Background: Analysis of blood pressure control has shown that optimal blood pressure control is generally low in many studies. Poor adherence to therapeutic plans and noncompliance are perhaps the most important factors responsible for poor control. In most cases poverty has been adduced to be responsible for non-compliance especially in the sub-Saharan Africa. Assessment of blood pressure control in situations where antihypertensives are given free is necessary. Objectives: To assess blood pressure control in a population where antihypertensives are given free. Setting: International institute for tropical Agriculture (IITA).Design: Cross-sectional study. Subjects: One hundred and forty three consecutive hypertensive subjects (106 males and 37 females) being followed-up in the medical clinic of the International Institute for Tropical Agriculture (IITA) for variable numbers of years were studied. Blood pressure was considered to be well controlled if it was less than 140/90 mmHg and uncontrolled if higher than 140/90mmHg. Results: About 51(36%) of the subjects may be described as being fully controlled on the treatment instituted while 54(38%) of the subjects were not controlled at all. In about 18% of the patients, the systolic blood pressure alone was controlled while in 8% the diastolic blood pressure alone was controlled. Main Outcome measures: Level of blood pressure control in this study is poor suggesting that availability of free drug alone is not enough to improve adherence to antihypertensives. Conclusion: The percentage of hypertensive patients with optimal blood pressure control in this population is low, although this was higher when compared to a report from a similar study where drugs were not given free to patients. Physicians managing hypertension in such establishments should pay attention to adequate dosing and appropriate combination of drugs.

To present a case of a male adult with sickle cell anaemia and dependence (opioid) syndrome. Mr. A.E. was a 30year old unmarried, unemployed male with sickle cell anaemia from a polygamous family. He had limited education. He became dependent on intramuscular pentazocine because he felt unfulfilled and underachieved. His drug dependence became complicated by abscess formation in his right thigh, laterally. He had neglect of self , hygience ,and groom and, his behaviour became embarrassing. He lost the attention of significant others, and finally developed a depressive disorder.. The life-threatening nature of sickle cell anaemia, its unpleasant features, and its adverse social consequences (e.g. stigmatization) could lead a vulnerable patient to seeking refuge in mood-altering/euphoric substances. Therefore, a multidisciplinary approach to the management of sickle cell anaemia with emphasizes on psychosocial interventions in the adult, is suggested.

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