Blood pressure control in a population where antihypertensives are given free

Abstract

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.

Antihypertensive drug use and blood pressure control among in-patients with hypertension in a Nigerian tertiary healthcare centre

“…These patterns of antihypertensive combination use also conform to some studies. 14,15,27,28 Higher mean blood pressure of patients on antihypertensive combination was reported in a study that compared blood pressure between patients taking monotherapy and those on combination therapies. 28 Limitations of this study was due to retrospective nature of this study, some factors that may influence blood pressure control such as adverse reaction experienced, non-cardiovascular diseases, and surgical operation encountered by the patients were not recorded.…”

“…Some studies reported higher percentage of males while some reported higher percentage of female patients with hypertension. 14,15,22,23 It has been reported that women visit hospital often, they have better treatment adherence and better utilization of health care services than men. 24 Male preponderance among in-hospital patients with hypertension in this study may be because male patients do not visit clinic often until when they develop complication of hypertension, which may require hospital admission.…”

“…12 Several studies in Nigeria have reported low blood pressure control among patients visiting the outpatient clinics in tertiary hospitals primary healthcare's, and in population where antihypertensive drugs were given free despite frequent use of antihypertensive combinations. [13][14][15] Hospitalised patients are monitored by health care professionals, compliance is good and blood pressure control is expected to be better among them. This study retrospectively assessed drug use and blood pressure control among hospitalised hypertensive patients in a Nigerian teaching hospital.…”

Drug prescription/blood pressure control in patients on monotherapy attending a tertiary hospital in Nigeria

“…[12][13][14] Inadequate BP control could be as a result of several factors, but rational drug prescription taking into account racial differences, financial implications, and adverse effect could improve BP control. BP control in this study was poor; this finding is similar to studies carried out in this region.…”

Prescription pattern of anti-hypertensive drugs in a tertiary health institution in Nigeria

“…More than 50% of treated hypertensive patients have a blood pressure level greater than 140/90 mm Hg (uncontrolled hypertension) 3,4 . Several factors including, among others, poor adherence to therapeutic regimen, ignorance, and poverty [3][4][5] have been adduced for the high prevalence of uncontrolled hypertension. Recent reports have however focused on the role of health care provider to poor adherence to antihypertensive drugs 6,7 .…”