Self-care practice among adult hypertensive patients at ambulatory clinic of tertiary teaching Hospital in Ethiopia: a cross-sectional study


Hypertension (HTN) is a growing problem affecting approximately one billion people worldwide, two-thirds of them in low-income countries [1]. Alarmingly, 1.56 billion adults are estimated to have HTN in 2025 [1, 2]. HTN is a leading risk factor for cardiovascular disease (CVD) for stroke, myocardial infarction, congestive heart failure, decline, and death [1, 3, 4]. HTN is a major risk factor for CVD, causing 45% of cardiovascular morbidity and mortality worldwide [2]. In most cases, this condition remains asymptomatic until followed by a stroke, myocardial infarction, kidney failure, or vision problems [1, 5, 6].

In Ethiopia, hypertension is the most common non-communicable disease (NCD) with a prevalence rate of 19.6% [7, 8]. Uncontrolled high blood pressure can lead to heart attack and eventually heart failure and stroke, kidney failure, blindness, blood vessel rupture, and cognitive impairment [9]. HTN complications are estimated to cause about 9.4 million deaths each year, representing 17% of all deaths worldwide [10, 11]. The main cause of poor control of HTN is the inability to comply with HTN’s self-care practice [12, 13]. Self-care practices have been an important and cost-effective tool in the management and prevention of hypertension and its complications. Self-care of hypertension includes adherence to medication, intake of a low-fat diet, daily exercise, restriction of alcohol intake, smoking cessation, weight loss, self-monitoring of blood pressure (BP), regular health checkups, and reducing stress [14, 15].

Lifestyle changes, formerly known as non-drug therapies, play an important role in people with and without hypertension. It may serve as an early intervention before initiating medication in people with high blood pressure and maybe an adjunct to medication for those already on medication [16, 17]. Lifestyle changes can lower systolic blood pressure by about 4–11 mmHg. It is also estimated that for every 1 kg weight loss, blood pressure decreases by 1 mmHg [9, 17].

Although high blood pressure can be modified and treated, there is little knowledge about the treatment of hypertension in developing countries. In developing countries, more than three fourth of the burden of hypertension is attributable to a lack of knowledge and inadequate practice of self-care measures [10, 18, 19]. In previous studies conducted in Ethiopia, the prevalence of inadequate self-care practices reaches 77% [20, 21], which is very high as compared to the World Health Organization (WHO) recommendation.

Several factors have been associated with adherence to self-care activities, including socio-economic status, age, gender, educational status, place of residence, co-morbidity, access to health care, level of health literacy, length of therapy, culture, social support, self-efficacy, source of information on self-care and knowledge of disease and treatment [22–26].

Adhering to self-management practices in hypertension is essential for patient management to achieve desired treatment goals by improving quality of life, preventing complications, and reducing health care costs, but self-care practices remain low in developing countries [26–28]. Measuring the level of self-care activity for hypertension, along with determinants, is important for establishing a successful strategy for the treatment of hypertension. The literature recommends different self-care practice evaluation methods. One of the validated assessment scales routinely used is Hypertension Self-Care Activity Level Effects (H-SCALE) [29]. It addresses most of the self-care behaviors of the patients which are expected to affect glycemic control. There are studies in Ethiopia on HTN self-care practices. However, the level of hypertension self-care practices and contributing factors have not been well studied in the southwestern part of Ethiopia. Therefore, the study aimed to evaluate the self-care practices of adult hypertensive patients in an outpatient clinic of a tertiary teaching Hospital in Ethiopia.

— Update: 20-03-2023 — found an additional article Self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City administration, Eastern Ethiopia: A multi-center cross-sectional study from the website for the keyword self-care activities for hypertension.


According to a global report on high blood pressure, about 1.39 billion people had hypertension in 2010 (1). The trend of hypertension is shifting from developed countries to developing countries, where there is little knowledge of hypertension and its management (1, 2); an estimated 349 million in developed countries and 1.04 billion in developing countries suffer from hypertension (1).

In sub-Saharan Africa (SSA), high blood pressure projections will be between 125.5 and 162.8 million by 2025 (3, 4). Even though no countrywide study was conducted in Ethiopia, the results of a systematic review and meta-analysis revealed that hypertension was prevalent in 21.81 percent of the population (5). Despite the availability of hypertension treatment options, the majority of hypertensive patients are living with uncontrolled hypertension (6).

