Why the study?
Blood pressure control rates remain suboptimal in low- and middle-income countries despite effective drugs, and the role of self-care in blood pressure management is less studied in these settings.
Do self-care practices and family support improve blood pressure control in individuals with hypertension?
Do self-care practices and family support improve blood pressure control in individuals with hypertension?
Adherence to self-care activities and strong family support are significantly associated with better blood pressure control in individuals with hypertension in Kerala, India.
Family support for self-care was associated with better BP control; leaves open whether targeted interventions improve outcomes in LMIC hypertension.
<ns3:p> <ns3:bold>Background</ns3:bold> : Despite the availability of effective drugs, blood pressure (BP) control rate is sub-optimal in individuals with hypertension in low- and middle-income countries (LMICs). The role of self-care in the management of BP is less studied in LMIC settings. </ns3:p> <ns3:p> <ns3:bold>Methods</ns3:bold> : We conducted a community-based, cross-sectional study in individuals with hypertension in Kollam district, Kerala. A multistage cluster sampling method was used for the selection of study participants. We measured self-care by using an adapted Hypertension Self-Care Activity Level Effects (H-SCALE) scale. Descriptive statistics were used to summarise the data and logistic regression analysis was conducted to identify factors associated with BP control. </ns3:p> <ns3:p> <ns3:bold>Results</ns3:bold> : In total, 690 individuals with hypertension (women=60%) and a mean age of 57±8 years participated in the study. More than half (54%) of the participants were adherent to anti-hypertensive medications. However, the adherence rate was much lower for the dietary approach to stop hypertension (DASH) diet (12.8%), recommended level of physical activity (24%) and weight management (11.4%). Overall BP control was achieved in two of five individuals (38.4%, 95% CI: 34.7-42.0%). Among self-care activities, adherence to medications (AOR: 1.8, 95% CI: 1.3-2.5), DASH diet (AOR: 1.5, 95% CI: 1.0-2.4), and non-smoking status (AOR: 3.3, 95% CI: 1.7-6.4) were associated with control of BP. Additionally, good family support to self-care (AOR: 1.9, 95% CI: 1.1-3.1) was associated with better control of BP. </ns3:p> <ns3:p> <ns3:bold>Conclusion:</ns3:bold> In individuals with hypertension, the BP control rate is achieved in two of five individuals. Adoption of self-care activities are sub-optimal. Both family support and adherence to self-care activities are associated with BP control. Family based interventions to improve adherence to self-care activities could have a significant public health impact in achieving better population-level BP control rates in Kerala, India. </ns3:p>
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Chacko et al. (2020) studied this question.
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