A systematic review of adherence to lifestyle modifications by hypertensive patients

Abstract

Background: Lifestyle modification is a non-pharmacological strategy that can help reduce blood pressure significantly and it is very valuable in hypertension control. Aim: To review available literature on lifestyle modification practices among hypertensive patients globally. Methods: We searched and analysed studies published between 2019 and 2024 on adherence to lifestyle modifications by hypertension patients globally. Results: Adherence to lifestyle modification varied significantly by region (I²=85.2%, P < 0.001), with a pooled mean of 27.4% (95% CI: 19.8–35.1%): alcohol abstinence 86%, sodium restriction 54.6%, dietary adherence 47.7%, low-density lipoprotein cholesterol goal achievement 40%, and physical activity 34.3%. Barriers to lifestyle modification were low-level awareness, misconceptions about hypertension, financial constraints, difficulty adjusting to new habits, laziness, forgetfulness, stress, lack of motivation, social pressure, tasteless meals, use of traditional medicine, and time constraints. Conclusion: Despite the well-established benefits of lifestyle modifications in the management of hypertension, adherence remains suboptimal globally. There is a need for targeted interventions to enhance adherence, including educational programmes, policy-driven initiatives and personalized support for patients.