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Hipertansif Hastalarda Tedavi Edici Yaşam Tarzı Değişikliğine Uyumun Değerlendirilmesi: Aile Sağlığı Merkezi Örneklemi

Year 2023, Volume: 13 Issue: 4, 521 - 529, 30.12.2023

Tuna Şanlı Erkan Şengül Tuncay Müge Alvur Semra Selime Çiftlik

https://doi.org/10.31832/smj.1342491

Abstract

Amaç: Çalışmanın amacı hipertansiyon hastalarında tedaviye uyum ve yaşam tarzı değişikliği başarı durumunu ölçmek ve bu durumun kan basıncı kontrolü üzerindeki etkilerini incelemektir.
Yöntem: Çalışma, 300 hipertansiyon hastası ile yapıldı. Hastaların boy, kilo, kan basıncı ve bel çevresi ölçümleri, biyokimya ve hemogram sonuçları kaydedildi. Hastalara; tıbbi bilgileri, sosyodemografik özellikleri, yaşam tarzı alışkanlıklarını içeren anket soruları soruldu. Hipertansif Bireylerin Tedaviye Uyum ve Yaşam Değişikliği Başarısını Değerlendirme Ölçeği uygulandı.
Bulgular: Hastaların yaş ortalaması 62,41±10,49 yıl idi. Ortanca hipertansiyon süresi 10 yıl saptandı. Katılımcıların %36,7’si üç veya daha fazla antihipertansif ilaç kullanmaktaydı. Katılımcıların %44,7’sinde sistolik kan basıncı ≥140 mmHg, %33’ünde diyastolik kan basıncı ≥90 mmHg olarak ölçüldü. Hastaların %52’si tedaviye rağmen hipertansif olarak bulundu. Vücut kitle indeksine göre hastaların %59,7’si obezdi. Vücut kitle indeksi, kadınlarda 34,14±6,84 kg/m² iken, erkeklerde 30,20±4,76kg/m² idi (p=0,001). Sistolik ve diyastolik kan basıncı yüksek olanlarda vücut kitle indeksi ve bel çevreleri, kan basıncı normal olanlara göre daha yüksekti (p=0,001 ve p=0,001). Hipertansif Bireylerin Tedaviye Uyum ve Yaşam Değişikliği Başarısını Değerlendirme Ölçeğine göre hastaların %81’i uyumluydu. Uyumsuz hastaların %66,7’si, uyumlu hastaların %48,6’sı hipertansifti (p=0,014). Haftada en az 3 gün egzersiz yapan hastalar daha uyumlu bulundu (p=0,007). Uyumlu hasta grubunun obezite oranları daha düşüktü (p=0,047).
Sonuç: Çalışmamızda uyum oranı yüksek olarak değerlendirilen hasta grubunun obezite oranı daha düşük saptandı. Aynı grubun kan basıncı kontrollerinin daha iyi olduğu değerlendirildi. Hipertansiyon tedavisinde başarıya ulaşılabilmesi için, hastaların tedaviye uyum ve yaşam tarzı değişikliği konularında eğitilmesi gerekir.

