Self-reported diet management, dietary quality, and blood pressure control in Korean adults with hypertension

摘要

BackgroundHypertension is a global health problem. The prevalence of hypertension worldwide was 26% in 2000, and the total number of adults with hypertension will reach an estimated 1.56 billion in 2025 [1]. Elevated blood pressure (BP) is a leading cause of cardiovascular diseases, disability, and premature death [2, 3]. Along with population ageing, the burden of hypertension on our societies is predicted to increase continuously. However, hypertension is modifiable [4,5,6,7]; and well-controlled BP can prevent clinical complications, enhance quality of life, and improve prognosis [8,9,10,11].The optimal BP for adults with hypertension can be achieved through pharmacological treatment and nonpharmacological interventions. Daily preventive practices of the affected individual are essential for BP control [12]. During the past decades, the hypertension treatment rate has increased remarkably, especially in some countries including South Korea; and the BP control rate among hypertensive adults treated with medication has also substantially improved [13, 14]. The reason for this may be that self-management of medication has become easier with alleviation of potential barriers surrounding pharmacological treatment, i.e., limited health care, drug expense, inconvenience of dosing, and severity of side effects [15]. However, recent indices of hypertension management have remained stable; and a considerable number of medicated adults with hypertension do not reach the optimal BP control level [14].Lifestyle modifications such as healthy diet, low sodium consumption, sufficient physical activity, and limited alcohol consumption have been strongly recommended for all hypertensive individuals. These modifications can serve as an initial treatment before the start of medication or as an adjunct to medication in persons already on pharmacological treatment [16, 17]. There are few studies focusing on hypertensive individuals’ lifestyle management practices and their effects on BP control. According to some previous studies, adherence to lifestyle modification, particularly dietary modification, is much lower than that of medication compliance [18, 19]. This is true despite the noted beneficial impact of lifestyle modification in many clinical trials and epidemiologic studies. Contrary to pharmacological treatment, lifestyle modification has few or no harmful side effects and leads to improved overall cardiovascular health in addition to BP reduction [5]. Lifestyle modification can reduce the requirement for BP-lowering drugs [6]. Therefore, a more aggressive movement from pharmacological treatment toward lifestyle modification seems necessary.To the best of our knowledge, there are few studies that evaluate dietary management practices and their effects on BP control among adults diagnosed with hypertension. Thus, we aimed to investigate the association of self-reported dietary management, dietary quality, and BP control among Korean adults with known hypertension.