, it has been established that hypertension as a condition can be managed by controlling familiar risk factors such as alcohol consumption, tobacco use, physical inactivity and intake of an unhealthy diet. The researchers, therefore, intend to explore the non-pharmacologic hypertension management barriers and recommendations by hypertensive patients at Pentecost Hospital, Madina. The researchers employed the qualitative exploratory-descriptive design using a purposive sampling technique to select 20 participants between the ages of 35–65, who met the inclusion criteria. Using a semi-structured interview guide, participants were engaged in 30–60 minutes of face-to-face interviews. The demography of the participants revealed that 60% (12) were females, and 40% (8) were also males. Participants reported that they visit the clinic once a week with a budget of hundred Ghana Cedis to five hundred Ghana Cedis (100–500 GHS). Two main themes and 7 subthemes emerged from the study analysis. The barriers identified include financial constraints, difficulty adjusting to lifestyle changes, personal factors (laziness, forgetfulness, stress), lack of motivation, and busy work schedules and limited time. Recommendations were also made to overcome the barriers which include follow ups by health care professionals, and advice to hypertensive and non-hypertensive patients. In conclusion, the study found that adherence to non-pharmacologic management of hypertension is greatly influenced by one’s finances, some personal factors and external influences. Hence, it is necessary address these factors and also to ensure effective follow-ups and reminders in order to improve adherence to the non-pharmacologic management of hypertension. Further studies can also be conducted to address other obstacles to non-pharmacologic hypertension management.

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          Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study

          Objective Comparison of recent national survey data on prevalence, awareness, treatment and control of hypertension in England, the USA and Canada, and correlation of these parameters with each country stroke and ischaemic heart disease (IHD) mortality. Design Non-institutionalised population surveys. Setting and participants England (2006 n=6873), the USA (2007–2010 n=10 003) and Canada (2007–2009 n=3485) aged 20–79 years. Outcomes Stroke and IHD mortality rates were plotted against countries’ specific prevalence data. Results Mean systolic blood pressure (SBP) was higher in England than in the USA and Canada in all age–gender groups. Mean diastolic blood pressure (DBP) was similar in the three countries before age 50 and then fell more rapidly in the USA, being the lowest in the USA. Only 34% had a BP under 140/90 mm Hg in England, compared with 50% in the USA and 66% in Canada. Prehypertension and stages 1 and 2 hypertension prevalence figures were the highest in England. Hypertension prevalence (≥140 mm Hg SBP and/or ≥90 mm Hg DBP) was lower in Canada (19·5%) than in the USA (29%) and England (30%). Hypertension awareness was higher in the USA (81%) and Canada (83%) than in England (65%). England also had lower levels of hypertension treatment (51%; USA 74%; Canada 80%) and control (<140/90 mm Hg; 27%; the USA 53%; Canada 66%). Canada had the lowest stroke and IHD mortality rates, England the highest and the rates were inversely related to the mean SBP in each country and strongly related to the blood pressure indicators, the strongest relationship being between low hypertension awareness and stroke mortality. Conclusions While the current prevention efforts in England should result in future-improved figures, especially at younger ages, these data still show important gaps in the management of hypertension in these countries, with consequences on stroke and IHD mortality.
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            Prevalence of Hypertension in China: A Cross-Sectional Study

            Aims The present study aimed to assess the prevalence of hypertension among Chinese adults. Methods Data were obtained from sphygmomanometer measurements and a questionnaire administered to 46239 Chinese adults ≥20 years of age who participated in the 2007–2008 China National Diabetes and Metabolic Disorders Study. Hypertension was defined as blood pressure ≥140/90 mm Hg or use of antihypertensive medication. Results A total of 26.6% of Chinese adults had hypertension, and a significantly greater number of men were hypertensive than women (29.2% vs 24.1%, p<0.001). The age-specific prevalence of hypertension was 13.0%, 36.7%, and 56.5% among persons aged 20 to 44 years (young people), 45 to 64 years (middle-aged people), and ≥65 years (elderly people), respectively. In economically developed regions, the prevalence of hypertension was significantly higher among rural residents than among urban residents (31.3% vs 29.2%, p = 0.001). Among women or individuals who lived in the northern region, the disparity in the prevalence of hypertension between urban and rural areas disappeared (women: 24.0% vs. 24.0%, p = 0.942; northern region: 31.6% vs. 31.2%, p = 0.505). Among hypertensive patients, 45.0% were aware of their condition, 36.2% were treated, and 11.1% were adequately controlled. Conclusions The prevalence of hypertension in China is increasing. The trend of an increase in prevalence is striking in young people and rural populations. Hypertension awareness, treatment, and control are poor. Public health efforts for further improving awareness and enhancing effective control are urgently needed in China, especially in emerging populations.
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              Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis.

              Exercise is widely recommended as one of the key preventive lifestyle changes to reduce the risk of hypertension and to manage high blood pressure (BP), but individual studies investigating the effect of exercise on ambulatory BP have remained inconclusive. Therefore, the primary purpose of this systematic review and meta-analysis was to determine the effect of aerobic endurance training on daytime and night-time BP in healthy adults. A systematic literature search was conducted using PubMed and Cochrane Controlled Clinical trial registry from their inception to May 2012. Randomized controlled trials of at least 4 weeks investigating the effects of aerobic endurance training on ambulatory BP in healthy adults were included. Inverse weighted random effects models were used for analyses, with data reported as weighted means and 95% confidence limits. We included 15 randomized controlled trials, involving 17 study groups and 633 participants (394 exercise participants and 239 control participants). Overall, endurance training induced a significant reduction in daytime SBP [-3.2 mmHg, 95% confidence interval (CI), -5.0 to-1.3] and daytime DBP (-2.7 mmHg, 95% CI, -3.9 to -1.5). No effect was observed on night-time BP. The findings from this meta-analysis suggest that aerobic endurance exercise significantly decreases daytime, but not night-time, ambulatory BP.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: SoftwareRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                9 March 2022
                2022
                : 2
                : 3
                : e0000085
                Affiliations
                [1 ] School of Nursing and Midwifery, Department of Midwifery, Valley View University, Accra, Ghana
                [2 ] Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
                [3 ] Dean of Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
                [4 ] Assistant Lecturer, Ghana Christian University College, Accra, Ghana
                VinUniversity, VIET NAM
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-6730-4725
                Article
                PGPH-D-21-00587
                10.1371/journal.pgph.0000085
                10022142
                36962265
                270d95fa-88d5-45c0-b104-9fa07b812b66
                © 2022 Appiah et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 September 2021
                : 15 November 2021
                Page count
                Figures: 0, Tables: 2, Pages: 12
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Vascular Medicine
                Blood Pressure
                Hypertension
                Biology and Life Sciences
                Nutrition
                Diet
                Food
                Medicine and Health Sciences
                Nutrition
                Diet
                Food
                Biology and Life Sciences
                Nutrition
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                Medicine and Health Sciences
                Nutrition
                Diet
                People and Places
                Geographical Locations
                Africa
                Ghana
                Social Sciences
                Economics
                Finance
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Eating
                Biology and Life Sciences
                Agriculture
                Animal Products
                Meat
                Biology and Life Sciences
                Nutrition
                Diet
                Food
                Meat
                Medicine and Health Sciences
                Nutrition
                Diet
                Food
                Meat
                Social Sciences
                Economics
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                Financial Management
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