Understanding Perceptions and Practices for Zambian Adults in Western Province at Risk for Hypertension: An Exploratory Descriptive Study

Abstract

Hypertension is an important public health issue in Zambia. Despite the need for early detection, treatment, and ongoing monitoring, there is little documented research on hypertension in Zambia. The study aims were to: 1) better understand risk factors for hypertension in urban and rural communities in Mongu and Limulunga Districts, Western Province; 2) identify current health practices for hypertension and prevention in these communities; and 3) explore intersections between culture and hypertension perceptions and practices for study participants. A mixed methods approach was used; 203 adults completed surveys including demographics, anthropometric measures, blood pressure (BP), physicial activity, diet, and salt intake at five health check stations. Two focus groups were conducted with rural and urban community members to better understand their perspectives on hypertension. The prevalence of hypertension was 32.8% for survey participants. A further 24.6% had pre-hypertension. The mean total weight of salt added to food was nearly double the WHO recommendation with women adding significantly more salt to food than men. Significant differences in waist circumference were observed between men and women with men at low risk and women at substantialy high risk. In focus groups, participants cited westernized diets, lack of physical activity, stress, psychological factors, and urbanization as causative factors for hypertension. Participants lacked understanding of BP medications, healthy lifestyles, adherence to treatment, and ongoing monitoring. Focus group participants mentioned challenges in obtaining treatment for hypertension and desired to be active contributors in creating solutions. They recommended that government priorize hypertension initiatives that increase access to health education to reduce risk, enhance early detection, and support lifestyle changes and medication adherence. Our findings suggest that policy-makers need to engage communities more effectively to develop successful public health strategies to prevent, detect, and manage hypertension in Western Province, Zambia, particularly in rural areas.

The Association Between Depression and Self-Reported Sleep Quality Among Hypertensive Patients in a Rural Area of Central Sulawesi

“…During the data collection for this study, we found that majority of rural participants said regular exercise was not a common practice because they viewed it as a part of their daily physical activity during working such as walking or farming. The participants' understanding regarding exercise and physical activity in this study was similar with a study by Oelke et al (2015) in Zambia. The benefit of exercise on sleep are still unclear, but may related to energy efficiency (Myllymaki et al, 2011).…”

Hypertension prevalence and risk factors in rural and urban Zambian adults in western province: a cross-sectional study

“…Four Health Checks in total were conducted; two in Mongu District and two in Limulunga District. Word-of-mouth recruitment strategies were used, based on their successful use in other recruitment efforts [ 13 ]. A sample size of 250, based on approximately 30 participants per variable, was deemed to provide sufficient power to detect significant relationships [ 17 ].…”

“…In Zambia, studies of hypertension prevalence and risk factors have been sparse until more recently. Oelke et al [ 13 ] found a prevalence of 32.8% hypertension in Zambian adults living in Mongu, the urban capital of Western Province. Slightly lower prevalence rates have been reported in rural Zambia.…”

“…Rural and urban hypertension risk factor comparison : Rural populations in Africa have been shown to generally be more advanced in age, less overweight or obese, have lower incomes, higher use of smokeless tobacco products, be less educated, more active, and to have a higher prevalence of malnutrition [ 4 , 6 , 11 , 13 , 15 ]. Lower hypertension prevalence in rural African populations have been attributed to lifestyle factors, such as increased daily exercise as a result of their work requirements compared to the slightly more sedentary lifestyles of urban populations [ 13 , 16 ]. Increased adoption of a westernized diet has had a strong influence on both urban and rural populations [ 11 ].…”

Hypertension and the effect of dietary salt on inflammation: An interventional study

“…Population level data consistently show high salt consumption in SSA [9]. In Zambia for example, respondents in a survey always added salt to their food before eating and salt consumption was estimated to be twice higher than that recommended by the World Health Organization (WHO), even among hypertensive patients [10,11]. A reduction in dietary salt from the current intake of 10 grams per day to the recommended level of less than 5 grams per day, could have major bene ts for cardiovascular health with signi cant healthcare cost savings for both patients and the general population [5,12,13].…”