Hypertension is a risk factor for health failure, stroke, and Kidney diseases (7). Uncontrolled hypertension causes 10.4 million deaths per year globally (8). Increasing systolic blood pressure (SBP) by 20 mmHg and diastolic blood pressure (DBP) by 10 mmHg above normal ranges the risk of cardiovascular diseases, strokes, and kidney diseases are doubled (9, 10). The report of the World Health Organization (WHO) showed that uncontrolled hypertension cause 9.4 million complications and 17 million deaths due to cardiovascular diseases (CVD) globally (11).

Self-care activities are recommended by the World Health Organization (WHO) to improve the efficacy of antihypertensive drugs (12). Compliance with self-care practices helps hypertensive patients to control their blood pressure; prevent and reduce complications; and subsequent morbidities, disabilities, and death (13).

Hypertension self-care practices are a dynamic and active process that necessitates knowledge, attitude, discipline, determination, commitment, self-regulation, empowerment, and self-efficacy to manage diseases and achieve healthy living (14). It contains taking medications, consumption of a low-salt diet, moderating alcohol drinking, physical exercises, weight management, not smoking, blood pressure monitoring, and reducing stress (15, 16). Previous showed that sex, age, occupational status, time since diagnosis, comorbidities, knowledge about the disease, self-efficacy, social support, smoking, and khat chewing are associated with components of self-care practice of hypertension (17–20).

Though there have been few documented studies on self-care practices among hypertensive patients in Ethiopia, the roles of depression and anxiety were not studied. Moreover, to the knowledge of the researchers, there is paucity of evidence about self-care practices and associated factors in the study area. Therefore, this study assessed the level of self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City Administration, Eastern Ethiopia.

Materials and Methods

Study design and area

A hospital-based cross-sectional study was conducted in the Harari region state and Dire Dawa City Administration, Eastern Ethiopia from June 15 to July 15, 2021. Harari regional state is one of the eleven states in Ethiopia. Harar is the capital city of the Harari region found 526 km distance from the southeast of Addis Ababa. There are two public Hospitals found in Harar regional state; Hiwot Fana Compressive Specialized University Hospital (HCFSUH) and Jugal hospitals (JH). Based on the 2007 Central Statistical Agency population census, the total population of the town was projected to be 259,260, of those 130,097 are females in 2021.

Dire Dawa City Administration is one of the two federal city Administrations in Ethiopia. It is found in the Eastern part of Ethiopia at a distance of 515 km away from Addis Ababa. There are two public Hospitals found in Dire Dawa City Administration; Dilchora Referal Hospital (DRH) and Sabian Hospital (SGH). According to the 2007 Central Statistical Agency population census, the total population of the Dire Dawa has an estimated population of 599,651, of whom 301,496 are females in 2021.

Study participants and eligibility criteria

All hypertensive patients on follow-up at the selected public hospitals during the study period and fulfilled the inclusion criteria were the study population. Patients aged ≥18 years and taking antihypertensive drugs for ≥6 months were included in the study. Patients who had cognitive impairment and who were severely ill were excluded from the study since they cannot provide valid information.

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Sampling and sampling procedures

Sample size was calculated by using single population proportion formula with the assumptions of: Zα/2 = 1.96, 95% confidence level, 5% margin of error, the prevalence of good self-care practices ( = 0.49) (18), with 10% for non-response rate, and yields a total sample size of 422. For the previous 3 months, clients' flow to each hospital for hypertension follow-up was reviewed from the registration book to estimate the expected number of patients that will come for the follow-up in 1 month (study period). Based on this the expected number of hypertensive patients who will come for the next month was 978. Then calculated sample size (422) was allocated to each hospital based on their respective expected number of patients who come in 1 month period. Finally, study participants were selected by using systematic random sampling of every -value (2). K = N/n, 978/422 with k = 2.3 ≈ 2. The first patient were selected by the lottery method.

