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

Abstract

Background: Hypertension is a modifi able risk factor for cardiovascular disease, stroke and renal disease worldwide. Despite improvement in treatment modality and therapeutic intervention, with proven benefi ts in reducing the burden of uncontrolled hypertension, majority of peoples' blood pressure still remain uncontrolled. Aim: To assess the patterns of blood pressure control and its associated factors among hypertensive patients on follow-up. Setting: This study was done at the general outpatient department of Federal Teaching Hospital, Ido-Ekiti, Southwest Nigeria, which is a referral centre for private and government owned-health facility in the state and its environs. Methods: Hospital-based cross sectional study was conducted from June 4-August 31, 2019. Systematic random sampling method was used to select the 320 participants. Semi-structured interviewer-administered questionnaire was used to seek information on participants' socio-demographic characteristics, lifestyle changes and level of adherence to antihypertensive medication. Blood pressure was measured and recorded. Data was analyzed using SPSS 20. Multivariate logistic regression analysis was used to identify the factors associated with poor blood pressure control. Results: Mean age of the participants was 63.9± 11.5 years. 56.6% had their blood pressure controlled within the recommended limits. In multivariate analysis, civil servant (OR =45.160, 95% CI: 6.143-332.000) and adherence to medication (OR=15.35, 95% CI: 6.303-37.391) were the independent associated factors with good blood pressure control while old age (OR= 0.894, 95% CI: 0.837-0.955) and diabetes (OR= 0.072, 95% CI: 0.016-.0,318) were independent associated factors with poor blood pressure control. Conclusions: Old age and diabetes are the predictors of poorly controlled blood pressure and therefore, clinicians and other stakeholders should provide close attention and targeted blood pressure control among this set of patients.

Blood Pressure Control and Its Determinants Among Outpatient Hypertensive Subjects in Port Harcourt: A Survey of Two Teaching Hospitals

“…Respondents recruited from the cardiology medical outpatient clinics are more likely to have various cardiovascular complications as well as other causes of secondary hypertension which might make blood pressure control more difficult. Other local studies reported a higher control rate of 53.3% compared to ours [7,26]. A striking finding in this study was the high prevalence of uncontrolled blood pressure among the study participants attending the Cardiology outpatient clinic which underscores the need to emphasize and probably evolve more effective strategies, even amongst specialist Cardiologists, specifically targeting optimal blood pressure control among patients with hypertension.…”

“…Reasons for poor drug adherence are multiple and may be mostly due to medication cost, pill burden, medication unavailability, and depression amongst others. Ezeala et al [27] reported high depression scores, low disability scores and presence of co-morbidities such as peptic ulcer disease significantly correlated with nonadherence to antihypertensive medications. A similar study conducted in Ethiopia [25] reported a low prevalence (11.4%) of nonadherence compared to our finding, however, the study included participants with co-morbidities such as diabetes mellitus, which probably enhanced adherence in their patients for fear of developing more severe cardiovascular complications.…”

“…Blood pressure control, however, remains unsatisfactory worldwide [4,5]. Studies in Africa also demonstrate this inadequacy of controlled blood pressure levels [6][7][8]. A systematic review of studies in 23 African countries [9] reported a widespread poor control of hypertension across the continent, even in those that were aware of their status and were treated.…”