الفهرس 
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Abstract
Hypertension )HTN) is a progressive cardiovascular syndrome arising from complex interrelated etiologies that extends beyond high blood pressure of ≥ 140 ⁄ 90 mm Hg consistently in general population and often includes obesity. Management of hypertension requires pharmacological (drugs) and non-pharmacological (lifestyle) management. If lifestyle modification is insufficient to achieve the desired blood pressure (BP), there are several drug options for the treatment and management of hypertension.
This study explored factors affecting treatment adherence among hypertensive patients in Ain Shams university hospitals in Egypt, based on of the Health Belief Model in the evaluation of adherence behavior.
Aim of the study:
Identify the factors affecting adherence of hypertensive patients to antihypertensive medications and lifestyle modification through the following:
-Assessment of level of adherence of hypertensive patients to antihypertensive medications and lifestyle modification.
-Assessment of factors affecting adherence of hypertensive patients to antihypertensive medications and lifestyle modification.
Research questions:
Q1. What are the factors affecting adherence of hypertensive patients to antihypertensive medications and lifestyle modification?
Research Design:
A descriptive design was used to achieve the aim of the current study.
Subjects and methods:
Setting:
The study was conducted at the outpatient clinics (cardiac and medicine clinics) at Ain shams university Hospitals affiliated to Ain Shams University.
Sample:
A purposive sample of 100 adult conscious patients with hypertension at age of ≥18 years who are diagnosed as hypertensive for at least 6 months and more will be recruited in the current study.
Tools of data collection:
Data pertinent to study variables will be collected using the following tools:
1) Patient’s demographic and medical status characteristics structured interview questionnaire: To assess subject’s socio-demographical characteristics as age, gender, marital status…etc. and medical health status data such as weight, height, BMI ….etc.
2) Medications adherence questionnaire: To assess patient’s adherence to medications (6 questions).
3) Lifestyle adherence questionnaire: To assess patient’s adherence to lifestyle modification eg. Adherence to healthy diet, exercise, smoking cessation, weight maintenance ….etc (14 questions).
4) Factors affecting patient’s adherence questionnaire: To assess factors affecting patient’s adherence eg. Perception of severity, perception of risk, perception of benefits, perception of barriers, internal factors, and health care provider factors ...etc (76 question).
Results:
The results of this study have shown the following:
• The subjects had low adherence to medications (20%) while they had high adherence to lifestyle modification (70%).
• Regarding to sublets’ demographic characteristics the age of the studied hypertensive subject’s; the mean age and standard deviation (SD) was 50.94 ± 11.33 years, 52% females, 66% in urban areas, 55% married, 45% technical worker or employee, 37% & 30% had secondary and university education, respectively.
• 31% of subjects were having adequate monthly income.
• About 36% of subjects had hypertension family members in the same house.
• Regarding to the study subjects’ perception of factors affecting adherence, the highly total perceived variables was perception of benefits (80%) and the lowest total perception was toward perception of stimulating factors (32%).
• Regarding the correlation between treatment adherence by the study subjects’ and factors affecting adherence. It is clear from this table that, there were positive correlations between certain factors affecting adherence (variables of modified health belief model) such as (perception of severity, perception of risk and perception of benefits) and medications adherence, but there was negative correlations between perception of barriers and medications adherence. Also there is a positive correlation between perception of benefits and lifestyle modification adherence, but there was a negative correlation between perception of barriers and lifestyle modification adherence.