An appraisal of blood pressure control and its determinants among patients with primary hypertension seen in a primary care setting in Western Nigeria

Abstract

Achieving guideline-recommended blood pressure is imperative in reducing the rising tide of uncontrolled hypertension and its attendant sequelae, which are major causes of morbidity and mortality globally. The aim of the study was to describe the pattern of blood pressure control and identify the factors influencing blood pressure control among patients with primary hypertension seen at family medicine clinics of FMC, Abeokuta. Methods: This was a descriptive cross-sectional hospital-based study. A systematic random sampling technique was used in selecting 360 hypertensive respondents over four months. Data were collected through a pre-tested interviewer-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) version 17.0 was used to analyse data. Results: Blood pressure was controlled in 167 (46.4%) of the respondents. The independent predictors of blood pressure control were female gender (p = 0.001, OR = 2.494, 95% confidence interval (CI) = 1.477-4.214), regular use of medication (p = 0.001, OR = 2.900, 95% CI = 1.508-5.577), regular clinic attendance (p < 0.001, OR = 3.512, 95% CI = 1.772-6.960), and absence of diabetes mellitus (p < 0.001, OR = 7.357, 95% CI = 3.190-16.966). Conclusions: The rate of blood pressure control among the hypertensive respondents was low. Multiple independent predictors of controlled blood pressure call for a team-based approach as well as multiple approaches including education of patients, expansion of a community-based health insurance programme and intensification of treatment efforts when managing hypertensive patients.

Blood Pressure and Control Factor in Hypertensives Monitored at the Referral Hopsital in Boma. Democratic Repubic of the Congo

“…This observation agrees with previous reports highlighting the fact that in most countries, less than 20% of patients achieve BP goals and therapy with a single antihypertensive agent fails to achieve BP goals in up to 80% of patients [1] The prevalence of uncontrolled hypertension observed in the present study was similar than that reported by Dennison et al (64%) [26], Rayner et al (60.2%) [27].and by Abiodun et al .62.3%, (67%) [28]. It lower than that reported by Mutua [37] The differences in these studies can be justified by the media, the different sample sizes, the references retained as control (140/90 and BP.130 / 80 mmHg), and finally the co-morbidity in the presence (CKD and DM) and without forgetting the quality of the drugs which differs from country to country…”

Blood pressure control and its associated factors among hypertensive patients in federal teaching hospital, ido- ekiti, Southwest Nigeria

“…Comparative prevalence of B.P control in Africa revealed 50.3% in Ethiopia and 33.4% in Kenya [8,9]. In Nigeria, proportion of blood pressure control ranges from 17.2 -53.3% [10][11][12][13]. The current emphasis is on the control of both the systolic and diastolic blood pressure, the systolic hypertension is by far common in low socio-economic people as compared to diastolic hypertension [9].…”

“…The current emphasis is on the control of both the systolic and diastolic blood pressure, the systolic hypertension is by far common in low socio-economic people as compared to diastolic hypertension [9]. Between 2009 and 2010, only 50% of adult subjects with hypertension have their B.P controlled below 140/90mmHg [11].…”

“…Studies have shown that the control of B.P is still low even among the subjects who offer themselves for treatment [11][12][13][14]. Reasons for poor B.P control are multi-factorials [7,[10][11][12][13]. Socio demographic factors, co-morbidities and poor lifestyle changes have been found to be associated with poorly controlled hypertension.…”

“…Socio demographic factors, co-morbidities and poor lifestyle changes have been found to be associated with poorly controlled hypertension. [7,11,12]. Obesity, sedentary lifestyle, consumption of red meat, cigarettes smoking and alcoholic intake are the common poor lifestyle changes linked with poorly controlled hypertension [7][8][9].…”