Data collection tool and procedures

A pretested and validated interviewer-administered questionnaire was used for data collection. The questionnaire contains five parts: part I: socioeconomic characteristics; part II hypertension Knowledge-Level Scale (HK-LS) (21). The internal consistency was checked by using Cronbach's alpha and it was 0.81. Part III: Hypertension Self-Care Activity Level Effects (H-SCALE) (22). In this study, internal consistency was checked by Cronbach's alpha which was (α = 0.85). The Cronbach's alpha of sub-domains; medication adherence, low salt, physical activity adherence, weight management, and alcohol use were 0.94, 0.74, 0.81, 0.93, and 0.92, respectively. Part IV clinical-related characteristics, and part V psychosocial related factors like anxiety, depression, and social support. The internal consistency of the Generalized Anxiety Disorder 7-item (GAD-7) scale was 0.90 (23); whereas the internal consistency of the Patient Health Questionnaire-9 (PHQ-9) was 0.95 (24), and social support was assessed by Oslo Social Support Scale (OSSS-3), and its internal consistency was 0.86 (25). Data were collected by eight trained BSc nurses and supervised by four MSc nurses.

Study variables and measurements

Dependent variable: Hypertension self-care practice. Independent variables: Socio-demographic variables: sex, age marital status, religion, educational level, place of residence, and monthly income. Hypertension knowledge. Clinically related variables: body mass index, duration of diagnosis, frequency of follow-up, follow-up miss, comorbidity. Psychosocial related factors: anxiety, depression, and social support.

Hypertension Knowledge was measured by HK-LS which contains 22 item questions. Nine of these items on the questionnaire were negatively phrased. Before the analysis, these were reversely scored. The total sum of the scores of the knowledge items gives a score ranging from 0 to 22. The mean was calculated. Respondents who scored equal to mean and above were considered as having “good knowledge about hypertension” unless poor knowledge.

Anxiety was assessed by the Generalized Anxiety Disorder 7-item (GAD-7) scale. Seven Likert-type scales were from 0 (not at all) to 3 (nearly every day); which gives a score ranging from 0 to 21. In the current study, patients with a score of ≥ 10 had anxiety (27).

Depression was screened using the patient health questionnaire-9 (PHQ-9). The nine Likert-type scales are scored from 0 (not at all) to 3 (nearly every day); with a score ranging from 0 to 27. In the current study, patients with a score of ≥ 10 had depression (23).

The level of social support was measured using Oslo social support scale (OSSS-3) which contains three items. The first item is rated on a four-point Likert scale ranging from 1 to 4. The second and the third items are rated on a five-point Likert scale ranging from 1 to 5. The sum score ranges from 3 to 14. The ranges from 12 to 14 to OSSS-3 was strong social support, 9–11 was considered moderate social support, and 3–8 was poor social support (28).

Data quality control

The questionnaire was initially prepared in English and then translated into the local languages Language experts then translated it back into English to ensure consistency. The data collectors and field supervisors were received training on the data collection tool and procedures. Before the actual study, the pretest was conducted among 5% (twenty-one) of the total sample at Haramaya General Hospital. During pretesting, the questionnaire was checked for its clarity, simplicity, understandability, consistency, and coherency. During the data collection period, close supervision was done by the supervisor.

Data processing and analysis

The data were entered into Epi data version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 20 for statistical analysis. Descriptive analyses were presented using frequency, percent, mean, and standard deviation. Bivariable and multivariable binary logistic regression analyses were used to see the association between independent variables and the outcome. Predictors' variables with a < 0.25 in bivariable were included in the multivariable model. The association between outcome variables and predictors was presented by the adjusted odds ratio (AORs) with a 95% confidence interval. The Hosmer-Lemeshow statistics indicate a good fit at a < 0.05 or greater.

Ethical consideration

Ethical clearance was obtained from the Institutional Health Research Ethics Review Committee (IHRERC) of Haramaya University College of Health and Medical Sciences. A formal letter of permission and support was provided to all the four public hospitals in which the study was conducted. Informed, voluntary, written, and signed consent was obtained from the heads of the respective hospitals. Participants were informed about the aim of the study and the advantage of the study; confidentiality, there was no risk of being participants, and they have full right to halt in the middle of the interview. Oral and written informed consent was taken from each participant before data collection began. Confidentiality was maintained at all levels of the study through anonymous data collection. During data collection, the COVID-19 prevention protocol was kept.


Sociodemographic characteristics

A total of 422 participants were involved in this study, with a response rate of 100%. The age of the participants ranged from 24 to 79 years with a mean age of 45 (SD = ±12). About 220 (53%) were males and 264 (62.6%) of the patients were married and 67.3% of them were urban residents. One hundred seventy-four (41.2%) were Muslim religion followers and almost half, 200 (47.4%) of the respondents attended college and above. Regarding Khat chewing among the study participants 148 (35.1%) of them chewed khat in the last 30 days. Level of social support 167 (39.6%) of the participants had strong social support, 117 (27.7%) participants had moderate social support and 138 (32.7%) of them had poor social support (Table 1).

