الفهرس 
Epidemiology of HypertensionOnly 14 pages are availabe for public view
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Abstract
Hypertension is considered the most prevalent cardiovascular disorder all over the world. Complications of raised blood pressure include heart failure, peripheral vascular disease, renal impairment, retinal hemorrhage and visual impairment. Despite the wide variety and availability of antihypertensive treatment, more than two-thirds of adult hypertensive patients have their blood pressure uncontrolled. The factor that significantly contributes to this situation is non-adherence. Therefore, non-adherence is a serious problem and should be understood as one of the major obstacles to the success of treatment of hypertension
The aim of the present work was to improve health status of hypertensive patients by trying to assess the percentage of adherence to management, determine the factors affecting it and assess the socioeconomic profile of the studied hypertensive patients.
To achieve such aim, a cross sectional study was conducted on hypertensive patients who attended Munshaat sultan family health center, in Menouf district, Menoufia governorate.
The study population sampled from hypertensive patients aged more than 21years old during the period from the 1st of July 2013 to the end of December 2013.
All the participants in the study were evaluated using pre-designed questionnaire to assess the personal history, medical history related to hypertension , medication adherence and factors affecting it including patient (e.g. sociodemographic, personal belief and perception), health system and provider related factors(patient satisfaction toward health care) and disease and drug related
factors(duration of hypertension, presence of complication or other chronic illness and frequency of drug dose), adherence to healthy life style practice including healthy diet, regular exercise ,weight loss and absence of smoking. The blood pressure was measured for all participants.
The non adherent patients were identified and invited to the family club in 10 session ( 10 focus groups) and evaluated through qualitative study including open ended questions about knowledge regarding hypertension and antihypertensive medication, reasons of non adherence to medications a& knowledge regarding Lifestyle modifications and reasons of non adherence.
from this study it was found that:
1- The percentage of adherence among hypertensive patients was 44%.
2- There was statistically significant difference between medication adherence and blood pressure control
3- The adherence was affected by sociodemographic criteria of the patients; Patients who were older than 60 years, were more adherent than patients less than 60 years old with percentage of 60.3% and 29.03% respectively. More than half of adherent patients were primary educated or illiterate, about 60 % of adherent patients were married and majority of adherent patients have family members helping them to remember medication.
4- There was statistically significant difference between adherent and non-adherent patients regarding their belief about medication causing addiction. There was non-significant difference between both groups
5- Adherence is affected by patient satisfaction toward health care services, the overall patient satisfaction can be classified in to the following: about (55.8%) of the patients are unsatisfied about health care services and (44.2%) are satisfied. About 56.6% of adherent patients were satisfied toward health care service and providers.
6- There was statistically significant difference between medication adherence and explanation of patient condition and management by the doctor, As 63.2% of adherent patients received health education from physician and about 73% of non adherent patient didn’t receive health education.
7- Adherence was affected by medical history of the patients; As 57.4% of adherent patients were not having any other chronic diseases and 62.5% of them were taking one drug dose for hypertension daily.
8- The commonest causes of non adherence to medication were in order: forgetfulness to take drug and lack of money followed by fear of drug addiction and frequent change of drug dose respectively.
9- There was statistically significant difference between medication adherence and reduction of fat in diet, reduction of salt in food and smoking. As (83.6%) of non adherent patients to medication were smoker, 75.9% of them didn’t reduce fat in diet and 75.8% of them didn’t reduce salt in food
10- Lack of motivation and difficulty in changing habits were the main causes of non adherence to healthy diet in about 61.5% and 46.2% of non adherent patients to medication respectively.