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

Introduction 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 from April 1 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 collected data were entered into Epi-info version 7 and analyzed by Statistical Package for Social Science (SPSS) version 26. 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, the statistical significance was declared at a p-value < 0.05. 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: 1.20–9.62), 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.

High burden of non-adherence to blood pressure-lowering medications: meta-analysis of data from over 34,000 adults with hypertension in Sub-Saharan Africa

“…In 21 studies (22.1%), the authors used the proportion of days medication was taken (PDMT ≥ 80%) per week . The next most frequently used tool was the Hill-Bone Compliance Questionnaire (n = 11, 11.6%) (70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80). The pill count method was used in six studies (6.3%) (81)(82)(83)(84)(85)(86), and only one study used biological assays (87).…”