Association of Medical Nutrition Therapy in the Management of Hypertension among Patients at Lady Reading Hospital, Peshawar: A Cross-Sectional Study

Abstract

Background: Hypertension is a major public health problem around the globe and Medical Nutrition Therapy is one of the non-pharmacological methods used to treat hypertension. The association between Medical Nutrition Therapy and Blood Pressure Control in Hypertensive patients of Lady Reading Hospital (LRH), Peshawar was assessed.

Methods: The methods used were non-probability (convenient sampling) and a cross sectional study involving 384 hypertensive patients at LRH, Peshawar. A structured and pre tested questionnaire was used for collecting data which included socio-demographic characteristics, dietary practices and adherence to MNT and analyzed on SPSS version 27. Descriptive and inferential statistics such as chi square test of association was used and values of p<0.05 were taken as statistically significant.

Results: There were 384 participants, of whom 98 were good adherers (25.5%), 224 were moderate adherers (58.3%) and 62 were poor adherers (16.1%). Overall, 283 were able to control their blood pressure (73.7%). There was a tendency towards a greater proportion of controlled BP among participants with good MNT adherence, 77.6%, than among those with poor adherence, 64.5%, (χ² = 3.53, p = 0.171) although this composite adherence-BP association was not statistically significant. Reduced sodium (salt) intake was significantly associated with better blood pressure control (80.9% controlled vs 70.0%; p = 0.029); reduced intake of fried/processed food and regulation of meal timing were not significantly associated with outcomes (p > 0.05) while regular intake of fruit/vegetables was not significant (p = 0.352). Better control of blood pressure was significantly associated with higher BMI category (p < 0.001).

Conclusion: There was significant effect of dietary sodium restriction on the maintenance of BP control, and higher BMI on poorer control; there was a trend towards better control with composite MNT adherence, but this was not significant. The results here confirm that sodium reduction and weight management are important components of hypertension care that are achievable with Medical Nutrition Therapy and weight management, but that greater structure and adherence with nutrition counselling are needed to enhance the impact of these approaches.