Researchers in Morocco studied 604 people with high blood pressure to understand why so many struggle to keep their numbers healthy. They found that about 6 out of 10 people weren’t controlling their blood pressure well. The biggest problems were not taking medicine as prescribed, not exercising enough, eating too much salt, and being unhappy with their doctor’s office. These findings show that helping people stick to their treatment plans and making health centers better could make a real difference in controlling high blood pressure.

The Quick Take

  • What they studied: Why do so many people with high blood pressure struggle to keep it under control, even when they’re getting treatment?
  • Who participated: 604 adults with high blood pressure who visit primary health centers in Settat, Morocco. Researchers measured their blood pressure, asked about their diet and exercise, and checked if they were taking their medicine.
  • Key finding: About 61% of people studied (369 out of 604) had blood pressure that wasn’t well controlled. The main reasons were: skipping or forgetting medicine, not exercising, eating too much salt, and not being satisfied with their health center.
  • What it means for you: If you have high blood pressure, taking your medicine every day, moving your body regularly, cutting back on salt, and finding a health provider you trust may help you control it better. However, this study was done in Morocco, so results may be different in other places.

The Research Details

This was a cross-sectional study, which means researchers took a snapshot in time of 604 people with high blood pressure at health centers in Settat, Morocco. They asked patients questions about their knowledge of high blood pressure, whether they took their medicine as directed, and how much they exercised. They also measured each person’s blood pressure and body measurements like weight and height.

The researchers used specific tools to measure what they were studying. They used the GIRERD test to check if people were taking their medicine correctly, and the GPAQ questionnaire to measure physical activity. These are standard tools that scientists use around the world.

They then looked at which factors were most strongly connected to having uncontrolled blood pressure. This type of study is good for finding patterns and connections, but it can’t prove that one thing directly causes another.

Cross-sectional studies like this one are useful because they can quickly show us what problems are most common in a group of people. By identifying the main reasons why blood pressure control fails, doctors and health centers can focus their efforts on the biggest problems. This helps them design better programs to help patients.

This study has several strengths: it included a fairly large number of people (604), used standard measurement tools that are recognized worldwide, and looked at multiple factors that might affect blood pressure control. However, because it’s a snapshot in time rather than following people over months or years, we can’t be completely sure about cause-and-effect relationships. The study was done in one city in Morocco, so the results might be different in other countries or communities.

What the Results Show

The most striking finding was that about 6 out of every 10 people with high blood pressure (61.1%) weren’t controlling it well, even though they were receiving treatment. This is a serious problem because uncontrolled high blood pressure increases the risk of heart attacks and strokes.

The research identified four main factors connected to poor blood pressure control. The strongest connection was with not taking medicine as prescribed—people who didn’t take their medicine regularly were nearly 9 times more likely to have uncontrolled blood pressure. The second biggest factor was not exercising enough; people with low physical activity were about 5 times more likely to have uncontrolled blood pressure.

Not following a low-salt diet was also important, with people who didn’t limit salt being about 1.2 times more likely to have uncontrolled blood pressure. Finally, people who weren’t satisfied with their health center were about 1.4 times more likely to have uncontrolled blood pressure.

These numbers might seem small for diet and satisfaction, but they’re still meaningful when you’re talking about thousands of people. The strongest effects were clearly from medicine compliance and exercise.

The study also showed that patient satisfaction with health centers matters for blood pressure control. This suggests that the quality of care and how patients feel about their doctors and clinics affects whether they stick with their treatment plans. When people feel good about their health center, they’re more likely to follow their doctor’s advice.

These findings fit with what other researchers have found around the world. Studies from many countries show that medicine compliance is one of the biggest reasons why blood pressure control fails. The importance of exercise and diet also matches previous research. However, this study adds important information about how patient satisfaction with health centers affects outcomes, which is sometimes overlooked in other research.

This study was done in one city in Morocco, so the results might not apply to other places with different healthcare systems or populations. Because it’s a snapshot in time, we can’t be sure whether these factors cause poor blood pressure control or are just connected to it. The study relied on people answering questions honestly about their medicine use and exercise, which might not always be accurate. Finally, the study didn’t look at other important factors like stress, sleep, or family history that might also affect blood pressure control.

The Bottom Line

If you have high blood pressure: (1) Take your medicine exactly as prescribed every day—this is the most important factor (strong evidence); (2) Exercise regularly, aiming for at least 150 minutes per week of moderate activity like brisk walking (strong evidence); (3) Reduce salt in your diet by avoiding processed foods and not adding salt to meals (moderate evidence); (4) Find a healthcare provider and clinic you trust and feel comfortable with (moderate evidence). These recommendations are based on this research plus other studies showing similar results.

Anyone with high blood pressure should pay attention to these findings, especially if their blood pressure isn’t well controlled despite treatment. Healthcare workers and clinic managers should also care about this research because it shows how to improve their services. However, people in other countries should remember that this study was done in Morocco, so some factors might be different where they live.

You might see improvements in blood pressure control within 2-4 weeks of starting to take medicine regularly and increasing exercise. However, it usually takes 3-6 months of consistent effort to see major improvements. Some people may need medicine adjustments during this time, so regular check-ups with your doctor are important.

Want to Apply This Research?

  • Track daily medicine intake with a simple yes/no checklist, weekly exercise minutes (goal: 150 minutes), and daily salt intake by logging meals. Record blood pressure readings weekly at the same time of day.
  • Set a daily phone reminder for medicine time, schedule three 50-minute exercise sessions per week, and create a simple salt-reduction challenge by replacing one high-salt food each week with a lower-salt option.
  • Weekly review of medicine compliance percentage, monthly average blood pressure trends, and quarterly satisfaction rating of your healthcare provider. Share these trends with your doctor to adjust treatment if needed.

This research describes patterns found in one study in Morocco and should not replace advice from your personal healthcare provider. High blood pressure is a serious condition that requires professional medical care. Before making changes to your medicine, diet, or exercise routine, talk with your doctor. This information is educational and not a substitute for medical diagnosis or treatment. If you experience chest pain, severe headache, or shortness of breath, seek emergency medical care immediately.