Abstract
Objective: The role of lifestyle and diet changes in hypertension management is very well known. Economic constraints, additional benefits, and few or almost no side effects have made it an attractive option for hypertension control. However, it is still not widely used in primary care. This study was conducted to assess the knowledge and approach of primary care physician (PCP) towards the D.A.S.H (Dietary approaches to stop hypertension) in Tunisia. Design and method: We surveyed 132 PCPs among the 148 PCPs. We used a questionnaire on Google forms, with 16 questions assessing practices regarding the D.A.S.H, its use and source of information about it. Results: The participants had a mean duration of practice of 9.2 years (+/-3.4SD). They all receive hypertensive patients daily with an average of 6.12 (+/-2.7SD). Most of the PCPs (60.7%, n=80) recommend the lifestyle changes. However only 82.5% (n=65) of them based their recommendations on guidelines. The D.A.S.H is used by 60% (n=48), these participants knew the D.A.S.H diet through internet. Weight loss, low salt intake, daily physical activity and stop smoking were recommended by most of the PCPs. For the low salt intake, few (35%, n=28) precised that it includes sauces and cold cuts. Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut and sugar-sweetened beverages and sweets was recommended by only 12 PCPs. Most (74%) said that lifestyle changes can alone, if well conducted, help to lower the blood pressure. Ninety percent (90%) said that they are more effective with the medication, and it could help lowering the number and the doses of the drug used. All the PCPS(n=132) said that their informations about the DASH diet and others heart-healthy diets are incomplete which may lead to the failure of the lifestyle changes. Conclusions: PCPs’ knowledge and management of lifestyle in hypertensive patients is poor in Tunisia. Our data point to a need for continually updating about the non-pharmacological treatment of hypertension
Published Version
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