Coping with hypertensive treatment at Bono Regional Hospital in Sunyani, Ghana: a prospective observational cohort study.

Introduction: the stress associated with hypertension treatment makes using coping strategies inevitable. However, most patients with hypertension apply inefficient coping strategies, leading to uncontrolled blood pressure (BP). The study analyzed coping strategies associated with hypertension treatment and determined how these coping strategies predicted the current BP of patients with hypertension. Methods: the study was a prospective observational cohort conducted between January and December, 2020. Consecutive sampling technique was used to enumerate 508 patients who consistently sought treatment at the healthcare facilities. A sphygmomanometer was used to measure BP to determine controlled and uncontrolled BP based on Ghana Health Service standards. A questionnaire was adapted from Coping Inventory for Stressful Situations-2 to measure patients' coping strategies. Descriptive statistics, cut off percentage and multiple linear regression were applied in analyzing the data at a 0.05 level of significance. Results: females were two-thirds (74%) of the study population and the mean age was 58.40 ± 11.72. All patients with hypertension used the three coping strategies: emotion-oriented coping (EOC), task-oriented coping (TOC) and avoidance coping (AC). However, EOC was highly used (61.2%), followed by TOC (58.5%) and AC (46.2%). Also, the study found coping with treatment regimens to be relatively poor since it was only physical exercise (79.5%) that they effectively observed. The multiple linear regression results revealed that the three coping strategies were significant predictors of current BP levels [F (3, 117) = 12.390 at p < 0.001]. Thus, AC, TOC, and EOC explained 37.4% of the variability of current BP status (R2 adj=0.374). Specifically, patients who use TOC (66.3%) were more likely to have a controlled BP than those using EOC (53.7%) and AC (35.8%). Conclusion: patients' coping strategies were inadequate for hypertension treatment since treatment regimens were poorly observed. Meanwhile, EOC is most likely to negatively affect a patient's treatment, leading to uncontrolled BP. Our study recommends the need to encourage patients to combine their EOC with TOC to enable them control their BP better.

Heavy metal content and health risk assessment of commonly patronized herbal medicinal preparations from the Kumasi metropolis of Ghana.

PURPOSE: To address the question of whether users of herbal products (HPs) are exposed to harmful contaminants, we evaluated six HPs mostly patronized in Kumasi for heavy metal contamination and assessed the health risk associated with their use. This study is one of the first safety evaluation studies on finished multiherbal products in the region. METHOD: Three antimalarial, two antidiabetic and one antihypertensive HPs were selected after a mini-survey and coded randomly as HP A-F. The HPs were acid digested for quantitative analysis of heavy metals using Inductively Coupled Plasma Mass Spectrometer. Hg quantification was carried out using cold vapour atomic absorption spectroscopy. RESULTS: The cancer risk estimation values for the carcinogenic metals ranged between 1.54 × 10-9 to 3.73 × 10-4 and were all within acceptable limits. The non-cancer health risk evaluation revealed that, some of the products pose health risk to consumers. The estimated daily intake (EDI) for As in HPF was 2.48 × 10-4 mg/kg/day compared to the reference limit of 1.67 × 10-4 mg/kg/day. HPF also had high hazard index (HI) of 5.70 (HI >1) in children as compared to 1.68 (HI >1) in adults showing a 3.4 folds increase in the health risk among the former. CONCLUSION: The six polyherbal products exhibited carcinogenic risk within acceptable limits. Although, the non-carcinogenic risk assessment of products HPA to HPE suggests safety, this can only be ascertained after further characterization of their health risks in detailed chronic toxicity studies. The high HI for product HPF suggests health risk for consumers of this product.