Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

Muleta, Sintayehu; Melaku, Tsegaye; Chelkeba, Legese; Assefa, Desta

doi:10.1186/s40885-017-0085-x

Cited by 38 publications

(89 citation statements)

References 39 publications

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“…Suboptimal BP control was more prevalent in the elderly (56.5% and 68% among patients aged 50-75 years and above 75 years, respectively). These findings have been similar to those of other studies done in South Africa [17] and Ethiopia [18] which indicated an association of poor BP among the elderly. The explanation for this may be due to the increase in arterial stiffness and poor adherence to medication associated with advancing age, so the recommended cutoff point of BP in DM patients of <140/90 mmHg is too tight to the elderly people.…”

Section: Discussionsupporting

confidence: 92%

“…The difference is because a wide range of age categories was used. Likewise, a family history of hypertension was shown to have a strong association with suboptimal BP control by having 71.4% prevalence (p ≤ 0:02), it was different from the study done in Ethiopia which found the prevalence of 17.56% [18].…”

Section: Discussioncontrasting

confidence: 75%

“…Duration since the diagnosis of HTN in this study was also associated with suboptimal BP control, where 65.8% of the participants with the duration of more than 11 years were compared to those who had less duration. This was also observed in the study done in Ethiopia where the prevalence was 46.6% for participants who had duration of more than 5 years [18]. The difference is because a wide range of age categories was used.…”

Section: Discussionsupporting

confidence: 61%

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Suboptimal Blood Pressure Control, Associated Factors, and Choice of Antihypertensive Drugs among Type 2 Diabetic Patients at KCMC, Tanzania

Mbwete

Kilonzo

Shao

et al. 2020

Journal of Diabetes Research

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Background. Hypertension (HTN) can be present in up to two-thirds of patients living with diabetes mellitus (DM). It is a risk factor for the development of diabetes as well as complications like coronary artery disease (CAD), nephropathy, retinopathy, and neuropathy. Hypertension is treatable, and the degree to which it is controlled determines the risk of development of cardiovascular diseases and other complications in a given individual patient. Even though antihypertensive drugs are available and issued to hypertensive diabetic patients, the rate of control of HTN is often inadequate. The aim of this study was to assess the prevalence of suboptimal blood pressure (BP) control, its associated factors, and the choice of antihypertensive drugs among type 2 DM patients at Kilimanjaro Christian Medical Centre (KCMC). Methods. A hospital-based cross-sectional study was conducted at the KCMC diabetes clinic from October 2018 to March 2019 among type 2 DM patients with HTN based on the inclusion criteria. Data were collected using structured questionnaires, and written informed consent was obtained. Suboptimal BP was defined as BP levels≥140/90 mmHg according to the American Diabetes Association guideline published in 2018. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 25. Chi-square analysis was done to identify the independent predictors of BP control, and a p value of <0.05 was considered to be statistically significant. Results. The data of 161 participants was analysed; the mean age was 63.9±20.2 years, with the majority being females (67.1%). Despite all participants being on different classes of antihypertensives, 57.8% had suboptimal BP control. Among the participants with good BP control, 52.7% were on angiotensin-converting enzyme inhibitors (ACE-I). Poor diabetes control was observed in 50.1% participants as indicated by elevated glycated haemoglobin. Conclusion. This study demonstrated that BP control in type 2 DM patients was suboptimal in more than half of the participants. The study showed that the use of ACE-I or angiotensin II receptor blockers (ARBs) in the majority of DM patients has a good impact in the control of blood pressure. The early initiation of ACE-I or ARBs among the diabetic patients will improve the optimal BP control.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 75%

Section: Discussionsupporting

confidence: 61%

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Suboptimal Blood Pressure Control, Associated Factors, and Choice of Antihypertensive Drugs among Type 2 Diabetic Patients at KCMC, Tanzania

Mbwete

Kilonzo

Shao

et al. 2020

Journal of Diabetes Research

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“…Among the included hypertensive patients, 2534 were found to have uncontrolled BP. Eleven of the included studies used cross-sectional study design [14][15][16][17][18][19][20][21][22][23][24] while the remaining two were cohort in design [25,26]. Almost all the included studies were hospital based except for one which was conducted at health centers [18].…”

Section: Study Characteristicsmentioning

confidence: 99%

Uncontrolled hypertension in Ethiopia: a systematic review and meta-analysis of institution-based observational studies

