Non-Pharmacological Management of Hypertension: Exploring Determinants for Optimizing Physical Activity Implementation in Cameroon

Abstract

Highlights: Public health relevance—How does this work relate to a public health issue? Physical inactivity remains highly prevalent among hypertensive patients in Cameroon. Key personal and environmental determinants influence adherence to WHO physical activity recommendations. Public health significance—Why is this work of significance to public health? Identifying sociodemographic and clinical predictors of inactivity helps target high-risk groups. Understanding locally reported barriers and facilitators guides more culturally adapted interventions. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Integrating structured physical-activity counselling into routine hypertension care is urgently needed. Policymakers should strengthen community-level PA support, especially for older adults, women, and patients with chronic conditions. Physical activity (PA) is a cornerstone of non-pharmacological hypertension management, yet evidence on its determinants remains limited in African populations. We conducted a cross-sectional study among 383 hypertensive patients in two referral hospitals in Cameroon to assess PA levels and associated factors. PA was classified as insufficiently active (<600 MET-min/week) or active (≥600 MET-min/week). Overall, 54% of participants were insufficiently active, 37.9% had moderate activity, and 8.1% reported vigorous activity. Older age was strongly associated with inactivity, particularly for ages 60–74 (aOR = 2.84, p < 0.001) and for ≥75 years (aOR = 18.67, p < 0.001). Comorbidities also predicted inactivity, including renal failure (aOR = 2.41, p < 0.001) and diabetes/other complaints (aOR = 4.92, p < 0.001). Female sex increased the odds of inactivity (aOR = 1.42, p = 0.038). Whereas higher education was protective, particularly secondary (aOR = 0.12, p < 0.001) and high-school level (aOR = 0.05, p < 0.001). Among inactive participants, the most frequent barriers were lack of motivation (38.6%), physical impairment (37.2%), lack of prescription (23.2%), and space constraints (21.7%), whereas perceived benefits (39.1%), motivation (26.1%), and available space (32.4%) were the most cited facilitators; however, none of these factors showed a significant association with PA in chi square analysis. The high prevalence of inactivity and the strong influence of sociodemographic and clinical characteristics underscore the need for tailored interventions that target older adults, women, and patients with comorbidities, while strengthening education and structured support for PA within hypertension care pathways.