Uncontrolled hypertension in Ethiopia: a systematic review and meta-analysis of institution-based observational studies

Amare, Firehiwot; Hagos, Bisrat; Sisay, Mekonnen; Molla, B.

doi:10.1186/s12872-020-01414-3

Cited by 35 publications

(44 citation statements)

References 36 publications

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“… 7 – 10 Unfortunately, the majority of patients’ BP was poorly controlled in most health care settings, especially in countries with minimal resources. 7 , 9 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study

2021

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Introduction: Despite the fact that the goals for the management of hypertension are well-defined and effective therapies are available, control of hypertension remains poor in countries with low resources including Ethiopia. This study aimed to determine blood pressure control rate and its determinants among ambulatory adult hypertensive patients at Jimma University Medical Center. Methods: A general prospective cohort study was conducted among adult hypertensive patients who had regular follow-up at Jimma University Cardiac Clinic from 20 March to 20 June 2018. Hypertensive patients who fulfilled the inclusion criteria were selected in the first month of the data collection period. Then, only those patients who visited the clinic at the first month were consequently followed-up for the next 3 months. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Patients’ specific data were collected using a structured data collection tool. Data were analyzed using the statistical software package SPSS version 21.0. Bivariate and multivariable logistic regression analysis was used to identify independent variables influencing blood pressure control. p-values of less than 0.05 were considered statistically significant. Results: From a total of 416 patients, 237 (57.0%) were male with a mean age of 56.50 ± 11.96 years. Two hundred and fifty eight (62.0%) participants had comorbid conditions and 275 (66.1%) were on combination therapy. The rate of blood pressure control was 42.8%. Age ⩾60 years was negatively associated with uncontrolled blood pressure (adjusted odd ratio = 0.52, confidence interval = 0.31–0.88, p = 0.015). Medication non-adherence (adjusted odd ratio = 1.64, confidence interval = 1.04–2.58, p = 0.034) and non-adherence to international guidelines (adjusted odd ratio = 2.33, confidence interval = 1.49–3.64, p < 0001) were positively associated with uncontrolled blood pressure. Conclusion: The rate of blood pressure control among hypertensive patients was suboptimal. Age, clinicians’ non-adherence to international guidelines, and patients’ non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.

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“… 7 – 10 Unfortunately, the majority of patients’ BP was poorly controlled in most health care settings, especially in countries with minimal resources. 7 , 9 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study

2021

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“…In Ethiopia, the result of a systematic review and meta-analysis showed that 48% of patients had controlled blood pressure. 16 However, the magnitude of uncontrolled hypertension showed wide variations ranging from 11% 17 to 70% 18 in individual studies.…”

Section: Introductionmentioning

confidence: 99%

Self-care practice and associated factors among hypertensive patients in public health facilities in Harar Town, Eastern Ethiopia: A cross-sectional study

et al. 2020

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Background: Self-care practice is the activity that a hypertensive patient undertakes intending to improve their health. Poor self-care practice leads to uncontrolled hypertension. Therefore, strategies designed to prevent and control hypertension-related death, disability, and morbidity should consider the level of the patient’s self-care practice and risk factors. This study assessed self-care practice and associated factors among hypertensive patients in public health facilities of Harar Town in eastern Ethiopia. Method: An institution-based cross-sectional study was conducted among 398 randomly selected hypertensive patients from 25 March 2019 to 16 April 2019. Pretested structured questionnaires adapted from validated tools were used to collect data from participants using electronic Open Data Kit software through face-to-face exit interview. Data were analyzed by SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with self-care practice. Adjusted odds ratio with 95% confidence interval was used to report association and the significance was declared at p-value < 0.05. Results: Level of good self-care practice was 29.9% (95% confidence interval: 25.3% and 34.7%). Age ⩾ 60 years (adjusted odds ratio = 3.4, 95% confidence interval: 1.2 and 9.3), formal education (adjusted odds ratio = 2.3, 95% confidence interval: 1.3 and 4.2), absence of comorbidities (adjusted odds ratio = 1.8, 95% confidence interval: 1.1 and 3.1), adequate knowledge about hypertension (adjusted odds ratio = 4.7, 95% confidence interval: 2.5 and 8.8), good social support (adjusted odds ratio = 2.7, 95% confidence interval: 1.6 and 4.7), and being khat abstainer (adjusted odds ratio = 1.9, 95% confidence interval: 1.1 and 3.5) were significantly associated with good self-care practice. Conclusion: The prevalence of good self-care practice was low. In this study, good self-care practice was significantly associated with age, formal education, comorbidities, knowledge about hypertension, social support, and current khat chewing condition. Regular check-up and follow-up of patients’ compliance with self-management protocol, and more emphasis should be given to identify factors that potentially impeding patients’ adherence to hypertension self-management protocol.

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“…Diverging from the results obtained, the metanalysis of Amare et al in Ethiopia found a prevalence of uncontrolled hypertension among hypertensive patients undergoing treatment of 48% [2].…”

Section: Discussionmentioning

confidence: 96%

Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day

Cestário

Santim

Alves

et al. 2022

EJMED

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Hypertension affects 1.4 billion of the world population, being considered the main cause of cardiovascular diseases and, therefore, an important cause of premature and preventable mortality worldwide. It is associated with complications such as atherosclerotic coronary artery disease, congestive heart failure, stroke, intracerebral hemorrhage, and chronic kidney disease. Given this prevalence and risk, strategies were created to control the disease, such as changes in lifestyle and use of medications. However, non-adherence to treatment is a frequent concern and it is associated with adverse results and an increased number of complications. Therefore, the present study aims to present the incidence of arterial hypertension in the population of a city in the inland part of São Paulo, relating it to its risk factors, adherence to treatment and disease control. The objective is evaluating the incidence and rate of uncontrolled systemic arterial hypertension on a campaign day in a city in the inland part of São Paulo. The method is observational, cross-sectional, descriptive, population-based study, random sample of 545 individuals, 231 women and 314 men, collected in a city in the northwest of São Paulo on a campaign day. The study showed a prevalence of 46.24% for hypertensive patients, with 88.9% adherence to treatment and pressure loss of 34.23%. Among the analyzed hypertensive patients, there was a higher incidence among the elderly, obese, and people with diabetes mellitus. Regarding adherence and disease control, better results were noted among patients with complications such as AMI and thrombotic events, and less adherence among obese, alcoholics and smokers. The results of the present study are consistent with literature data, showing that even with knowledge of the disease, part of the population does not have adequate treatment, showing the need for integrated health policies for early diagnosis, distribution and treatment regulation, and actions to improve lifestyle.

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Uncontrolled hypertension in Ethiopia: a systematic review and meta-analysis of institution-based observational studies

Cited by 35 publications

References 36 publications

Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study

Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study

Self-care practice and associated factors among hypertensive patients in public health facilities in Harar Town, Eastern Ethiopia: A cross-sectional study

Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day

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