Treatment of hypertension in rural Cambodia: results from a 6-year programme

Abstract

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged X64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI:28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (464 years), uncontrolled DBP (X90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting.

Caseload, management and treatment outcomes of patients with hypertension and/or diabetes mellitus in a primary health care programme in an informal setting

“…; Isaakidis et al . ). While we do not have data to substantiate our speculation, the high rate of LTFU in Kibera is likely to be a reflection of (i) the highly transient population of Kibera and the competing interests of work and survival in such a setting, and (ii) lack of awareness of the disease(s) coupled with lack of adherence to treatment in the long run.…”

“…; Isaakidis et al . ). In these studies, the model of care was based on a specialised HIV/Chronic Diseases clinic model and not on a primary care approach.…”

Patient-centred innovation to ensure access to diabetes care in Cambodia: the case of MoPoTsyo

“…In practice, care outside of the national hospitals in the capital and the provincial hospitals is limited. Some private-not-for-profit hospitals have launched diabetes care projects, but these proved difficult to sustain without external support [ 23 , 24 ]. In urban areas, the private health sector has grown steadily and many small-scale health service providers, especially lower echelon providers, get most of their revenues through selling pharmaceuticals.…”

The prevalence and associated factors for prehypertension and hypertension in Cambodia

“…With recent evidence highlighting the prevalence of hypertension and related metabolic disorders in Cambodia,1 2 attention is now being given to initiating evidence-based prevention and control strategies. A national survey in 2010 revealed that hypertension had an urban prevalence of approximately 16.90%, a rural prevalence of 10.00%, and overall country prevalence of 11.20% among persons aged 25–64 years 3…”