Factors associated with blood pressure control among patients attending the outpatient clinic of a South African district hospital

Abstract

Objective

To determine the prevalence and factors associated with blood pressure (BP) control.

Methods

In a cross-sectional study involving 251 consecutively-sampled patients, a semi-structured questionnaire collected information on socio-demography, co-morbidities, hypertension treatments and BP control. Data analysis included descriptive statistics and logistic regression.

Results

Most participants were: on treatment for >5 years (60.6%); on three or more drugs (93.6%); treated according to guidelines (77%); and reported not missing medications in the last week (86.5%). BP control was achieved in only 31.5% and 16.7% of participants at the current and last visits, respectively. In multivariate regression analysis, a history of myocardial infarction (odd ratio [OR] = 0.41; P = 0.04) and being divorced/widowed (OR = 3.1; P = 0.01) predicted poor BP control.

Conclusion

This study confirms the prevalent sub-optimal control of BP and suggests the need for further studies to examine the relationship between marital support, critical medical events and BP control.

Keywords

Africa location treatment cardiovascular physiology disease control disease

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References

World Health Organization. A global brief on hypertension. Silent killer, global public health crisis, Geneva: WHO, 2013. Available at: http://apps.who.int/bitstream/10665/790591/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1 (accessed 12 April 2014).

Peltzer

Phaswana-Mafuya

. Hypertension and associated factors in older adults in South Africa. Cardiovasc J Afr 2013; 24: 67–71.

Gaziano

Reddy

Paccaud

Horton

Cardiovascular disease. In: Jamison

Breman

Measham

Alleyne

Claeson

Evans

(eds). Disease control priorities in developing countries, 2nd edn. New York: Oxford University Press/World Bank, 2006, pp. 645–662.

Department of Health, Medical Research Council, OrcMacro. South Africa Demography and Health Survey 2003, Pretoria: Department of Health, 2007. Available at: http://www.mrc.ac.za/bod/sadhs2003part1.pdf (accessed 9 March 2011).

Ker

. Essential hypertension. CME 2006; 24: 176–182.

Trilling

Froom

. The urgent need to improve hypertension care. Arch Fam Med 2000; 9: 794–801.

Agyemang

Bruijnzeels

Owusu-Dabo

. Factors associated with hypertension awareness, treatment, and control in Ghana, West Africa. J Hum Hypertens 2006; 20: 67–71.

Seedat

. Hypertension in developing nations in sub-Saharan Africa. J Hum Hypertens 2000; 14: 739–747.

Peer

Steyn

Dennison

Levitt

Nyo

Nel

. Determinants of target organ damage in black hypertensive patients attending primary health care services in Cape Town: the Hi-Hi study. Am J Hypertens 2008; 21: 896–902.

10.

Peer

Steyn

Lombard

Gwebushe

Levitt

. A high burden of hypertension in the urban black population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study. PloS One 2013; 8: e78567–e78567.

11.

Onwukwe

Omole

. Drug therapy, life style modification and blood pressure control in a primary care facility, south of Johannesburg: an audit of hypertension management. S Afr Fam Pract J 2012; 54: 156–161.

12.

Lloyd-Sherlock

Beard

Minicuci

Ebrahim

Chatterji

. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control. Int J Epidemiol 2014; 43: 116–128.

13.

Garson D. Factor analysis. Available at: http://www2.chass.ncsu.edu/garson/pa765/factor.spv. (accessed 5 April 2014).

14.

Seedat

Croasdale

Milne

Opie

Pinkney-Atkinson

Rayner

. South African hypertension guideline 2006. S Afr Med J 2006; 96: 337–362.

15.

Chobanian

Bakris

Black

Cushman

Green

Izzo

Jr . Seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–2572.

16.

Rayner

. Hypertension: Detection and management in South Africa. Nephron Clin Pract 2010; 116: c269–c273.

17.

Mayosi

Flisher

Lalloo

Sitas

Tollman

Bradshaw

. The burden of non-communicable diseases in South Africa. Lancet 2009; 374: 934–947.

18.

Zhou

Nie

Dai

Wang

Fan

. Sex differences in stroke case fatality: a meta-analysis. Acta Neuro Scand 2013; 128: 1–8.

19.

Mkhonto

Labadarios

Mabaso

. Association of body weight and physical activity with blood pressure in a rural population in the Dikgale village of Limpopo Province in South Africa. BMC Res Notes 2012; 5: 118–118.