Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 31;72(717):e269-e275.
doi: 10.3399/BJGP.2021.0493. Print 2022 Apr.

Lifestyle advice for hypertension or diabetes: trend analysis from 2002 to 2017 in England

John A Henry  1 , Susan A Jebb  1 , Paul Aveyard  1 , Cesar Garriga  1 , Julia Hippisley-Cox  1 , Carmen Piernas  1
Affiliations

Lifestyle advice for hypertension or diabetes: trend analysis from 2002 to 2017 in England

John A Henry et al. Br J Gen Pract. .

Abstract

Background: Guidelines recommend that GPs give patients lifestyle advice to manage hypertension and diabetes. Increasing evidence shows that this is an effective and practical treatment for these conditions, but it is unclear whether GPs offer this support.

Aim: To investigate trends in the percentage of patients with hypertension/diabetes receiving lifestyle advice versus medication.

Design and setting: This was a trend analysis of self-reported data from the annual Health Survey for England (HSE) (2003-2017) and GP-recorded data from the QResearch database (2002-2016).

Method: The percentage of patients with hypertension or diabetes who received lifestyle advice or medication was calculated in each year. Associations between likelihood of receiving lifestyle advice and characteristics were assessed using multivariable logistic regression.

Results: The percentage of patients receiving lifestyle advice was consistently lower than those receiving medication in both self-reported and medical records. There was consistent evidence of increasing trends in the percentage of patients with hypertension receiving lifestyle advice (HSE 13.8% to 20.1%; Ptrend <0.001; QResearch 11.0% to 22.7%; Ptrend <0.001). For diabetes, there was a non-significant decline in self-reported receipt of lifestyle advice (45.0% to 27.9%; Ptrend = 0.111) and a significant increase in medically recorded delivery of this advice (20.7% to 40.5%; Ptrend <0.001). Patients with hypertension who were overweight or obese were more likely to receive lifestyle advice than those of a healthy weight, whereas the opposite was true for diabetes.

Conclusion: Only a minority of patients with diabetes or hypertension report receiving lifestyle advice or have this recorded in their medical records. Interventions beyond guidelines are needed to increase the delivery of behavioural interventions to treat these conditions.

Keywords: diabetes mellitus; hypertension; lifestyle advice; primary health care; weight loss.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
a) Trends in the proportion of patients receiving lifestyle advice or medication for hypertension as reported in available years from the Health Survey for England from 2003 to 2017. b) Trends in the proportion of patients receiving lifestyle advice or medication for hypertension within 1 year of diagnosis as reported in the QResearch database from 2002 to 2016.
Figure 2.
Figure 2.
a) Trends in the proportion of patients receiving lifestyle advice or medication for diabetes as reported in available years from the Heath Survey for England from 2003 to 2017. b) Trends in the proportion of patients receiving lifestyle advice or medication for type 2 diabetes within 1 year of diagnosis as reported in the QResearch database from 2002 to 2016.
See this image and copyright information in PMC

References

    1. NHS The NHS Long Term Plan. 2019 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term... (accessed 15 Feb 2022). - PubMed
    1. Mozaffarian D, Kamineni A, Carnethon M, et al. Lifestyle risk factors and new-onset diabetes mellitus in older adults. The Cardiovascular Health Study. Arch Intern Med. 2009;169(8):798–807. - PMC - PubMed
    1. Shimbo D. Dietary and lifestyle factors in hypertension. J Hum Hypertens. 2016;30:571–572. - PubMed
    1. Patel MS, Small DS, Harrison JD, et al. Effectiveness of behaviorally designed gamification interventions with social incentives for increasing physical activity among overweight and obese adults across the United States: the STEP UP Randomized Clinical Trial. JAMA Intern Med. 2019;179(12):1624–1632. - PMC - PubMed
    1. Platt L, Melendez-Torres GJ, O’Donnell A, et al. How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis. BMJ Open. 2016;6(8):e011473. - PMC - PubMed