Predictors of blood pressure control and antihypertensive drug adherence among hypertensive patients: Hospital-based cross-sectional study

Abstract

Background: Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is a key to controlling blood pressure. Objective: To assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in Selected Public Hospitals under Addis Ababa City Administration. Method: A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected Public Hospitals under the Addis Ababa City Administration from May 1, 2022, to August 31, 2022. The study population was 393 and patients who fulfilled the eligibility criteria were selected by systematic random sampling and the first participant was selected randomly. Data collection was conducted by reviewing the patients electronic medical records and by interviewing patients with a structured questionnaire. Data was entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was done to see the association between the dependent and independent variables. Result: The rate of antihypertensive drug adherence and blood pressure control was 72.5 % and 23.4% respectively. Participants with uncontrolled blood pressure were found to be 41.7% less adherent than those with controlled blood pressure (AOR= 0.59; 95% CI, 0.36-0.97). Non-adherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR=3.85; 95% CI, 1.41-10.52) are associated with good adherence, whereas using single antihypertensive drug (AOR=0.53; 95% CI, 0.30–0.94), and non–adherence to moderate physical exercise (AOR=0.30; 95% CI, 0.20–0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR=1.95; 95% CI, 1.04-3.28) and blood pressure measurement at home (AOR=0.59; 95% CI, 0.36–0.99) were independent predictors of controlled blood pressure. Drinking alcohol (AOR=1.92; 95% CI, 1.05–3.49) is inversely associated with blood pressure control. Conclusion: Despite good adherence to antihypertensive medications, blood pressure control was low. This signifies the importance of lifestyle measures beyond pharmacologic intervention.