Keywords

Tedaviye Uyum Hipertansiyon Yaşam Tarzı Değişikliği Obezite

References

  • Türk Kardiyoloji Derneği. Türk kardiyoloji derneği ulusal hipertansiyon tedavi ve takip kılavuzu; 2000. https://www.tkd.org.tr/kilavuz/k03.htm.
  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365(9455): 217-23.
  • Onat A, Can G, Yüksel H, et al. TEKHARF tıp dünyasının kronik hastalıklara yaklaşımına öncülük. Onat A, editör. İstanbul, Logos Yayıncılık, 2017;1-294.
  • Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD Hipertansiyon Tanı ve Tedavi Kılavuzu 2022.https://file.temd.org.tr/Uploads/publications/guides/documents/Hipertansiyon-Kilavuzu-2022.pdf (Erişim tarihi:08.11.2023).
  • Altun B, Arici M, Nergizoğlu G, Derici U,Karatan O,Turgan Ç, et al. Turkish society of hypertension and renal diseases. Prevalence, awareness, treatment and control of hypertension in turkey (the patent study) in 2003.J Hypertens 2005; 23(10): 1817-23. 
  • Sengul S, Akpolat T, Erdem Y, Derici U,Arici M,Sindel S, et al. Turkish society of hypertension and renal diseases. Changes in hypertension prevalence, awareness, treatment, and control rates in turkey from 2003 to 2012.J Hypertens 2016; 34(6): 1208-17.
  • Arıcı M, Altun B, Erdem Y, Derici U, Nergizoğlu G, Turgan Ç, et al. Türk hipertansiyon prevalansçalışması(PatenT).http://www.turkhipertansiyon.org/pdf/Turk_Hipertansiyon_Prevalans_Calismasi_Ozeti-1.pdf.
  • Graves JW. Management of diffucult to control hypertension. Mayo Clinic Proceedings 2000; 75(3): 278-84.
  • Hill M, Miller NH. Antihipertansif tedaviye uyum. Primer hipertansiyon.İzzo JL, Black HR, editörler. 3. Baskı, İstanbul, Nobel kitapevi, 2004.
  • Feldman R, Bacher M, Campbell N, Drover A, Chockalingam A. Adherence to pharmacologic management of hypertension. Can J of Public Health 1998; 89(5): 116-8.
  • Gozum S, Hacihasanoglu R. Reliability and validity of the Turkish adaptation of medication adherenee self-efficacy scale in hypertensive patients. Eur J of Cardiovasc Nurs 2009; 8(2): 129-36.
  • Esirgen L. Hipertansif bireylerin tedaviye uyum ve yaşam değişikliği başarısını değerlendirme ölçeğinin geliştirilmesi. Uzmanlık tezi. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Halk Sağlığı Ana Bilim Dalı, İstanbul, 2018.
  • Report of a WHO Consultation on Obesity. Geneva, World Health Organization, 1997.
  • Mert H, Özçakar N, Kuruoğlu; A multidisciplinary special study module research: treatment compliance of patients with hypertension, Türk Aile Hek Derg 2011; 15(1): 7-12.
  • Ogedegbe G. Barriers to optimal hypertension control. J Clin Hypertens (Greenwich) 2008; 10(8): 644-6.
  • Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96(4): e5641.
  • Abaci A, Oguz A, Kozan O, Toprak N,Senocak H, Deger N, et al. Treatment and control of hypertension in Turkish population: a survey on high blood pressure in primary care (the TURKSAHA study).J Hum Hypertens 2006; 20(5): 355-61.
  • Alhaddad IA, Hamoui O, Hammoudeh A, Mallat S. Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population: adherence. Vasc Health Risk Manag 2016; 12: 407-13.
  • Oliveira-Filho AD, Barreto-Filho JA, Neves SJ, Lyra Junior DP. Association between the 8- item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control. Arq Bras Cardiol 2012; 99(1): 649-58.
  • Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
  • Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP).Diabetes Care 2002; 25(9): 1551-6.
  • Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28(2): 169-80.
  • Van Italie TB. Health implications of overweight and obesity in the United States. Ann Intern Med 1985; 103(6): 983-8.
  • Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G. Relationship between patients knowledge and medication adherence among patients with hypertension. Patient Prefer Adherence 2016; 10: 2437-47.
  • Vatansever Ö, Ünsar S. Esansiyel hipertansiyonlu hastaların ilaç tedavisine uyum/öz etkililik düzeylerinin ve etkileyen faktörlerin belirlenmesi. Turk Soc Cardiol Turkish Journal of Cardiovasc Nurs 2014; 5(8): 66-74.
  • Mollaoglu M, Solmaz G, Mollaoglu M. Adherence to therapy and quality of life in hypertensive patients. Acta Clin Croat 2015; 54(4): 438-44.
  • Gün Y, Korkmaz M. Hipertansif Hastaların Tedavi Uyumu ve Yaşam Kalitesi. DEUHYO ED. 2014; 7(2): 98-108.
  • Kim Y, Kong KA. Do hypertensive individuals who are aware of their disease follow lifestyle recommendations better than those who are not aware? PloS One 2015; 10(8): e0136858.
  • Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PloS One 2013; 8(4): e62775.
  • Mekonnen HS, Gebrie MH, Eyasu KH, Gelagay AA. Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia. BMC Pharmacol Toxicol 2017; 18(1): 2.

