Characteristics, treatment, and control of hypertension in public primary healthcare centers in Nigeria: baseline results from the Hypertension Treatment in Nigeria Program

Ojji, Dike; Baldridge, Abigail S.; Orji, Ikechukwu A; Shedul, Gabriel; Ojo, Tunde M; Ye, Jiancheng; Chopra, Aashima; Ale, Boni Maxime; Shedul, Grace; Ugwuneji, Eugenia N; Egenti, Nonye B; Aluka-Omitiran, Kasarachi; Okoli, Rosemary; Eze, Helen; Nwankwo, Ada; Banigbe, Bolanle; Tripathi, Priya; Kandula, Namratha R.; Hirschhorn, Lisa R.; Huffman, Mark D.

doi:10.1097/hjh.0000000000003089

Cited by 15 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pressure blood smoker soar many times throughout day during respondents smoke. 21 Enhancement this occur because the constricting nicotine vessels blood so that compel heart work hard and cause pressure blood increases. 22 Based on results obtained more respondents with low physical activity experienced hypertension, while analysis bivariate show that no connection among physical activity physique with incident hypertension incident.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Hypertension Incidence in the Work Areas of the Bone and Barru District Health Centers in 2022

Maria

Yusnitasari

Lifoia

et al. 2022

MKMI

View full text Add to dashboard Cite

Hypertension is often called the silent killer because it does not show any symptoms. Hence, not all people with hypertension are aware that they suffer from a chronic condition that can cause degenerative diseases, to death. Hypertension is a problem that is often found in society, both in developed and developing countries, especially in Indonesia. The purpose of this study was to determine the factors associated with the incidence of hypertension in the work area of Dua Boccoe Health Center and Blue Health Center of Bone Regency and Padongko Health Center and Palakka Health Center of Barru Regency, with a high prevalence of hypertension cases in Bone Regency (29.33%) and Barru Regency (33.59%). The type of research used is observational with cross-sectional design with a total of 356 respondents. Data were processed using the SPSS program with chi-square analysis and logistic regression. The results of the study based on the chi-square test showed that there was a relationship between the variables of age, education level, family history of hypertension, smoking, and stress with the incidence of hypertension (p<0.05) and there was no relationship between the variables of sex and physical activity with the incidence of hypertension (p>0.05). Furthermore, based on the logistic regression test, respondents were at a 6.5 times greater risk of developing hypertension if they had stress risk factors. Therefore, respondents are expected to carry out regular health checks and maintain a healthy lifestyle to control risk factors for hypertension.

show abstract

Section: Discussionmentioning

confidence: 99%

Determinants of Hypertension Incidence in the Work Areas of the Bone and Barru District Health Centers in 2022

Maria

Yusnitasari

Lifoia

et al. 2022

MKMI

View full text Add to dashboard Cite

show abstract

“…This trial was embedded within the Hypertension Treatment in Nigeria (HTN) Program, a prospective, longitudinal type 2 hybrid study design to evaluate implementation and effectiveness of a multi‐level, evidence‐based implementation package in 60 public PHCs using an interrupted time series design. 17 , 18 The HTN Program was initiated in January 2020. PHCs with at least two full‐time staff within the Federal Capital Territory, Nigeria, that were accessible to the study team by road and in all seasons, were functional (i.e., defined as open at least between the hours of 8 am to 4 pm and providing the minimum service package for primary healthcare centers), and were willing to participate were randomly selected through a multi‐stage sampling frame.…”

Section: Methodsmentioning

confidence: 99%

“…At the patient level, data were collected within the PHCs by trained healthcare workers and record officers. 17 Particularly, patients’ blood pressure measurements were taken in duplicate by a trained healthcare worker using an automated blood pressure monitor (Omron M3; HEM‐7131‐E, Kyoto, Japan) provided by the study team. We used the average of both blood pressure as the final blood pressure.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Fixed‐dose combination therapy‐based protocol compared with free pill combination protocol: Results of a cluster randomized trial