Clinical related characteristics

The majority of participants, 255 (60.4%), had normal body mass index followed by an overweight 80 (19%). Regarding the duration of diagnosis with HTN, almost half of 215 (51.8%) of the patients, were diagnosed <5 years ago. Almost half, 216 (52%), had a 3-month follow-up appointment, and about 208 (52%), had a history of missed follow-ups. About 182 (43.1%), of the patients, had other comorbidity/s, and the majority, 111 (60%) had diabetes mellitus. Among the respondents, 94 (22.27%) had anxiety and 85 (20.14%) had depression (Table 2).

Hypertension self-care practices

About two hundred twenty 52% (95% CI, 48.2–58%) of the patients had good hypertension self-care practices (SCPs). The mean score of the patient's knowledge about hypertension was 13.02 + 3.72 with ranges of 2 to 21. The majority, 253 (60%) had good knowledge about hypertension while the rest had poor knowledge about hypertension 50, 40.8, 29.6, 85.3, 73, 50.2% were adherent to antihypertensive medication, low-salt diet, physical activity, smoking abstains, alcohol abstainer, and weight management (Figure 1).

Bivariable and multivariable analysis

In bivariable analysis, sex, age, educational level, place of residence, number of antihypertensives, Knowledge about hypertension and treatment, chewing khat, social support, and depression were significantly associated with a good self-care practice at a < 0.25. In the multivariable logistic regression, educational level, knowledge about hypertension and treatment, chewing khat, social support, and depression were independent predictors of self-care practices at a < 0.05 (Table 3).

Accordingly, participants who received formal education were 2.45 times more likely to practice good self-care than those who did not receive a formal education (AOR = 2.45, 95% CI: 1.18–4.85). The odds of having good self-care among participants with good hypertension knowledge were 3.5 times higher than those with poor knowledge (AOR = 3.5, 95% CI: 2.17–5.12). Patients who did not chew khat were twice as likely as their counterparts to practice good hypertension self-care (AOR = 2.01, 95% CI: 1.44–3.94). Those who received strong social support were 1.9 times more likely to practice good hypertension self-care than those who received poor social support (AOR = 1.92, 95% CI: 1.16–3.11). Patients without depression were 1.63 more likely as compared to patients with depression to have good self-care practices (AOR = 1.63 95% CI: 1.23–3.92).

Read more  9 Self-care Tips to Lower Your Blood Pressure


This study was assessed self-care practices and associated factors among hypertensive patients in public hospitals, in Eastern Ethiopia. This study revealed that 52% (95% CI, 48.2–58%) of hypertensive patients had good SCPs. According to this study, ~1 out of every two hypertensive patients have good self-care practices. Those who have a formal education, a good knowledge about hypertension, those did not chew khat, having strong social support, and those did not have depression were significantly associated with self-care practices.

According to findings from this study, 52% (95% CI, 48.2–58%) of hypertensive patients had good SCPs. A similar finding was reported in studies conducted in South India (52.4%) (29), Debre Tabor, Ethiopia (54.1%) (17), Dessie town (49%) (18), and Addis Ababa (51%) (30). The finding was higher than the studies conducted in West Bengal (37.1%) (31), Harar (29.9%) (32), Debre Berhan 24% (17), Mekele (20.3%) (33), and Addis Ababa (39.5%) (34). This could be explained by sample size differences, socio-cultural variations, and levels of knowledge about hypertension and management. On contrary, this finding was relatively lower than studies conducted in Nekemte (68.92%) (35), Gondar (59.4%) (36), Harar (62.1%) (19), and Saudi Arabia (74.4%) (20). This disparity could be attributed to assessment tools as well as socioeconomic status. For instance, a study in Harar adapted from WHO STEP surveillance, but in this study, we used H-SCALE to assess self-care practices.

Our study showed that having formal education was 3.45 more likely to have hypertension self-care practices than their counterparts. This is in line with studies done in Dessie town (18), Harar (32), Malaysia (37), and India (31). The possible explanation might be educated people can understand by reading things that are useful for hypertension self-care and they shall understand recommended lifestyle modifications to prevent hypertension and its complication (18, 32). This implies the need to design an educational intervention convenient for those who hadn't formal education.

