Hypertension screening, prevalence, treatment, and control at a large private hospital in Kampala, Uganda: A retrospective analysis

Abstract

Adult hypertension prevalence in Uganda is 27%, but only 8% are aware of their diagnosis, accordingly treatment and control levels are limited. The private sector provides at least half of care nationwide, but little is known about its effectiveness in hypertension control. We analyzed clinical data from 39 235 outpatient visits among 17 777 adult patients from July 2017 to August 2018 at Uganda’s largest private hospital. We calculated blood pressure screening rate at every visit, and hypertension prevalence, medication treatment, and control rates among the 5 090 patients with two or more blood pressure checks who received any medications from the hospital’s pharmacy. We defined hypertension in this group as 1) an average of two blood pressure measurements at separate consecutive visits, higher than 140 mm Hg systolic or 90 mm Hg diastolic, 2) receipt of any antihypertensive medication, or 3) the use of a hypertension electronic medical record code. We deemed hypertension control as normotensive at the most recent check. 12 821 (72.1%) of patients received at least 1 blood pressure check. Among the 5 090 patients above, 2 121 (41.6%) had hypertension (33.4% age-standardized to a world population standard): 1 915 (37.6%) with elevated blood pressure, and 170 (3.3%) were normotensive but receiving medication. 838 (39.4%) of patients with hypertension received medication at least once. Overall, 18.3% of patients achieved control (27% of treated patients, and 15% of untreated patients). Hypertension is common and incompletely controlled in this Ugandan private-sector population, suggesting several avenues for novel interventions.

Undiagnosed Hypertension Among Market Salespersons in Kitgum Central Market, Northern Uganda

“… 2 However, our findings is not in agreement with a study done in Uganda which found a prevalence of hypertension of 27% and only 8% were aware of their diagnosis. 11 A national survey in Uganda found that only 7.7% of the people with hypertension were aware of their blood pressure status. 12 This difference might have been due to the differences in the study populations and the study design as our study was a cross sectional, but the study done by Majumdar and the team was retrospective, while the study by Gawattude and his team was a nationwide survey, while our study only investigated market salesperson.…”

The epidemiology of behavioral risk factors for noncommunicable disease and hypertension: A cross-sectional study from Eastern Uganda

“…These baseline survey findings were pivotal in providing the key benchmarks to track NCD risk factors in the Ugandan population and informed the design of national-level NCD policy guidelines to address key NCD risk factors, including the importance of creating more public awareness about the NCDs and their risk factors [9,10]. Additional studies have described the barriers to hypertension prevention and management in rural settings, emphasized the need to increase the monitoring and screening of NCD risk factors at community levels through village health teams, and underscored broader access to essential NCD medicines, particularly in rural areas [11][12][13]. However, there have been a limited number of studies that examined the prevalence of hypertension and NCD risk factors together, along with factors associated with hypertension.…”

May Measurement Month 2021: an analysis of blood pressure screening results from Uganda

“… 2 Overall, 18.3% of patients achieved control. 3 Strategies are therefore needed to increase the prevention, detection, awareness, treatment, and control of hypertension in sub–Saharan Africa in general and in Uganda in particular. The WHO has set the following recommendations: to address population prevalence and control of hypertension through reducing modifiable risk factors, improving and expanding identification and treatment of people with hypertension, treatment intensification for patients whose BP is not controlled, ensuring access to medicines, tracking BP control rates in clinical settings, and measuring population prevalence.…”