Sanuade

Ale

Baldridge

et al. 2023

J of Clinical Hypertension

Self Cite

View full text Add to dashboard Cite

Fixed‐dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster‐randomized trial evaluates effectiveness and safety of a treatment protocol that used two‐drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. Eligible patients were adults (≥18 years) with hypertension. The primary outcome was the odds of a patient being controlled at their last visit between baseline to 6‐month follow‐up in the FDC group compared to the free pill group. 4427 patients (mean [SD] age: 49.0 [12.4] years, 70.5% female) were registered with mean (SD) baseline systolic/diastolic blood pressure 155 (20.6)/96 (13.1) mm Hg. Baseline characteristics of groups were similar. After 6‐months, hypertension control rate improved in the two treatment protocols, but there were no differences between the groups after adjustment (FDC = 53.9% versus free pill combination = 47.9%, cluster‐adjusted p = .29). Adverse events were similarly low (<1%) in both groups. Both protocols improved hypertension control rates at 6‐months in comparison to baseline, though no differences were observed between groups. Further work is needed to determine if upfront FDC therapy is more effective and efficient to improve hypertension control rates.

show abstract

“…The intervention phase includes implementation of the remainder of the package components and evaluation over the subsequent 37 months (December 2020 to December 2023). Analysis and dissemination of baseline results occurred following conclusion of the control period [ 18 ]. Midway through the intervention phase, an additional component of CHEW-led home blood pressure monitoring and health coaching was introduced within a subset of 10 participating primary healthcare centers.…”

Section: Methodsmentioning

confidence: 99%

Hypertension Treatment in Nigeria (HTN) Program: rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial

Baldridge

Aluka-Omitiran

Orji

et al. 2022

Implement Sci Commun

Self Cite

View full text Add to dashboard Cite

Background Hypertension is the most common cardiovascular disease in Nigeria and contributes to a large non-communicable disease burden. Our aim was to implement and evaluate a large-scale hypertension treatment and control program, adapted from the Kaiser Permanent Northern California and World Health Organization HEARTS models, within public primary healthcare centers in the Federal Capital Territory, Nigeria. Methods A type 2 hybrid, interrupted time series design was used to generate novel information on large-scale implementation and effectiveness of a multi-level hypertension control program within 60 primary healthcare centers in the Federal Capital Territory, Nigeria. During the formative phase, baseline qualitative assessments were held with patients, health workers, and administrators to inform implementation package adaptation. The package includes a hypertension patient registry with empanelment, performance and quality reporting, simplified treatment guideline emphasizing fixed-dose combination therapy, reliable access to quality essential medicines and technology, team-based care, and health coaching and home blood pressure monitoring. Strategies to implement and adapt the package were identified based on barriers and facilitators mapped in the formative phase, previous implementation experience, mid-term qualitative evaluation, and ongoing stakeholder and site feedback. The control phase included 11 months of sequential registration of hypertensive patients at participating primary healthcare centers, followed by implementation of the remainder of the package components and evaluation over 37 subsequent, consecutive months of the intervention phase. The formative phase was completed between April 2019 and August 2019, followed by initiation of the control phase in January 2020. The control phase included 11 months (January 2020 to November 2020) of sequential registration and empanelment of hypertensive patients at participating primary healthcare centers. After completion of the control phase in November 2020, the intervention phase commenced in December 2020 and will be completed in December 2023. Discussion This trial will provide robust evidence for implementation and effectiveness of a multi-level implementation package more broadly throughout the Federal Capital Territory, which may inform hypertension systems of care throughout Nigeria and in other low- and middle-income countries. Implementation outcome results will be important to understand what system-, site-, personnel-, and patient-level factors are necessary for successful implementation of this intervention. Trial registration ClinicalTrials.gov NCT04158154. The trial was prospectively registered on November 8, 2019.

show abstract

Characteristics, treatment, and control of hypertension in public primary healthcare centers in Nigeria: baseline results from the Hypertension Treatment in Nigeria Program

Cited by 15 publications

References 17 publications

Determinants of Hypertension Incidence in the Work Areas of the Bone and Barru District Health Centers in 2022

Determinants of Hypertension Incidence in the Work Areas of the Bone and Barru District Health Centers in 2022

Fixed‐dose combination therapy‐based protocol compared with free pill combination protocol: Results of a cluster randomized trial

Hypertension Treatment in Nigeria (HTN) Program: rationale and design for a type 2 hybrid, effectiveness, and implementation interrupted time series trial

Contact Info

Product

Resources

About