Magnitude of Uncontrolled Hypertension and Associated Factors among Adult Hypertensive Patients in Public Hospitals of Central Zone, Tigray, Ethiopia: A Cross-sectional Study 2018

Abstract

Background: - Uncontrolled hypertension is if SBP is ≥140 mm Hg and/or DBP ≥90 mm Hg for general hypertensive population or if SBP ≥130 mm Hg and/or DBP ≥80 mm Hg in patients with established diabetes mellitus or chronic kidney disease based on the average of two or more properly measured, seated, BP readings on each of two or more office visits. The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients in public hospitals of central zone, Tigray, Ethiopia, 2018. Methods:- A hospital based cross sectional study design was used. The study population was all sampled adult hypertensive patients who had follow up in public hospitals of central zone, Tigray and the data collection period was from March 01 to April 30, 2018. About 421 study participants were selected using systematic random sampling. Interviewer administered structured questionnaire, chart review checklist and measurements were used. The collected data was checked for its completeness manually and then entered and cleaned in to epi data version 3.1 and exported to Statistical packages for social science version 22 for analysis. Bivariate and multivariable analyses were done to identify factors of uncontrolled hypertension. Then those variables significant at p<0.25 with the outcome variable in bivariate analysis were selected for multivariable analysis and odds ratio with 95% confidence level was computed and p-value < 0.05 was described as a significant association in multivariable analysis. Result: - Among 421 respondents about 177(42%) had uncontrolled hypertension. Co-morbidity [AOR=0.36, (0.205, 0.631)], five to ten years duration of medication taken [AOR=0.398, (0.218, 0.725)], side effect of medication [AOR=0.542, (0.339, 0.866)] and medication adherence [AOR=4.092, (2.419, 6.924)] were significantly associated with uncontrolled hypertension. Conclusion: - In this study the magnitude of uncontrolled hypertension was high. Co-morbidity, antihypertensive medication taken for long duration, side effect of antihypertensive medication and non adherence to antihypertensive medication shows statistical association with uncontrolled hypertension.

Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow Up at Negelle and Adola General Hospital, Guji Zone, Southern Ethiopia: Facility Based Case Control Study

“…The odds of non-adherence to antihypertensive medication in those cases were 2 times higher than their counterparts. This study was in line with a cross-sectional study done in different regional areas of study including Ethiopia (Amhara, Tigray) and Brazil (5,15,27,30,44,45). This might be due hypertension treatment requires taking the right drug with the right dose at the right time.…”

Uncontrolled hypertension among hypertensive patients in Sub-Saharan Africa: A systematic review and meta-analysis

“…The twenty-four studies [ 1 , 3 , 6 , 7 , 9 , 11 , 12 , 14 , 18 , 21 – 26 , 28 , 29 , 31 , 38 – 43 ] and two studies [ 10 , 44 ] were conducted using cross-sectional and retrospective cohort study designs respectively. Regarding geographical region, nineteen studies were found in Ethiopia [ 1 , 3 , 6 , 9 , 10 , 14 , 18 , 21 , 22 , 24 , 26 , 28 , 38 – 44 ], one study in Kenya [ 23 ], Nigeria [ 7 ], Cameroon [ 12 ], Sudan [ 25 ], South Africa [ 31 ], Tanzania [ 11 ], and selected SSA countries [ 29 ]. The total sample size of the included studies was 11,600, where the smallest sample size was 131 in Ethiopia (Jimma University Medical Center) and the largest sample size was 2,198 in selected SSA countries.…”

“…The total sample size of the included studies was 11,600, where the smallest sample size was 131 in Ethiopia (Jimma University Medical Center) and the largest sample size was 2,198 in selected SSA countries. The overall pooled prevalence of uncontrolled hypertension was obtained from all twenty-six included primary studies [ 1 , 3 , 6 , 7 , 9 – 12 , 14 , 18 , 21 – 26 , 28 , 29 , 31 , 38 – 44 ], while the data regarding the predictors of uncontrolled hypertension were obtained from the twenty-three studies [ 1 , 3 , 6 , 9 – 12 , 14 , 18 , 22 , 24 – 26 , 28 , 29 , 31 , 38 – 44 ] with a response rate ranging from 75.72 to 100% ( Table 1 ).…”

“…Uncontrolled hypertension is defined as if SBP is ≥140mmHg and/or DBP ≥90mmHg for the general hypertensive population or if SBP is ≥130mmHg and/or DBP ≥80mmHg in patients with established diabetes miletus (DM) or chronic kidney disease (CKD) [ 14 , 24 , 25 , 28 , 31 ].…”