Amare

Hagos

Sisay

et al. 2020

BMC Cardiovasc Disord

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Background: Uncontrolled hypertension is one of the major risk factors of cardiovascular and cerebrovascular diseases. The prevalence of hypertension in Ethiopia is expected to reach up to 30%. The aim of this study was to determine the prevalence of uncontrolled hypertension among hypertensive patients on treatment in Ethiopia. Methods: Electronic databases and search engines including EMBASE (Ovid), PubMed/Medline, and Google Scholar were searched for original records in the English language addressing hypertension control in Ethiopia from 2000 to 2018. Data were extracted using a format prepared in Microsoft Excel and exported to STATA 15.0 software for analyses. The study protocol is registered at PROSPERO with reference number ID: CRD42018116336. Results: A total of 13 studies with 5226 hypertension patients were included for systematic review and meta-analysis. The pooled prevalence of uncontrolled hypertension in Ethiopia was 48% (95% confidence interval (CI): 36, 61%). The result of the subgroup analysis, based on the year of publications, revealed that the prevalence of uncontrolled BP was highest in 2016 (63%; CI: 60, 67%) and in 2015 (59%; CI: 53, 65%). Univariate meta-regression revealed that sampling distribution was not a source of heterogeneity for the pooled estimate as well as the sub group analysis. Conclusion: The prevalence of uncontrolled hypertension was high in Ethiopia. This alarming public health issue fuels the ever-increasing cardiovascular and cerebrovascular diseases. The ministry of health has to design a policy and implementation mechanisms to reduce uncontrolled hypertension prevalence and improve awareness on blood pressure control.

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“…Determinants of poor blood pressure control were reported in earlier studies 9 , 10 but due to its potential in posing an immediate life threat in certain circumstances, various aspects of the disease and patients status must be considered very carefully in interventions to control the elevated BP. Lifestyle modifications to control hypertension should include medication adherence, 11 , 12 dietary modification, 13 , 14 adequate physical activity, 15 , 16 stress control, 17 smoking cessation, 18 and establishment of an effortless and efficient communication milieu to provide information or the required consultation for hypertensive patients.…”

Section: Introductionmentioning

confidence: 98%

<p>Predictive Performance of Pender’s Health Promotion Model for Hypertension Control in Iranian Patients</p>

Gorbani¹,

Mahmoodi²,

Sarbakhsh³

et al. 2020

VHRM

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Objective: The main aim of this study was to investigate predictive factors of adherence to the hypertension control therapeutic and lifestyle recommendations in a sample of Iranian patients based on the constructs of Pender's health promotion model. Patients and Methods: The cross-sectional study was performed on the 380 hypertensive patients who were referred to the health centers, the emergency and internal diseases departments of the Bagheralolom Hospital, and the cardiologists' offices in the city of Ahar, North West of Iran. Data were collected using a researcher designed questionnaire based on the Pender's health promotion model. The Pearson correlation test, multivariate linear regression, and independent t-test were used for data analysis. Results: Mean age of the recruited patients was 52.94 (SD=12.8). Perceived benefits, perceived barriers, situational influences, and interpersonal influences (adjusted R 2 = 0.525) explained 52.5% of the observed variation in adherence to hypertension control recommendations. Conclusion: Successful hypertension control in patients with chronic morbidity need to be based on sound data about major determinants of the relevant health/illness behaviors. The study findings revealed that the Pender's health promotion model could be applicable as a theoretical framework to identify major determinants of adherence to hypertension control recommendations. Future cross-cultural validation of the study findings in more representative and larger sample sizes could add to the legitimacy of the evidence surrounding self-care practices in hypertensive patients.

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Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

Cited by 38 publications

References 39 publications

Suboptimal Blood Pressure Control, Associated Factors, and Choice of Antihypertensive Drugs among Type 2 Diabetic Patients at KCMC, Tanzania

Suboptimal Blood Pressure Control, Associated Factors, and Choice of Antihypertensive Drugs among Type 2 Diabetic Patients at KCMC, Tanzania

Uncontrolled hypertension in Ethiopia: a systematic review and meta-analysis of institution-based observational studies

<p>Predictive Performance of Pender’s Health Promotion Model for Hypertension Control in Iranian Patients</p>

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