Health-Promoting Behaviors in Hypertension and CKD

Oleksii Korzh, MD, PhD, and colleagues conducted a study designed to examine the relationships among health behaviors and quality of life (QoL) and to test a proposed model among people with hypertension and concomitant chronic kidney disease (CKD) in primary care. The researchers also sought to examine the mediation effect of modifiable risk factors between self-care health behaviors and QoL. Results were reported in Primary Health Care Research & Development [doi:10.1017/S1463423622000299].

The prospective study was conducted in primary care centers from January 2018 to January 2020. A total of 170 patients who were diagnosed with hypertension and CKD at least 12 months prior to study enrollment were included in the study. The parameters of interest were self-efficacy, self-care health behaviors (including subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation), modifiable risk score, and QoL (assessed using the 36-Item Short-Form Health Survey instrument).

Results of the analyses demonstrated a significantly positive direct effect of self-efficacy on self-care health behaviors, with a standardized regression coefficient of 0.87 (P=.007) a negative indirect effect on risk factors, with a standardized regression coefficient of 0.11 (P=.006); and a positive indirect effect on QoL, with a standardized regression coefficient of 0.62 (P=.008).

Self-care health behaviors had a significantly positive direct effect on QoL, with a standardized regression coefficient of 0.72 (P=.012); there was also an indirect effect of 0.053 (P=.004). The direct effect of risk factors on QoL was also significant (standardized regression coefficient, 0.44; P=.018). The direct effect of self-care health behaviors on QoL was 0.77 (P=.008); that was reduced to 0.72 (P=.012). The reduced effect of 0.05 was significant (P=.004), confirming the mediating role of modified risk factors.

“This study indicates health-promoting behaviors in hypertensive patients with CKD have a potential impact on their QoL in primary care,” the researchers said. “Primary care physicians should focus on motivation strategies to encourage individuals to perform self-care health-promoting behaviors associated with the improved QoL in order to achieve better outcomes in risk factor management.”