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S. Dassanayake1, M. Skinner2, G. Sole2, G. Wilkins3
1Centre for Health Activity Rehabilitation and Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand, 2Centre for Health Activity Rehabilitation and Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand, Dunedin, New Zealand, 3Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Background: Resistant hypertension (RHT) is a phenotype of hypertension and managing blood pressure (BP) in people with RHT by medication only is challenging. Aerobic and strengthening exercises are validated as a cost-effective therapeutic modality to reduce BP in hypertension and may also be effective in BP management in RHT. Nonpharmacological management, including a collaborative patient-centred approach to decision making, based around patient education about the condition and exercise are recommended for BP management in RHT. Thus the physiotherapist is an integral team member in developing a therapeutic exercise programme and guidance on physical activity for the individual living with RHT.
Purpose: To explore the perspectives of individuals living with RHT including awareness of their condition, understanding and use of physical activity and exercise in BP management and perceived barriers to engage with physical activity and exercise.
Methods: Thematic analysis and an inductive approach were used to identify the themes derived from the codes identified in the quotes of interviews transcribed from the audio-recordings.
Results: Ten participants diagnosed with RHT were interviewed (7 men). Their mean age and BMI were 52.7±11.7 years (range 35.0-74), 32.5±4.8 kg/m2, (range 30.5-4.0) respectively and mean BP was 143±21/ 83±13 mmHg (range 108-178/62-100).
The four themes emanated in the analysis reflected that: 1) participants’ awareness of the condition RHT was limited, and they strongly believed that the medication was the only treatment to reduce BP; 2) participants had limited knowledge about the side effects of medication but expressed a willingness to reduce medications; 3) participants believed that they should be involved in physical activity and/or exercise as these would help to reduce their BP and could prolong their life span; and 4) they perceived lack off collaborative decision making in managing their condition, limited knowledge about non-pharmacological modalities such as exercise, as well as barriers such as fear limiting their involvement with exercise.
The four themes emanated in the analysis reflected that: 1) participants’ awareness of the condition RHT was limited, and they strongly believed that the medication was the only treatment to reduce BP; 2) participants had limited knowledge about the side effects of medication but expressed a willingness to reduce medications; 3) participants believed that they should be involved in physical activity and/or exercise as these would help to reduce their BP and could prolong their life span; and 4) they perceived lack off collaborative decision making in managing their condition, limited knowledge about non-pharmacological modalities such as exercise, as well as barriers such as fear limiting their involvement with exercise.
Conclusions: The participants’ health literacy was limited in regard to RHT, associated risks, side effects of medication and effectiveness of physical activity and exercise in BP management. Decision making in the treatment process needs to be more collaborative to enhance the clinician-patient relationship and increase participants’ awareness about those aspects of RHT management they can control.
Implications: The therapeutic effects of BP reduction through physical activity should be considered in BP management in RHT. Thus, referrals to physiotherapists to implement exercise programmes for individuals with RHT would be beneficial. This research supports the role of the physiotherapist in contributing to management of BP, including BP resistance to medication in those with RHT. Further, BP management should be an integral part of physiotherapy education both at pre-entry level and in practice.
Funding acknowledgements: None
Keywords:
Resistant hypertension
Physical activity and Exercise
Health literacy
Resistant hypertension
Physical activity and Exercise
Health literacy
Topics:
Cardiorespiratory
Health promotion & wellbeing/healthy ageing/physical activity
Non-communicable diseases (NCDs) & risk factors
Cardiorespiratory
Health promotion & wellbeing/healthy ageing/physical activity
Non-communicable diseases (NCDs) & risk factors
Did this work require ethics approval? Yes
Institution: University of Otago
Committee: University of Otago Human Ethics Committee
Ethics number: H19-164
All authors, affiliations and abstracts have been published as submitted.
