Evaluation of hypertension control in Greek primary care units. The VANK study

Skliros, E.; Vasibossis, A; Loumakis, P; Sotiropoulos, Alexios; Giannakaki, G; Razis, N

doi:10.1038/sj.jhh.1001540

Cited by 7 publications

(10 citation statements)

References 9 publications

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“…The result of the study showed that from a total of 131hypertensive diabetics only 43.51% of the patients met the currently recommended BP for diabetes of <140/90 mmHg [ 4 ]. The level of BP control found in this study is lower than studies from Chilean (59.7%) [ 20 ], Greece (55.6%) [ 19 ], USA (49.8%) [ 21 ] and South Africa (57%) [ 22 – 24 ]. It was also lower as compared study done by Greenberg et al [ 14 ] and Berlowitz et al [ 25 ].…”

Section: Discussioncontrasting

confidence: 89%

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Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

et al. 2017

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BackgroundHypertension is the major contributor to cardiovascular diseases related morbidity and mortality. Blood pressure is not well controlled in the majority of patients with both diabetes and hypertension. The main objective of this study was to assess blood pressure control and its determinants among diabetes mellitus co- morbid hypertensive ambulatory patients.MethodsHospital based cross sectional study was conducted among diabetes mellitus co-morbid hypertensive ambulatory adult patients based on the inclusion criteria. Patient specific data was collected using structured data collection tool. Data was analyzed using statistical software package, SPSS version 20.0. To identify the independent predictors of blood pressure control, multiple stepwise backward logistic regression analysis was done. Statistical significance was considered at p-value <0.05. Patient’s written informed consent was obtained after explaining the purpose of the study. Patients were informed about confidentiality of the information obtained.ResultsFrom a total of 131 study participants 51.14% were males with the mean (SD) age of the 50.69 ± 13.71. The mean duration of time since the diagnosis of hypertension was 7.44 ± 5.11 years. The mean (SD) SBP was 149.79 ± 16.32 mmHg, while the mean (SD) DBP was 89.77 ± 9.34 mmHg. More than one fourth (25.20%) of study participants had a controlled SBP, while about 27.48% had a controlled DBP. The overall control of BP was achieved in about 57 (43.51%) of the study participants. Older age (≥50 years) (AOR = 2.06; 95% CI: 2.65–7.79; P = 0.002), female gender (AOR = 1.42; 95% CI: 1.19–2.14; P = 0.042), duration of hypertension (AOR = 2.88, 95% CI: 1.27, 8.31, P = 0.02), non-adherence (AOR 2.05; 95% CI: 2.61–9.33; P = 0.01) and uncontrolled blood sugar(AOR = 1.65; 95% CI: 2.14–3.32; P = 0.04) are independent predictors for uncontrolled blood pressure.ConclusionsBlood pressure control to target goal was suboptimal in the study area. Diabetic patients who were older, female, live longer duration with hypertension, non-adherent to their medications and poor glycemic control were more likely to have uncontrolled BP. Therefore, more effort should be dedicated to control the blood pressure in diabetics.

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Section: Discussioncontrasting

confidence: 89%

“…Hypertension is twice as common in persons with diabetes as it is in others. Hypertension is known to contribute to diabetic micro-and macro-vascular complications [ 19 ]. To reduce the risk, hypertension must be diagnosed accurately and promptly, and the patient must receive adequate treatment.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

et al. 2017

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“…Inadequate control of BP appears to be a prevalent problem challenging the primary care in Addis Ababa. The level of BP control found in this study (31%) is lower than obtained from HC-based studies from Chile (59.7%), 22 Oman (39%), 23 Greece (55.6%), 24 the United States (49.8 %), 25 and South Africa (57%). 26 This difference in the level of BP control might be due to a more goal-oriented strategy in the treatment of hypertension, as the use of combination antihypertensive agents was common in most of the studies.…”

Section: Discussioncontrasting

confidence: 84%

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

2020

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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.

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“…Inadequate control of BP appears to be a prevalent problem challenging the primary care in Addis Ababa. The level of BP control found in this study (31%) is lower than obtained from HC based studies from Chile (59.7%) (20) , Oman (39%) (21) , Greece (55.6%) (22) , USA (49.8 %) (23) and South Africa (57%) (24) . This difference in the level of BP control might be due to a more aggressive strategy in the treatment of hypertension as the use of combination antihypertensive agents was common in most of the studies.…”

Section: Discussioncontrasting

confidence: 83%

Blood Pressure Control Practice and Determinants among Ambulatory Hypertensive Patients Attending Primary Health care facilities in Addis Ababa

Amare

Nedi

Berhe

2019

Preprint

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Background Hypertension is the major risk factor for cardiovascular diseases (CVDs) related morbidity and mortality. Blood pressure (BP) is often not adequately controlled in clinical practice. Information regarding BP control in primary care settings is limited in Ethiopia.The aim of this study was to assess BP control and associated factors among hypertensive patients attending primary healthcare facilities in Addis Ababa. Methods A cross sectional study was conducted in 12 health centers in Addis Ababa city selected by multistage sampling. A total of 616 hypertensive patients were included by a systematic random sampling technique. Data was collected by patient interview and patients’ medical record review. Results Out of 634 study participants, 616 had complete information onmedical record and during patient interview. The mean age of study participants was 58.90 (SD 13.04), most of them 321(52.1%) were ≥60 years old, and on monotherapy 485(78.9%). Methyldopa was the most monotherapy prescribed,128 (20.8%). Only 31%(n=191) of patients had controlled BP. Determinants for poor BP control were age of less than 60 years (Adjusted Odds Ratio (AOR)= 3.06, 95% 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), 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 BP were; weekly BP measurement (AOR 0.57, 95% CI: 0.36, 0.90) and tertiary level education (AOR= 0.26, 95% CI: 0.13, 0.54). Conclusion Only one third of patients had controlled BP. Effort should be made to address identified determinants including age, regular BP monitoring and level of education.

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Evaluation of hypertension control in Greek primary care units. The VANK study

Cited by 7 publications

References 9 publications

Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia

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

Blood Pressure Control Practice and Determinants among Ambulatory Hypertensive Patients Attending Primary Health care facilities in Addis Ababa

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