**2.1 Patient's history**

Detailed history, physical examination and interpretation of investigations should form an integral part of the routine care of patients with hypertension. Regarding measurements, it is important to ensure that PHC nurses who take blood pressure measurements have adequate initial training and their performance periodically reviewed. Equipment for measuring blood pressure must be correctly checked, serviced and adequately recalibrated according to the companies' instructors' manuals. When checking blood pressure, PHC nurses in the clinics should calm the setting and provide a relaxed, temperate atmosphere, with the patients quiet and seated, and arms outstretched and supported. Use of a correct machine for the patient's arm is important [9]. A community-based study to estimate the prevalence of hypertension and its associated factors in municipalities of Kathmandu, Nepal [10], found that factors associated with hypertension were smoking, Body Mass Index (BMI), alcohol use, poor physical activity and diabetes.

The guidelines [9] emphasise the importance of the following lifestyle modifications:


In South Africa, the following lifestyle modification is also recommended [11]:

• Educate patients about adequate dietary fibre intake (fruits, vegetables and unrefined carbohydrate).

#### **2.2 Study design**

The research is quantitative because it sought to measure the phenomenon by attaching numerical values to express quantity [12]. The observation was carried out in the PHC facilities whereby entries of patients' files were evaluated. Perusal of patients' files and documentation using checklist was also done. Furthermore, quantitative research is described as a formal, objective, systematic methodology to describe variables, to test relationships, and to examine cause and effect [13]. However, for this study, only the former is applicable. The patients whose files were perused had experienced an event that is a "follow-up consultation for hypertension". Moreover, the patients were mostly pensioners and depending on old age grant and even the unemployed ones without the medical aids. They resided around the townships and villages of Tshwane.
