Characterizing Patients with Uncontrolled Blood Pressure at an Urban Hospital in Hanoi, Vietnam

Abstract

Great efforts to advance the diagnosis and treatment of hypertension for controlling hypertension have been made; however, the rates of uncontrolled blood pressure are still high. This study explored the rate of uncontrolled hypertension in patients with hypertension managed in an urban hospital of Vietnam and identified associated factors. A cross-sectional survey was performed from August to October 2019 among hypertensive patients at an urban hospital in Hanoi, Vietnam. Blood pressure was evaluated at the time of medical examination. Demographic, clinical, and behavioral characteristics were also collected. Multivariate logistic regression was used to identify the factors related to uncontrolled hypertension. Among 220 patients, the rate of uncontrolled hypertension was 40.5%. Females had a lower likelihood of having uncontrolled hypertension compared to males (adjusted OR = 0.33; 95% CI = 0.11–0.98). Higher duration of diseases (adjusted OR = 1.07; 95% CI = 1.01–1.14) and higher body mass index (adjusted OR = 1.23; 95% CI = 1.05–1.45) were positively associated with uncontrolled hypertension. Patients who carried supplies needed for self-care, cut down on stress, exercised regularly, and stopped/cut down on smoking were also less likely to develop uncontrolled hypertension. This study reveals that uncontrolled hypertension was common among hypertensive patients in Vietnam. Improving self-care capacity and encouraging healthy behaviors are critically important to control blood pressure, particularly among patients who were males and had high disease duration and body mass index.

Self-Care Management for Hypertension in Southeast Asia: A Scoping Review

“… n=17,199, M age = 44 years (range=25–64) National Men (24.5%) and Women (17.5%) were current smokers. Men (25.1%) and Women (15.8%) did not drink alcohol Traditional: Alcohol consumption, tobacco cessation Nguyen et al 52 (2020) Vietnam To explore the rate of uncontrolled hypertension and identified associated factors n=220 Hospital, urban area Did not smoke (87.7%), alcohol drinkers (28.6%), overweight/obesity (58%), did not adhere to medication (99.6%), did not follow a low-salt diet (50.5%), exercised regularly (85.0%) Traditional: Tobacco cessation, Alcohol consumption, bodyweight management, medication adherence, dietary intake, physical exercise Ko-Ko-Zaw et al 53 (2011) Myanmar To determine the prevalence of hypertension and its associated factors n=4616 ≥20 National Medication consumption (32%), current smokers (24.9%), alcohol drinkers (47.1%), moderate physical activity (47%), overweight (29.9%), obese (11.8%) Traditional: Medication adherence, tobacco cessation, alcohol consumption, physical exercise, bodyweight management Han et al 54 (2015) Myanmar To determine the prevalence of the adherence and to identify the factors related to medication adherence among hypertensive patients n=216, M age= 52.8 years Hospital, Urban area Poor medication adherence (49.1%) Traditional: Medication adherence, Oo et al 55 (2018) Myanmar To describe the relationships between personal and environmental factors and health behaviors in persons with hypertension n=104, M age= 53.27 years (range= 21 to 80) Urban area Moderate level of health behaviors (70.59 ± 12.39) Unspecified Haung et al 56 (2020) Myanmar To identify the prevalence of self-care behaviors and their associated factors among hypertensive patients n=410 M age= 55.4 years (range =30–70) Rural area Did not adhere to medication (75.9%), low diet quality (62.2%), inadequate physical activity (75.1%), poor bodyweight management (90.5%), smoking (49.8%), did not drink alcohol (97.8%) Traditional: Medication adherence, dietary intake, physical exercise, bodyweight management, tobacco cessation, and al...…”

“…In the quantitative and mixed-method studies, body weight management (29 studies 20 , 24 , 25 , 29 , 30 , 33 , 36 , 39–50 , 52 , 53 , 56–62 , 64 ) and physical exercise (22 studies 21 , 22 , 24 , 30–33 , 35 , 38 , 40–43 , 45 , 47 , 52 , 53 , 56 , 57 , 60 , 61 , 75 ) were the most reported, whereas in the qualitative studies, medication adherence and diet intake was the most reported self-care practice. In addition, a few studies described alternative self-care management methods such as stress-relieving methods (6 studies 35 , 40 , 60 , 66 , 68 , 75 ), sleep and rest (2 studies 68 , 74 ), and spiritual fulfilment was described in one study.…”

“…In the quantitative and mixed-method studies, studies indicated that traditional self-care management, such as body weight management, physical exercise, dietary intake, and medication adherence were poorly practiced. Respectively, studies showed unaddressed risk factors for heart disease and stroke with a 50% incidence or more being reported for overweight/obese (8 studies 20 , 30 , 33 , 50 , 52 , 56 , 57 , 61 ), low level physical exercise (8 studies 21 , 24 , 31 , 32 , 45 , 56 , 57 , 61 ), poor/low-quality dietary intake (9 studies 21 , 23 , 30 , 34 , 40 , 56 , 57 , 60 , 75 ), and poor adherence to medication (4 studies 27 , 32 , 52 , 56 ).…”

“…A study with the largest sample (313,714) was conducted by Nurdiantami et al 24 Sample sizes ranged from 5 to 30 participants in the qualitative studies reviewed. For study settings, in quantitative and mixed-method studies, 10 studies took place nationally, 24,41,[47][48][49][50][51]53,63,64 19 in the urban areas, 20,21,23,[31][32][33][36][37][38]40,42,[44][45][46]52,54,55,58,76 16 in rural areas, 22,[25][26][27][28][29]34,39,43,56,57,[59][60][61][62]75 and two studies in multiple settings. 30,35 For quantitative studies, four of them were conducted in urban settings, …”

Research Article Adherence to blood pressure control and association with comorbidities in elderly Vietnamese patients

“…Systolic hypertension, especially isolated (ISH), is common in older people aged ≥65 years and is a major risk factor for stroke and heart attack regardless of gender or ethnicity, and effective control of SBP is associated with a significant reduction in the incidence of these complications (Chrysant, 2018). Poorly controlled hypertension is widespread in Vietnam according to previous studies (Nguyen, 2020). According to the JNC 8 Blood Pressure Guidelines, for patients 60 years of age or older, it is recommended that they start drug therapy to lower their SBP to 150 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, and in case of concomitant diabetes or chronic kidney disease (CKD), SBP should remain <140 mm Hg and DBP <90 mm Hg (Burns et al, 2019).…”