Blood pressure control practice and determinants among ambulatory hypertensive patients attending primary health care facilities in Addis Ababa

Abstract

Background: Hypertension is the major risk factor for cardiovascular diseases related morbidity and mortality. Blood pressure is often not adequately controlled in clinical practice. Information regarding blood pressure control in primary care settings is limited in Ethiopia. Objectives: This study aimed to assess blood pressure control practice and determinates among hypertensive patients attending primary health care facilities in Addis Ababa. Methods: A cross-sectional study was conducted on 616 hypertension patients in 12 health centers in Addis Ababa city. Data were collected by interviewing patients and reviewing their medical records. Data were collected from 3 August to 30 October 2015. Results: A complete information was obtained from 616 patients’ medical records, and patients were then interviewed. The mean age was 58.90 (SD ± 13.04) years, and most of them (n = 321, 52.1%) were 60 years old or above, and more than three-fourth (n = 485) were on monotherapy. Methyldopa was the most monotherapy medication prescribed, 128 (20.8%). Only 31% (n = 191) of the patients had controlled blood pressure. Determinants for poor blood pressure control were age less than 60 years (adjusted odds ratio (AOR) = 3.06, 95% confidence interval (CI): 1.96, 4.78); work status: government employee (AOR = 2.41, 95% CI: 1.18, 4.90), retired (AOR = 1.79, 95% CI: 1.01, 3.18), and private business (AOR = 2.09, 95% CI: 1.17, 3.74); and being hypertensive for 10 or more years (AOR = 1.96, 95% CI: 1.11, 3.43). Significant predictors of achieving controlled blood pressure were weekly blood pressure measurement practice (AOR = 0.57, 95% CI: 0.36, 0.90) and tertiary-level education (AOR = 0.26, 95% CI: 0.13, 0.54). Conclusions: Only one-third of the patients had controlled blood pressure. Efforts should be made to address identified determinants including age, regular blood pressure monitoring practice, and level of education.

Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study

“…In contrast to this logic, our study showed that those unable to write and read were more likely to have controlled blood pressure compared to those having higher education level (AOR = 3.34, 95% CI: 1.05–10.65, P = 0.041). This finding is supported by the result of another study conducted in Addis Ababa [ 37 ].…”

“…Our study found that 52.2% of patients had controlled blood pressure according to the Eighth Joint National Committee (JNC8) criteria [ 26 ]. This finding is higher than the results of previous studies in different part of Ethiopia with the same cut off points for the definition of controlled blood pressure [ 23 , 37 ]. The disagreement of findings may be due to difference in sample size, socio-demographic characteristics, and lifestyle practice of study participants.…”

Determinants of blood pressure and blood glucose control in patients with co-morbid hypertension and type 2 diabetes mellitus in Ghana: A hospital-based cross-sectional study

“…The differences in results may be due to a better understanding of the co-morbid nature of their disease condition and therefore a better rate of adherence to their treatment. This study further revealed that those who were employed had controlled BP levels which disagrees with a similar study in Addis Ababa where patients who were employed had uncontrolled BP levels [35]. This may be due to the strains of their jobs and therefore a recognition of the need to adhere to treatment to prevent a worsened clinical outcome.…”

“…The findings from this study also showed that controlled BP levels were high among the older age groups which is inconsistent with the findings from a similar study conducted in Ethiopia where patients who fell among the older age groups had two times uncontrolled BP compared to patients among the younger age groups [4] This observed result may be due to the fear in the prevalence of worse clinical outcomes in the elderly who present with comorbid hypertension and diabetes and hence a better rate of adherence to treatment. Although other studies did not find any significant association between marital status and control of BP levels [4,35], this study showed that those who were not currently married had controlled BP levels. Patients taking two or three doses of medications daily, had controlled BP levels which is inconsistent with other studies which have showed that multiple daily dosing of medications leads to a higher rate of non-adherence and consequently unfavourable clinical outcomes [36][37][38].…”

Self-care practice among hypertensive patients in Ethiopia: systematic review and meta-analysis

“…8 9 According to different studies, UHTN is a common health public problem in Ethiopia. [9][10][11][12][13] To control high blood pressure and to improve high blood pressure status, it is important to apply self-care practices (SCPs). 14 The main domains of SCP are adherence to medication, physical activity, weight management, low-salt diet, non-smoking, moderate alcohol usage, and dietary management.…”