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ASSESSMENT OF DIETARY COMPLIANCE AND PHYSICAL EXERCISE AMONG HYPERTENSIVE PATIENTS ATTENDING MEDICAL OUTPATIENT CLINIC IN UNIVERSITY OF NIGERIA TEACHING HOSPITAL ITUKU-OZALLA.

CHAPTER ONE

 INTRODUCTION 
Background to the Study
 Hypertension is fast emerging as a modern epidemic in the world, Developed countries are considering it as a leading cause of death but even developing countries do not lag behind being affected by it. Hypertension is classified as either primary (essential) or secondary. It is a killer disease associated with the blood pressure that occurs due to over contraction or over relaxation of the ventricles. Many carriers of this disease are unaware of it because there is no immediate symptom which makes the carriers get along without knowing it. The danger, according to Aburto, Hansan, Gulierrez, Hooper, Elliott Cappuccio, (2013) comes when the unchecked, resultant effect usually called cardiovascular accident attacks which results to cardiac arrest, stroke, constant fainting, and continuous loss of energy. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively, in the arterial system. The systolic pressure occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction. Normal blood pressure at rest according to Arguedas, Leiva & Wright (2013), is within the range of 100–140 mmHg systolic and 60–90 mmHg diastolic. Hypertension is present if the blood pressure is persistently at or above 140/90 millimeters of mercury (mmHg) for most adults; different criteria apply to children. Hypertension according to Basiotis, Carlson, Gerrior, Juan & Lino (2012), usually does not cause symptoms initially, but sustained hypertension over time is a major risk factor for hypertensive heart disease, coronary artery disease, stroke, aortic aneurysm, peripheral artery disease, and chronic kidney disease. Even though hypertension is one of the leading cardiovascular disease and is called “a silent killer” (Bhavnager, 2009), it is however easily detectable and manageable. It is linked with changes in diet and life style factors and poor knowledge about the management of the disorder (Verma, 2007). A healthy life style is one in which individuals are aware of risks to their health and can make informed choices for maintenance. These choices include stopping smoking, consuming little quantity of alcoholic drinks per day, weight reduction and regular exercises. In addition, a diet with low sodium, low fat and plenty of fresh fruit and vegetable are required (Peltzer, 2002). Dietary and lifestyle changes can improve blood pressure control and decrease the risk of health complications, although treatment with medication is still often necessary in people for whom lifestyle changes are not enough or not effective. Losing some excess weight can make a big difference. Blood pressure according to Ilo et al (2014) can fall by up to 2.5/1.5 mmHg for each excess kilogram which is lost. Losing excess weight has other health benefits too. For example brisk walking, swimming, cycling, dancing etc. Regular activity can lower blood pressure in addition to giving other health benefits. Physical exercise regimes which are shown to reduce blood pressure include isometric resistance exercises, aerobic exercise, resistance exercise and device-guided breathing (Brook, Appel, Reubenfire et al, 2013). Regular moderate exercise such as walking briskly or performing aerobic exercise (lasting for at least 30 minutes, at least three times per week) can lower systolic blood pressure considerably (Miller et al, 2002). The reductive effect is synergistic with other modifiable factors such as dietary modification and a reduction in alcohol consumption. Whelton et al, (2002) found that regular physical exercise alone can lead to a reduction in systolic blood pressure by 4 -9mmHg. Dietary compliance as it concerns a hypertensive patient looks at strict adherence to food regulations given by experts on diets to regulate the health of the patient, to avoid complications arising from careless eating, to ensure that medications on hypertension go as prescribed by the medical expert Kearny, Whelton & Reymolds (2004). The symptoms of hypertension include headache, heaviness in the head, sluggish movements, general redness and warm to touch feel of the body, prominent distended and tense vessels, fullness of the pulse, coloured and concentrated urine, loss of appetite, weak sight, impairment of thinking, yawning, drowsiness, vascular rupture and haemorrhagic stroke, law, Wald &Morris (2003). The therapeutic approach for the treatment of hypertensive disease according to Lewington et al (2002), included changes in lifestyle and dietary programme for patients (avoiding the consumption of wine, meat and pastries, reducing the quantity of food in a meal, maintaining a low energy diet and the dietary usage of spinach and vinegar).

Project detailsContents
 
Number of Pages78 pages
Chapter one Introduction
Chapter two Literature review
Chapter three  methodology
Chapter  four  Data analysis
Chapter  five Summary,discussion & recommendations
ReferenceReference
QuestionnaireQuestionnaire
AppendixAppendix
Chapter summary1 to 5 chapters
Available documentPDF and MS-word format


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