FACTORS AFFECTING BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS VISITING A TERTIARY CARE HOSPITAL IN KHYBER PAKHTUNKHWA
Article Sidebar
Main Article Content
Abstract
OBJECTIVE: To determine the factors affecting blood pressure (BP) control in adult hypertensive patients.
METHODS: A total of 246 adult hypertensive patients of both genders, age 20 years and above were included in this descriptive study conducted at the Department of Medicine, Lady Reading Hospital, Peshawar from May 2019 to September 2019. Statistical analysis of the data was done with SPPS version 21; Chi-square (χ2) test was applied using crosstab/correlation for the association of factors affecting the control of BP in patients with hypertension. P-value≤0.05 was considered statistically significant.
RESULTS: Out of 246 patients, 64 (26%) were males, and 182 (74%) were females. The mean age of patients was 56.09±10.33 years. Overall, BP was controlled in 74 (30.1%) and uncontrolled in 172 (69.9%) patients. Among the total, 107 (43.5%) patients were adherent and 139 (56.5%) were non-adherent to medications. Among the 107 adherent patients, 72 (67.3%) had controlled BP and 35 (32.7%) were uncontrolled. Among the 139 non-adherents, 134 (96.4%) had uncontrolled BP and 05 (3.6%) had controlled BP (p=0.000). Economically, 10.5% (n=4/38) of the ‘poor’ and 33.7% (n=70/208) of the ‘satisfactory’ patients had controlled BP whereas 89.5% (n=34/38) and 66.3% (n=138/208) had uncontrolled BP respectively (p=0.004). Age, gender, education level, duration, comorbidity, and a class of antihypertensive drugs did not affect the control of BP significantly (p>0.05).
CONCLUSION: Overall, one-third of the study participants had controlled BP and two-thirds of the adherents had controlled BP. Good adherence to medications and economic status significantly correlated with the control of hypertension.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population based measurement studies with 19.1 million participants. Lancet 2017;389(10064):37-55. https://doi.org/10.1016/s0140-6736(16)31919-5
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global Disparities of hypertension Prevalence and control: a systematic analysis of Population-Based studies From 90 countries. Circulation 2016;134(6):441-50. https://doi.org/10.1161/circulationaha.115.018912
Bloch MJ. Worldwide prevalence of hypertension exceeds 1.3 billion. J Am Soc Hypertens 2016;10(10):753-4. https://doi.org/10.1016/j.jash.2016.08.006
Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. PURE (Prospective Urban Rural Epidemiology) Study investigators. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013;310(9):959-68. https://doi.org/10.1001/jama.2013.184182
Burnier M, Egan BM. Adherence in Hypertension: A Review of Prevalence, Risk Factors, Impact, and Management. Circ Res 2019;124(7):1124-40. https://doi.org/10.1161/circresaha.118.313220
Shafi ST, Shafi T. A survey of hypertension prevalence, awareness, treatment, and control in health screening camps of rural central Punjab, Pakistan. J Epidemiol Glob Health 2017;7(2):135-40. https://doi.org/10.1016/j.jegh.2017.01.001
Jafar TH, Gandhi M, Jehan I, Naheed A, de Silva HA, Shahab H, et al. Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka. Am J Hypertens 2018;31(11):1205-14. https://doi.org/10.1093/ajh/hpy071
Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016;387(10022):957-67. https://doi.org/10.1016/s0140-6736(15)01225-8
Akhtar Y, Afridi MAR, Rahman Z, Ali Z. Assessment of drug compliance among hypertensive patients. J Postgrad Med Inst 2019;33(4):286-92.
Singh S, Shankar R, Singh GP. Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. Int J Hypertens 2017;2017:5491838. https://doi.org/10.1155/2017/5491838
Dastan I, Erem A, Cetinkaya V. Awareness, treatment, control of hypertension, and associated factors: Results from a Turkish national study. Clin Exp Hypertens.2018;40(1): 90-8. https://doi.org/10.1080/10641963.2017.1334797
Khader Y , Batieha A , Jaddou H, Rawashdeh SI, El-Khateeb M, Hyassat D, et al. Hypertension in Jordan: Prevalence, Awareness, Control, and Its Associated Factors. Int J Hypertens 2019;2019:3210617. https://doi.org/10.1155/2019/3210617
Yusufali AM, Khatib R, Islam S, Alhabib KF, Bahonar A, Swidan HM, et al. Prevalence, awareness, treatment and control of hypertension in four Middle East countries. J Hypertens 2017;35(7):1457-64. https://doi.org/10.1097/hjh.0000000000001326
Horsa BA, Tadesse Y, Engidawork E. Assessment of hypertension control and factors associated with the control among hypertensive patients attending at Zewditu Memorial Hospital: a cross sectional study. BMC Res Notes 2019;12(1):152. https://doi.org/10.1186/s13104-019-4173-8
Sarfo FS, Mobula LM, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O, et al. Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital based study. PLoS ONE 2018;13(3):e0193494. https://doi.org/10.1371/journal.pone.0193494
Peters SAE, Muntner P, Woodward M. Sex Differences in the Prevalence of, and Trends in, Cardiovascular Risk Factors, Treatment, and Control in the United States, 2001 to 2016. Circulation 2019;139(8):1025-35. https://doi.org/10.1161/circulationaha.118.035550
Knight EL, Bohn RL, Wang PS, Glynn RJ, Mogun H, Avorn J. Predictors of Uncontrolled Hypertension in Ambulatory Patients. Hypertension 2001;38(14):809-14. https://doi.org/10.1161/hy0901.091681
Yan XF, Yang JW, Bai XK, Wang HR, Feng F, Hou LL, et al. [Awareness, treatment and control of hypertension among 640,000 adults in East China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41(01):68-73. https://doi.org/10.3760/cma.j.issn.0254-6450.2020.01.013
Liu X, Gu W, Li Z, Lei H, Li G, Huang W. Hypertension prevalence, awareness, treatment, control, and associated factors in Southwest China: an update. J Hypertens 2017;35(3):637-44. https://doi.org/10.1097/hjh.0000000000001203
Hien HA , Tam NM, Tam V, Derese A, Devroey D. Prevalence, Awareness, Treatment, and Control of Hypertension and Its Risk Factors in (Central) Vietnam. Int J Hypertens 2018;2018:6326984. https://doi.org/10.1155/2018/6326984
Khanal MK, Dhungana RR, Bhandari P, Gurung Y, Paudel KN. Prevalence, associated factors, awareness, treatment, and control of hypertension: Findings from across sectional study conducted as a part of a community based intervention trial in Surkhet, Mid-western region of Nepal. PLoS ONE 2017;12(10):e0185806. https://doi.org/10.1371/journal.pone.0185806
Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord 2013;13:54. https://doi.org/10.1186/1471-2261-13-54
Sakboonyarat B, Rangsin R, Kantiwong A, Mungthin M. Prevalence and associated factors of uncontrolled hypertension among hypertensive patients: a nation-wide survey in Thailand. BMC Res Notes 2019:12(1):380. https://doi.org/10.1186/s13104-019-4417-7
Esposti ED, Martino MD, Sturani A, Russo P, Dradi C, Falcinelli S, et al. Risk factors for uncontrolled hypertension in Italy. J Hum Hypertens 2004;18(3):207–13. https://doi.org/10.1038/sj.jhh.1001656
Al-Qahtani AM. Prevalence and Determinants of Blood Pressure Control among Hypertensive Patients in Primary Care Centers, Najran, Saudi Arabia. Biomed Pharmacol J 2018;11(2):821-5. https://dx.doi.org/10.13005/bpj/1437