A systematic review of adherence to lifestyle modifications by hypertensive patients.

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 lowlevel 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.

Copyright © Authors 2025; Licensee: World Health Organization. EMHJ is an open-access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).