Assessment of Compliance with Treatment and Therapeutic Lifestyle Changes in Hypertensive Patients: A Sample of the Family Health Center

Year 2023, Volume: 13 Issue: 4, 521 - 529, 30.12.2023

Tuna Şanlı Erkan Şengül Tuncay Müge Alvur Semra Selime Çiftlik

https://doi.org/10.31832/smj.1342491

Abstract

ABSTRACT
Objective: The aim of this study was to measure treatment adherence and lifestyle modification success in hypertensive patients and to examine the effects of these factors on blood pressure control.
Method: The study was conducted with 300 hypertensive patients. Measurements of height, weight, blood pressure, and waist circumference, as well as biochemical and hematological results, were recorded. Patients were asked to complete a questionnaire covering medical information, sociodemographic characteristics, and lifestyle habits. The Hypertensive Individuals' Treatment Adherence and Lifestyle Modification Success Assessment Scale was administered.
Results: The mean age of the patients was 62.41±10.49 years. The median duration of hypertension was found to be 10 years. 36.7% of the participants were using three or more antihypertensive medications. Systolic blood pressure was ≥140 mmHg in 44.7% of participants, while diastolic blood pressure was ≥90 mmHg in 33%. Despite treatment, 52% of participants were found to be hypertensive. According to the body mass index (BMI), 59.7% of patients were obese. The BMI was 34.14±6.84 kg/m² for females and 30.20±4.76 kg/m² for males (p=0.001). Patients with high systolic and diastolic blood pressure had higher BMIs and waist circumferences compared to those with normal blood pressure (p=0.001 and p=0.001). According to the Hypertensive Individuals' Treatment Adherence and Lifestyle Modification Success Assessment Scale, 81% of patients were adherent. 66.7% of non-adherent patients and 48.6% of adherent patients were hypertensive (p=0.014). Patients who engaged in physical activity for at least 3 days a week were found to be more adherent (p=0.007). The adherent patient group had lower obesity rates (p=0.047).
Conclusion: In our study, the group of patients with higher adherence rates had lower obesity rates. It was also observed that this group had better blood pressure control. To achieve success in hypertension treatment, patients need to be educated about treatment adherence and lifestyle modifications.

