Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension

Abstract

Background: Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension. Methods: We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34-69 years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019. Results: Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), selfefficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people. Conclusions: Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.

Factors affecting adherence to lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019

“…This finding was higher than the study conducted in the southern part of Ethiopia, Korea, and Jordan where compliance with the recommended lifestyle was 27.3%, 35.5%, and 23%, respectively. 9,13,14 The higher level of adherence in this study compared with other studies in Ethiopia may be due to the higher health literacy level in Addis Ababa as patients are exposed to more information than in the rural part of Ethiopia. This report showed that a sedentary lifestyle was still high in developing countries like Ethiopia which increased the burden of chronic diseases like hypertension.…”

Dietary Salt-Related Determinants of Hypertension in Rural Northern Thailand

“…Another study conducted in Thailand among hypertensive patients in Bangkok showed that although hypertensive patients were aware of their uncontrolled hypertension, they still chose to have a high salt diet due to a preference for tastier and instant food [48]. The pattern of the findings from other countries was similarly observed, such as in Ethiopia [49,50], Nepal [42], India [51,52], Australia [53], Iran [54,55], Spain [56], and Korea [57]. These studies revealed that individuals generally have a reasonable knowledge of the salt and its adverse effects of overconsumption as well as their favorable attitudes toward salt reduction; however, almost none of them took action to reduce salt intake, and their blood pressure was still uncontrolled.…”

Regular Physical Activities and Related Factors among Middle-Aged and Older Adults in Jinan, China: A Cross-Sectional Study

“…For example, elderly patients with heart failure (HF) had decreased physical function due to decreased cardiorespiratory health and muscle strength, thereby reducing participation in physical activities [ 48 ]. On the other hand, compared with older adults without PDH, people with PDH were more likely to have lower self-efficacy [ 49 ], which reduced physical activities [ 50 ]. In addition, health intervention studies also supported our results, showing that the health conditions of hypertensive patients were also the main reason why these patients did not participate in physical activity programs [ 51 ].…”