Korean J Fam Med 2017; 38(4): 173-180  https://doi.org/10.4082/kjfm.2017.38.4.173
The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients
Myung Hwa Yang1, Seo Young Kang1, Jung Ah Lee1, Young Sik Kim1,*, Eun Ju Sung2, Ka-Young Lee3, Jun-Su Kim3, Han Jin Oh4, Hee Chul Kang5, Sang Yeoup Lee6
1Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Family Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
4Department of Family Medicine, Vievisnamuh Hospital, Seoul, Korea
5Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
6Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
Young Sik Kim Tel: +82-2-3010-3811, Fax: +82-2-3010-0578, E-mail: youngkim@amc.seoul.kr
Received: March 10, 2016; Revised: August 2, 2016; Accepted: August 16, 2016; Published online: July 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

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Abstract
Background: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.
Methods: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients’ lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mmHg diastolic.
Results: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.
Conclusion: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
Keywords: Hypertension; Lifestyle Change; Physical Activity; Salt Intake


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