BACKGROUND: In spite of the availability of myriads of antihypertensive medications, the control of high blood pressure is still low. Studies on effect of lifestyle behavioural changes through counselling on blood pressure control are scant in Nigeria. Therefore, this study set out to determine the role of lifestyle counselling on behavioural change among hypertensive patients attending the Federal Medical Centre, Ido-Ekiti. METHODS: A total of 322 adult hypertensive participants who had been on treatment for at least three consecutive months were randomised into two groups. Relevant data were collected using an interviewer-administered semi-structured questionnaire and clinical parameters were measured pre- and post-intervention. The intervention group was counselled on lifestyle behaviours, namely regular exercise, eating adequate fruits and vegetables, moderate alcohol intake and cessation of smoking. RESULTS: Post-intervention, among the intervention group 22.4%, 71.4% and 100%, as compared with the control group at 6.2%, 41.0% and 87.6%, met recommendations for physical activity, fruit and vegetable consumption and alcohol consumption respectively. The difference in each category was statistically significant (p < 0.001). However, the difference in smoking habits between the two groups (83.9% versus 79.5%) was not statistically significant (p = 0.313). There was a statistically significant difference (p <= 0.001) in the difference in mean arterial pressure (96.4 +/- 8.1 versus 106.2 +/- 7.6 mmHg) between the intervention and control group post-intervention. CONCLUSION: Lifestyle modifications form part of an important and effective treatment modality for hypertension. It is desirable that primary care physicians devise and implement clinical and public health strategies that promote and maintain a combination of pharmacologic interventions and lifestyle modifications.

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