AGE-RELATED DIFFERENCES IN ADHERENCE TO LIFESTYLE MODIFICATION AMONG UNCONTROLLED HYPERTENSIVE PATIENTS: EHUH 2 STUDY

Objective: Poor lifestyle adherence significantly contributes to still unsatisfied hypertension control in Croatia. This study explores age-related differences in lifestyle adherence among uncontrolled hypertensive patients. Design and method: This cross-sectional study was part of the ”Epidemiology of Hypertension in Croatia 2” (EH-UH 2) survey. Out of a total of 2021 participants randomly selected from the general adult population, this study involved 271 participants with treated uncontrolled hypertension. Subjects were divided into three age groups: A: 40-60 (N=82); B: 60-70 (N=107), and C: older than 70 years (N=78). Participants completed a survey on adherence to lifestyle changes, including weight reduction, salt intake restriction, increased physical activity, alcohol moderation, smoking cessation, and dietary modifications such as reducing dried meat consumption and increasing fish intake. Results: In the group A compared to the group C were more smokers (25.6% vs. 5.1%, p=0.003), they eat more cured meat (23.1% vs. 14.0%, p<0.0001), with higher salt intake (10.6 vs. 9.4 g/day), while no Na/K ratio difference was found (3.16 vs. 3.17). Fish consumption was lowest in group B (56.6% vs. 45% vs. 52.5%, p=0.04). Alcohol consumption and physical activity did not differ across groups. Salt reduction compliance decreased with age (93.9% vs. 63.6% vs. 22.2%, p<0.0001), while smoking cessation and weight loss adherences were significantly higher in the group C compared to the group A (41.6% vs. 20%; 83.3% vs.78.1%, respectively; p=0.01). Weight loss adherence was lowest in group B (56%, p=0.01). Group A mostly followed salt reduction and weight loss recommendations, and most rarely smoking cessation (93.9%, 78.1%, 20%, respectively). Group B adhered most to alcohol and salt reduction, and the least to smoking cessation (85.7%, 63.6%, 0%, respectively). Group C complied most with alcohol reduction and weight loss recommendations, and the least with salt reduction (100%, 83.3%, 22.2%, respectively). Conclusions: Compliance with lifestyle recommendations varied by age. Low smoking cessation adherence in younger and middle-aged adults and poor salt restriction in older groups highlight a significant challenge for public health initiatives. Physical activity should be increased in all age groups.