Good knowledge about hypertension and treatment was 1.5 times more associated with good self-care practices. This finding consistent with is similar to studies done in Debre Tabor (17), Harar (32), Mekele (33), Addis Ababa (38), and Saudi Arabia (20). The possible justification is because knowledgeable patients know about the disease, treatment, complications, and how it can be controlled and managed. Additionally, patients having good knowledge about hypertension and its treatment give more emphasis to self-care practices.

Our study showed that patients who did not chew khat were two times more likely to have good hypertension SCPs than khat chewers. This finding was consistent with studies done in Harar, Ethiopia (19, 32). It might be due to individuals who chew the khat being more likely to engage in alcohol drinking & smoking as reported in other studies (19, 32). Another possible justification is due to the effect of khat on psychoactive which results in forgetting recommended self-care practices (39).

The odds of having good self-care practices (SCPs) were 1.9 higher than those with strong social support as compared to those who had poor social support. This is in line with studies conducted in Harar (32), Dessie town (18), Debre Tabor (17), and China (40). This might be due to the existence of the family or relative support increasing adherence to components of self-care practices. The WHO self-care practices guideline supports the presence of good social support for coping with chronic diseases like hypertension (41). Prospective studies are also needed to determine the effects of social support on hypertension self-care practice.

The hypertensive without depression were two more likely to have hypertension self-care practices (SCPs) than those who had depression. This finding is similar in line with the study reported in Korea (42). The possible justification might be a cognitive effect of depression which causes difficulty in concentrating and forgetfulness of recommended SCPs. This implies that those patients who have depression need special consideration.

Limitations of the study

Since this study is a multicenter study it is a better representation of the study participants and generalizability of the result. Also in our study, we try to assess independent factors of depression and anxiety effects of hypertension self-care. This study has also some limitations, since data was collected by a self-report the patients may not memorize which leads to recall bias and may affect the results of this study.


This study reported that more than half of the respondents have good hypertension self-care practices. Formal education, good knowledge about hypertension, abstaining from khat chewing, good social support, and no depression was positively associated with self-care practices. The policymakers should consider these factors in specific public health interventions on hypertension self-care practices, as well as in strengthening the current non-communicable diseases control programs. To make this happen, public health facilities should strengthen efforts to provide targeted education to patients and family members on all components of self-care practice. In addition, patients with depression need special consideration in hypertension self-care management.

Data availability statement

Data can be made available on request to the corresponding authors.

Ethics statement

The studies that included human participants were reviewed and approved by Haramaya University, Institutional Health, and Research Ethics Review Committee of the College of Health and Medical Sciences. The participants were given their written informed consent to participate in this study. Informed, voluntary, written, and signed consent was obtained from each study participant after explanations about the aims, objectives, benefits, and harms of the study were provided. The person's information was entirely confidential. During data collection, the COVID-19 prevention protocol was kept.

Author contributions

All authors made essential contributions in designing, analyzing, interpreting, writing manuscripts, read and approve the final draft of the manuscript, and agreed on the final manuscript for publication.


Haramaya University has funded the data collection of this study. The funders had no role in the design of the study, analysis, interpretation, and publishing of the manuscript.


We would like to acknowledge the (HU) Haramaya University for financially supporting to data collection for this study. We express our thanks to data collectors and study participants for their time, volunteers, and effort.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


AOR, Adjusted Odd Ratio; BP, Blood Pressure; CI, Confidence Interval; COR, Crude Odd Ration; CVD, Cardiovascular Diseases; GAD-7, Generalized Anxiety Disorder 7-item; H-SCALE, Hypertension self-care Activity Level Effects; HK-LS, Hypertension Knowledge-Level Scale; LMICs, Low and Middle-Income Countries; NCD, Non-communicable Diseases; OSSS-3, Oslo social support scale; PHQ-9, Patient Health Questionnaire-9 items; SCPs, Self-care Practices; SSA, Sub-Saharan Africa; WHO, World Health Organization.


— Update: 20-03-2023 — found an additional article 9 Self-care Tips to Lower Your Blood Pressure from the website for the keyword self-care activities for hypertension.

As a nurse, I frequently hear, “I don’t want to take medication to lower my blood pressure.” And I get it!