Keywords

Compliance to Treatment Hypertension Lifestyle Change Obesity

References

  • Türk Kardiyoloji Derneği. Türk kardiyoloji derneği ulusal hipertansiyon tedavi ve takip kılavuzu; 2000. https://www.tkd.org.tr/kilavuz/k03.htm.
  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365(9455): 217-23.
  • Onat A, Can G, Yüksel H, et al. TEKHARF tıp dünyasının kronik hastalıklara yaklaşımına öncülük. Onat A, editör. İstanbul, Logos Yayıncılık, 2017;1-294.
  • Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD Hipertansiyon Tanı ve Tedavi Kılavuzu 2022.https://file.temd.org.tr/Uploads/publications/guides/documents/Hipertansiyon-Kilavuzu-2022.pdf (Erişim tarihi:08.11.2023).
  • Altun B, Arici M, Nergizoğlu G, Derici U,Karatan O,Turgan Ç, et al. Turkish society of hypertension and renal diseases. Prevalence, awareness, treatment and control of hypertension in turkey (the patent study) in 2003.J Hypertens 2005; 23(10): 1817-23. 
  • Sengul S, Akpolat T, Erdem Y, Derici U,Arici M,Sindel S, et al. Turkish society of hypertension and renal diseases. Changes in hypertension prevalence, awareness, treatment, and control rates in turkey from 2003 to 2012.J Hypertens 2016; 34(6): 1208-17.
  • Arıcı M, Altun B, Erdem Y, Derici U, Nergizoğlu G, Turgan Ç, et al. Türk hipertansiyon prevalansçalışması(PatenT).http://www.turkhipertansiyon.org/pdf/Turk_Hipertansiyon_Prevalans_Calismasi_Ozeti-1.pdf.
  • Graves JW. Management of diffucult to control hypertension. Mayo Clinic Proceedings 2000; 75(3): 278-84.
  • Hill M, Miller NH. Antihipertansif tedaviye uyum. Primer hipertansiyon.İzzo JL, Black HR, editörler. 3. Baskı, İstanbul, Nobel kitapevi, 2004.
  • Feldman R, Bacher M, Campbell N, Drover A, Chockalingam A. Adherence to pharmacologic management of hypertension. Can J of Public Health 1998; 89(5): 116-8.
  • Gozum S, Hacihasanoglu R. Reliability and validity of the Turkish adaptation of medication adherenee self-efficacy scale in hypertensive patients. Eur J of Cardiovasc Nurs 2009; 8(2): 129-36.
  • Esirgen L. Hipertansif bireylerin tedaviye uyum ve yaşam değişikliği başarısını değerlendirme ölçeğinin geliştirilmesi. Uzmanlık tezi. İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Halk Sağlığı Ana Bilim Dalı, İstanbul, 2018.
  • Report of a WHO Consultation on Obesity. Geneva, World Health Organization, 1997.
  • Mert H, Özçakar N, Kuruoğlu; A multidisciplinary special study module research: treatment compliance of patients with hypertension, Türk Aile Hek Derg 2011; 15(1): 7-12.
  • Ogedegbe G. Barriers to optimal hypertension control. J Clin Hypertens (Greenwich) 2008; 10(8): 644-6.
  • Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96(4): e5641.
  • Abaci A, Oguz A, Kozan O, Toprak N,Senocak H, Deger N, et al. Treatment and control of hypertension in Turkish population: a survey on high blood pressure in primary care (the TURKSAHA study).J Hum Hypertens 2006; 20(5): 355-61.
  • Alhaddad IA, Hamoui O, Hammoudeh A, Mallat S. Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population: adherence. Vasc Health Risk Manag 2016; 12: 407-13.
  • Oliveira-Filho AD, Barreto-Filho JA, Neves SJ, Lyra Junior DP. Association between the 8- item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control. Arq Bras Cardiol 2012; 99(1): 649-58.
  • Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
  • Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP).Diabetes Care 2002; 25(9): 1551-6.
  • Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28(2): 169-80.
  • Van Italie TB. Health implications of overweight and obesity in the United States. Ann Intern Med 1985; 103(6): 983-8.
  • Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G. Relationship between patients knowledge and medication adherence among patients with hypertension. Patient Prefer Adherence 2016; 10: 2437-47.
  • Vatansever Ö, Ünsar S. Esansiyel hipertansiyonlu hastaların ilaç tedavisine uyum/öz etkililik düzeylerinin ve etkileyen faktörlerin belirlenmesi. Turk Soc Cardiol Turkish Journal of Cardiovasc Nurs 2014; 5(8): 66-74.
  • Mollaoglu M, Solmaz G, Mollaoglu M. Adherence to therapy and quality of life in hypertensive patients. Acta Clin Croat 2015; 54(4): 438-44.
  • Gün Y, Korkmaz M. Hipertansif Hastaların Tedavi Uyumu ve Yaşam Kalitesi. DEUHYO ED. 2014; 7(2): 98-108.
  • Kim Y, Kong KA. Do hypertensive individuals who are aware of their disease follow lifestyle recommendations better than those who are not aware? PloS One 2015; 10(8): e0136858.
  • Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PloS One 2013; 8(4): e62775.
  • Mekonnen HS, Gebrie MH, Eyasu KH, Gelagay AA. Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia. BMC Pharmacol Toxicol 2017; 18(1): 2.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Services and Systems (Other)
Journal Section Articles
Authors

Tuna Şanlı 0000-0001-9373-6268

Erkan Şengül 0000-0003-3461-4740

Tuncay Müge Alvur 0000-0001-6792-5786

Semra Selime Çiftlik 0000-0003-0709-3716

Publication Date December 30, 2023
Submission Date August 14, 2023
Published in Issue Year 2023 Volume: 13 Issue: 4

Cite

AMA Şanlı T, Şengül E, Alvur TM, Çiftlik SS. Hipertansif Hastalarda Tedavi Edici Yaşam Tarzı Değişikliğine Uyumun Değerlendirilmesi: Aile Sağlığı Merkezi Örneklemi. Sakarya Tıp Dergisi. December 2023;13(4):521-529. doi:10.31832/smj.1342491

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