Uncontrolled blood pressure and associated factors in adult hypertensive patients undergoing follow-up at public health facility ambulatory clinics in Bishoftu town, Ethiopia: a multi-center study

Abstract

Background Uncontrolled blood pressure is an important medical and public health problem in developing countries like Ethiopia. Improving the management of hypertension requires a better comprehension of the factors influencing blood pressure control and the application of interventions. But in clinical practice, blood pressure is still not adequately controlled. Thus, this study aimed to assess uncontrolled blood pressure and associated among adult hypertensive patients on follow-up at public health facility ambulatory clinics in Bishoftu, Ethiopia. Methods A hospital-based cross-sectional study was conducted among 398 adult hypertensive patients who were on treatment and follow-up from April to May 31, 2022. Systematic random sampling was used to select study participants. Data were collected using an interviewer-administered, semi-structured questionnaire and chart review. The Eighth Joint National Committee (JNC 8) criteria was applied to define blood pressure control status. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association. Finally, at a p-value < 0.05, statistical significance was proclaimed. Result Of the total study participants, 249(62.6%) were male. The mean age was 62.26 ± 11.55 years. The overall proportion of uncontrolled blood pressure was 58.8% (95% CI: 54–64). Salt intake (AOR = 2.51; 95% CI: 1.49–4.24), lack of physical activity (AOR = 1.40; 95% CI: 1.10–2.62), habitual coffee consumption (AOR = 4.52; 95% CI: 2.67–7.64), higher BMI (AOR = 2.08; 95% CI: 1.24–3.49), and non-adherence to antihypertensive medications (AOR = 2.31; 95% CI: 1.3–3.89) were independent predictors of uncontrolled blood pressure. Conclusion More than half of the hypertensive patients in this study had uncontrolled blood pressure. Healthcare providers and other accountable stakeholders should urge patients to follow salt restriction, physical activity, and antihypertensive medication regimes. Reduced coffee consumption and weight maintenance are other crucial blood pressure control measures.

Prevalence of uncontrolled hypertension and contributing factors in Ethiopia: a systematic review and meta-analysis

“…The AHA/ACC guidelines ( 33 , 34 ), JNC-8 ( 22 , 24 , 25 , 28 , 30 – 32 , 35 – 45 ), and JNC-7 ( 23 , 27 , 29 , 46 , 47 ) were used as assessment tools for 2, 19, and 5 studies, respectively. Eight studies were conducted in the Amhara region ( 22 , 26 , 32 , 33 , 35 , 36 , 45 , 46 ), nine in Oromia ( 24 , 25 , 28 – 31 , 37 , 43 , 47 ), one in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) ( 34 ), four in Addis Ababa ( 39 , 40 , 42 , 44 ), and four in Tigray ( 23 , 27 , 38 , 41 ). In this meta-analysis 9,046 study participants were involved and 4,415 of them were found to have uncontrolled HTN.…”

Uncontrolled hypertension among hypertensive patients in Sub-Saharan Africa: A systematic review and meta-analysis

“…Moreover, patients who were non-adherent to physical activity were 2.13 times more likely to face uncontrolled hypertension than their counterparts [ 6 , 9 , 10 , 18 , 22 , 31 , 41 , 43 ].…”

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“…The twenty-four studies [1,3,6,7,9,11,12,14,18,[21][22][23][24][25][26]28,29,31,[38][39][40][41][42][43] and two studies [10,44] were conducted using cross-sectional and retrospective cohort study designs respectively. Regarding geographical region, nineteen studies were found in Ethiopia [1,3,6,9,10,14,18,21,22,24,26,28,[38][39][40][41][42][43][44], one study in Kenya [23], Nigeria [7], Cameroon [12], Sudan [25], South Africa [31], Tanzania…”

“…The total sample size of the included studies was 11,600, where the smallest sample size was 131 in Ethiopia (Jimma University Medical Center) and the largest sample size was 2,198 in selected SSA countries. The overall pooled prevalence of uncontrolled hypertension was obtained from all twenty-six included primary studies [1,3,6,7,[9][10][11][12]14,18,[21][22][23][24][25][26]28,29,31,[38][39][40][41][42][43][44], while the data regarding the predictors of uncontrolled hypertension were obtained from the twenty-three studies [1,3,6,[9][10][11][12]14,18,22,[24][25][26]28,29,31,[38][39][40][41][42][43]…”

“…The quality of each study was evaluated using the Joanna Briggs Institute (JBI) quality appraisal criteria [45]. Twenty-four studies [1,3,6,7,9,11,12,14,18,[21][22][23][24][25][26]28,29,31,[38][39][40][41][42][43] and two studies [10,44] were assessed using JBI checklist for cross-sectional and cohort studies respectively. Thus, among the twenty-four cross-sectional studies, sixteen studies scored seven of the eight questions, 87.5% (low risk), five studies scored six of the eight questions, 75% (low risk), and the remaining three studies also scored five of the eight questions, 62.5% (low risk).…”