The side effects of medications can be uncomfortable (especially the impact on libido). Plus, taking medication is inconvenient.

And expensive.

But, I can’t safely suggest that you stop taking your medication — you’re at a double risk of developing heart disease or having a cardiac event than someone with normal blood pressure.

However, I can offer tips to help you change your self-care to lower your blood pressure. Doing so can give you a chance of not needing your blood pressure medication or a lower dose, reducing the side effects you experience.

Yes, I know, changing your self-care requires learning new information. And it can be overwhelming to see how vital eating differently is to lower your blood pressure.

But don’t worry, I’ve got you covered!

This article provides 9 suggestions to help you lower your blood pressure naturally with your self-care.

Self-care can include everything from what eating approach you follow (your diet), how much activity you perform, what supplements you take, and what herbal or natural remedies you take or do to lower your blood pressure.

Consider trying these 9 self-care tips to lower your blood pressure:

1 Follow Your Healthcare Provider’s Recommendations & Monitor Your Blood Pressure

First things first. Follow your healthcare provider’s recommendations and take prescribed medications as directed. (Be sure to talk to your healthcare provider about reducing medications if you desire to reduce the dose or stop using medicine to lower your blood pressure. DO NOT STOP TAKING THEM until your health provider tells you it is safe and appropriate.) If you have hypertension (high blood pressure), your risk of cardiovascular complications is double compared to people with normal blood pressure.



You MUST monitor your blood pressure at home – especially if you want to prevent the necessity of taking or reducing the medications you are currently taking.

If you need a product recommendation:

I like this Blood Pressure Monitor. It’s accurate, reliable, highly rated, and stores historical measurements for two people.

Self-care activities for hypertensionSelf-care activities for hypertension

But, if it’s out of stock, I also like this Blood Pressure Monitor for reliability and accuracy.

Self-care activities for hypertensionSelf-care activities for hypertension

Often, the activity required of going to the doctor’s office or just being at the clinic can increase your blood pressure.

Just a quick note, you should not compare your blood pressure readings from one monitor to another. Each monitor will vary from another.

You need to look at the trend over time on one monitor. That’s why having your own blood pressure monitor is vital – especially if you want to reduce medications.

Self-care activities for hypertension
You MUST monitor your blood pressure.

As the information on the Internet has grown, more unproven – and some even harmful – advice is available. Be sure to tell your healthcare provider about the natural methods you use (or want to use) to reduce your blood pressure. Doing so will ensure that what you are doing is safe and effective.

And, if you work with an herbalist, tell them about your high blood pressure and what medications you are taking. Some herbs and natural supplements may interfere with medications.

Self-care activities for hypertension

Things to Do More:

2 Follow the Dash Diet

Diligently make healthy food choices.

Every. Single. Day.

If changing your diet is a struggle for you, you might consider the value of investing in your future health.

Programs like Noom and Weight-watchers can help you change your eating habits to reduce your blood pressure.

Vegetable-forward Cookbooks and Cooking Magazines Can Be a Great Help!

I use the following products regularly and love them!

First, Joy’s Simple Food Remedies is one of my favorite Cookbooks.

Self-care activities for hypertension

Eating Well is a monthly cooking magazine I read cover to cover.

Self-care activities for hypertensionSelf-care activities for hypertension

The College of Cardiology (COC) recommends the Dietary Approaches to Stop Hypertension or the more commonly called Dash Diet.

The DASH Diet is a flexible lifelong approach to healthy eating. Most people can adapt to this lifestyle change, even if they hate eating vegetables.

I like this beginner Dash Diet Cookbook because it has great recipes and tips to help stock your pantry and spice cabinet so you can add flavor (and not salt!). But there are many options if you think this is too basic.

Self-care activities for hypertensionSelf-care activities for hypertension

The emphasis of the DASH Diet is to:

  • Eat a proper portion size
  • Reduce the sodium in your diet
  • Eat a variety of foods rich in nutrients that help lower blood pressure

For example, foods with potassium, calcium, and magnesium. (Don’t forget to get your free list to help you.)

The Salt & Sodium Connection

The American Heart Association recommends no more than 2,300 milligrams (mg) daily for most adults.

For people with high blood pressure, an ideal limit is no more than 1,500 mg per day. Even cutting back 1,000 mg/day has been shown to improve blood pressure and heart health.

