Physician Factors Associated with the Blood Pressure Control among Hypertensive Patients

Abstract Background Hypertension is an important worldwide public-health challenge because of its high prevalence and for being a risk factor for cerebrovascular, cardiovascular and chronic renal disease. Despite these risk factors, blood pressure control among hypertensive patients is still poor. Objectives To assess dietary and lifestyle factors associated with uncontrolled blood pressure control among a series of Ugandan hypertensive patients under care at a Kiruddu hospital.Methods A cross sectional study involving 271 adult hypertensive patients attending general outpatient hypertensive clinic were enrolled. We collected data on dietary and lifestyle factors, social demographics, BMI, comorbidities, and adherence to hypertensive medication. Dietary factors were based on recommended DASH diet including nine food items salt; grains; fruits; vegetables; nut/seeds, and legumes; dairy; meat; fat; and sweets. Questionnaires on alcohol intake, smoking status and level of physical activity were also administered. An average of the previous two Blood pressure readings were recorded while weight and height were measured for each subject at enrolment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model.Results The mean age of study participants was 57 years (SD ± 0.76 years), with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption (less than 7days/week): 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21).Conclusion The proportion of hypertensive patients with uncontrolled BP was high (44.7%). Consumption of raw salt, inadequate fruit consumption being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, many of the factors that impact on the control of blood pressure are fortunately modifiable.

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ASSOCIATION OF DIETARY AND LIFESTYLE FACTORS ON BLOOD PRESSURE CONTROL AMONG ADULT HYPERTENSIVE PATIENTS ATTENDING A UGANDAN TERTIARY HOSPITAL

African Journal of Health, Safety and Environment ◽

10.52417/ajhse.v2i2.173 ◽

2021 ◽

Vol 2 (2) ◽

pp. 103-114

Author(s):

A. P. Nakalega ◽

L. Mugenyi ◽

L. Nuwabaine ◽

M. Amperiize ◽

K. B. Tabusibwa

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Lifestyle Factors ◽

Poor Adherence ◽

Fruit Consumption ◽

Uncontrolled Blood Pressure ◽

Hypertensive Patients ◽

Factors Associated ◽

Study Participants

Hypertension is an important worldwide public-health challenge due to its high prevalence and being a risk factor for cerebrovascular, cardiovascular, and chronic renal diseases. Despite these risk factors, blood pressure control among hypertensive patients is still poor. The main objective was to assess dietary and lifestyle factors associated with uncontrolled blood pressure control among Ugandan hypertensive patients at Kiruddu hospital. Materials and methods: A cross-sectional study involving 271 adult hypertensive patients attending the outpatient hypertensive clinic was enrolled. Data were obtained on dietary, lifestyle factors (alcohol intake, smoking status, and level of physical activity), social demographics, Body Mass Index (BMI), comorbidities, and adherence to hypertensive medication. An average of the current and previous two Blood pressure readings was recorded. Factors associated with uncontrolled blood pressure were assessed using a multivariate logistic regression model. Results: The mean age of study participants was 57 ± 0.76 years, with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that were associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption: 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21). Conclusion: The proportion of hypertensive patients with uncontrolled Blood Pressure was high (44.7%). Consumption of raw salt, inadequate fruit consumption, being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, factors that were associated with the control of blood pressure are modifiable.

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Abstract 426: Factors Associated With Multimorbidity And Its Link With Poor Blood Pressure Control Among 223,286 Hypertensive Patients

Hypertension ◽

10.1161/hyp.64.suppl_1.426 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Martin C Wong ◽

Harry H Wang ◽

Mandy W Kwan ◽

Clement S Cheung ◽

Ellen L Tong ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Clinical Care ◽

Antihypertensive Agents ◽

Pressure Control ◽

Multinomial Regression ◽

Hypertensive Patients ◽

Factors Associated ◽

Poor Blood Pressure Control ◽

Male Patients

Background: Multimorbidity, defined as the presence of ≥ 2 chronic disorders, has become the norm in many countries as populations age. It remains, however, very infrequently researched. This study evaluated the factors associated with multimorbidity in a predominantly Chinese hypertensive population. Methods: We included all adult patients prescribed their first antihypertensive agents in the public sector of the entire Hong Kong population from a validated clinical database. Multinomial regression analyses were performed to explore factors independently associated with multimorbidity. Results: 223,286 hypertensive patients (average age of 59.9 years, SD 17.6) were included. The prevalence of having 0, 1 and ≥2 additional chronic conditions was 59.6% [133,176/223,286], 32.8% [73,313/223,286] and 7.5% [16,797/223,286], respectively. Older age (>50 years), male sex, lower household income, receipt of comprehensive social security allowance and suboptimal blood pressure control (>140mmHg or >90mmHg; >130mmHg or >80mmHg for diabetes patients; AOR=3.38 to 4.49) were significantly associated with the presence of ≥2 additional conditions. There exists a synergistic effect among these variables as older (≥70 years), male patients receiving security allowance had substantially higher prevalence of ≥2 multimorbidity (19.9% vs 7.5% among all patients). Conclusions: Multimorbidity is very common in hypertensive patients and its prevalence increased markedly with the presence of risk factors identified in this study. Hypertensive patients with multimorbidities should receive more meticulous clinical care as their blood pressure control tends to be poorer.

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