Drug therapy, lifestyle modification and blood pressure control in a primary care facility, south of Johannesburg, South Africa: an audit of hypertension management

Onwukwe, Sergius Chuks; Omole, Olufemi B.

doi:10.1080/20786204.2012.10874196

Cited by 22 publications

(35 citation statements)

References 32 publications

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“…The major finding of this study revealed that about two-thirds of the hypertensive patients on antihypertensive treatment had controlled BP. The level of BP control found in this study (63.6%) was relatively comparable with studies from health care in Chilean (59.7%), 39 in USA at different levels of the health system (60%), 40 South Africa (57%), 41 Bhusal et al in India (58.9%), 5 by Sandoval et al in Chile (63.1%) 27 and by Cordero et al in Spain (55.4%). 10 This close similarity in the level of BP control might be due to similarities in the eligibility criteria for the studies as only hypertensive patients on pharmacologic therapy were included.…”

Section: Discussionsupporting

confidence: 86%

<p>Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia</p>

Fekadu¹,

Adamu²,

Gebre³

et al. 2020

IBPC

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Background: Hypertension is the leading cause of morbidity and mortality among noncommunicable diseases. The rate of blood pressure (BP) control among hypertensive patients is poor and the reasons for poor control of BP remain poorly understood globally. Therefore, this study aimed to assess the magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Nekemte referral hospital (NRH). Methods: A hospital-based cross-sectional study was conducted from February to April 2018 at NRH. BP control status was determined by the average consecutive BP recordings across the 3 months. The data was entered and analyzed using SPSS version 20.0 and p-value <0.05 was considered statistically significant. Results: Out of 297 study participants included, the majority were females, 181 (60.9%), and the mean age of the patients was 59.4 ±10.4 years. About half, 137 (46.12%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin-converting enzyme inhibitors (88.2%). The mean of systolic blood pressure was 132.41± 15.61mmHg, while the mean of diastolic blood pressure was 84.37± 9.32 mmHg. The proportion of participants with optimally controlled BP was 63.6% and 36% were adherent to their medications. Male sex (Adjusted Odd Ratio [AOR]: 1.89, 95% CI: 1.09-4.84), illiteracy (AOR= 1.56, 95% CI: 1.22-6.78), duration of hypertension diagnosis > 10 years (AOR= 2.01, 95% CI: 1.04-16.11), non-adherence (AOR= 3.14, 95% CI: 1.35-10.76) and lack of physical exercise (AOR= 2.8, 95% CI: 1.16-6.74) were positively associated with uncontrolled BP status. Whereas age older than 55 years (AOR= 0.38, 95% CI: 0.11-0.92) was negatively associated with uncontrolled BP. Conclusion: BP control was relatively achieved in about two-third of pharmacologically treated patients. We recommend better health education and care of patients to improve the rate of BP control status.

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Section: Discussionsupporting

confidence: 86%

<p>Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia</p>

Fekadu¹,

Adamu²,

Gebre³

et al. 2020

IBPC

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“…Antihypertensive medication utilization pattern in this study was more of similar with a study conducted in South Africa (24) . However, a study conducted in Chile (20) and USA (25) used ACEI more often than diuretics.…”

Section: Discussionsupporting

confidence: 86%

“…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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“…But this study was lower than with a study conducted in Oman in (2011) (61%) (14), in South Africa in (2012) (58%) (15), in Nigeria in (2013) (65%) (16) and Zimbabwe in (2012) (67.2%) (9). This variation might be due to discrepancies in lifestyle behaviours such as feeding habits that bring hypertension to be difficult to control.…”

Section: Discussioncontrasting

confidence: 61%

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

Negash

Siyoum

Hailemariam

et al. 2019

Preprint

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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.

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Drug therapy, lifestyle modification and blood pressure control in a primary care facility, south of Johannesburg, South Africa: an audit of hypertension management

Cited by 22 publications

References 32 publications

<p>Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia</p>

<p>Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia</p>

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

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

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