Self-care activities for hypertension
9 Self-care Tips to Lower Your Blood Pressure

If you’re working to lower your blood pressure (or lose weight), you need to understand how much sodium is in salt so you can make changes to control your intake. Sodium chloride or table salt is approximately 40% sodium.

  • 1/4 teaspoon salt = 575 mg sodium
  • 1/2 teaspoon salt = 1,150 mg sodium
  • 3/4 teaspoon salt = 1,725 mg sodium
  • 1 teaspoon salt = 2,300 mg sodium

On a food label, the values reported are ‘per serving.’ If you eat an entire can of soup containing two servings, you have double the sodium intake listed.

Watch out for the ‘Salty 6’ – the top six common foods that add the most salt to your diet. Read food labels so you can use products or brands that contain the lowest sodium for these items:

  • Bread and Rolls
  • Pizza
  • Soup
  • Cold cuts and cured meats
  • Poultry
  • Sandwiches

3 Be Active

Be active.

Regular exercise is necessary.

Walking counts as exercise, and it works!

Just focus on activities you enjoy. Hate to exercise? Try this!

Things to Do Less:

4 Stop smoking

According to the Mayo Clinic, smoking cessation is a self-care activity that quickly reduces your blood pressure.

Your blood pressure and heart rate recover from the cigarette-induced spike within 20 minutes of quitting.

Therefore, if you don’t smoke, never start!

Many workplaces, insurance companies, and state or local governments have smoking cessation programs (and coverage). Don’t let cost detour you – research coverage options or scholarships for smoking cessation programs.

The programs with the most successful outcomes offer some kind of accountability coaching, or ongoing support and encouragement.

5 Reduce your stress

Stress management will look different to all of us, but the point is that reducing your stress level can help lower your blood pressure level.

Ongoing stress is harmful to your health.

It can lead to life-threatening diseases. This doesn’t exactly mean getting a massage every other day.

It means taking a critical look at your stressors and looking for possibilities to manage the impact, lessen, or even eliminate them as needed. Make choices that eliminate stressors in your life and deal with ongoing stress to avoid burnout.

Some Basics…

6 Limit Your Alcohol Intake

Limit your alcohol intake to avoid extra calories.

7 Cut Back on Caffeine

Monitor the amount of caffeine you drink and eat. Caffeine is in food too.

8 Lose a Little Weight

Lose extra pounds and watch your waistline regularly.

Losing just 10% of your current weight can positively impact your blood pressure!

Most Importantly – Take One Step at a Time!

All of these self-care tips to lower your blood pressure are important to do on an ongoing basis.

While it may seem overwhelming, it’s important to realize that none of these self-care tips are impossible, especially if you are determined to take better care of yourself or reduce the medications you have to take to manage your blood pressure.

The most important thing to do is to START. Start small–just pick one thing to do at a time.

But, even changing one part of your self-care can be overwhelming or create anxiety. That’s okay.

We all can feel overwhelmed making a lifestyle change, so I’ve got one last self-care tip.

9 Start Meditating

Meditation has been shown in research to reduce anxiety and stress.

If you are a person of faith, engaging in prayer is a form of meditation. And worship and regular church attendance have also been found to reduce anxiety and manage stress.

If your faith is important to you, I want to encourage you to utilize the truth of God shared in the Bible. You can use scripture to help you find the courage to start taking better care of yourself and the motivation to continue good self-care.

Likely, you are not just trying to take better care of yourself. You may take care of others too. Whether you care for your children, support your spouse, care for aging parents, serve in a ministry, or maybe even all of the above, it takes motivation to make self-care a priority when caring for others.

So consider taking care of yourself to worship and honor the Lord. Find more information here.

Finally, in closing, take the time to identify your personal needs so you can give yourself the proper care needed to lower your blood pressure.

Follow your health provider’s medical advice and implement these 9 self-care tips to lower your blood pressure.

Self-care with the specific intent to reduce your blood pressure may help you decrease your dose or possibly even the need for your medication (with your healthcare provider’s direction).

And, you never know, you might find you feel better and enjoy taking better care of yourself!

Here are two free downloads:

  1. A Blood Pressure Register Form
  2. 4 Quick Tips to Lower Blood Pressure

Thanks for reading! Know someone who would benefit from reading this post? Share it on social media!

Self-care activities for hypertension
Self-care activities for hypertension
Self-care activities for hypertension

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About the Author: Tung Chi