scholarly journals Adherence to drug therapy among hypertensive patients attending two district hospitals in Ghana

2020 ◽  
Vol 20 (3) ◽  
pp. 1355-1367
Author(s):  
Emmanuel Sarkodie ◽  
Daniel Kwame Afriyie ◽  
Araba Hutton-Nyameaye ◽  
Seth Kwabena Amponsah
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Antihypertensive Medications ◽  
Major Drawback ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Medical Practitioners ◽  
District Hospitals ◽  
Predictors Of Adherence

Background: A major drawback to the management of hypertension among patients is poor adherence to pharmacother- apy. Factors that influence non-adherence to antihypertensive drugs could vary, depending on the prevailing condition of patient and setting. Knowledge of adherence patterns and behavior of hypertensive patients to pharmacotherapy could improve health-directed policies towards hypertension management. Objective: The objective of this study was to determine factors that influence adherence to oral antihypertensive drugs among patients attending two district hospitals in the Volta Region of Ghana. Methods: The study was cross-sectional. Respondents were hypertensive patients attending Krachi West District (n=187) and Hohoe Municipal (n=183) hospitals between March 2016 to May 2016. Data was collected using a structured question- naire and Morisky 8 Item Measurement of adherence scale. Results: Adherence to oral antihypertensive drugs was 89.2%. However, more than half of these respondents appeared to have uncontrolled blood pressure; and this may be due to self-response bias, blood pressure being measured only on the day of the interview or use of fake drugs (which was not assessed in this study). The strongest predictors of adherence were; knowledge on hypertension, perception of severity of condition and the amount of alcohol consumed in a day by respondents. Conclusion: Good adherence to oral antihypertensive drugs was observed in this population despite uncontrolled hyper- tension in a number of the respondents. The three independent predictors of adherence to antihypertensive medications in this study were respondent’s knowledge about hypertension, perception of severity of their condition and the amount of alcohol consumed in a day. Regular patient education and counseling by medical practitioners should be encouraged in these settings to improve patient adherence. Keywords: Adherence; antihypertensive drug; hypertension; Ghana.

scholarly journals A comparative study on the adherence to anti-hypertensive medications in urban and rural areas of Hubballi

2019 ◽  
Vol 6 (4) ◽  
pp. 1701 ◽  
Author(s):  
Pratibha Rao Katapadi ◽  
Dattatreya D. Bant
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Rural Population ◽  
Antihypertensive Drugs ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Public Health Issue ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients

Background: Hypertension is a significant public health issue worldwide and can have deleterious effects on the health when it is not under control. Adherence to antihypertensive medications is thus necessary for better control of blood pressure and to reduce the risk of complications. There are various factors which support or hinder the patient’s adherence to anti- hypertensive treatment. Thus this study was done to reflect the factors influencing the adherence to antihypertensive drugs among urban and rural population.Methods: A community based cross sectional study was conducted in urban and rural field practice areas of Karnataka Institute of Medical Sciences, Hubballi. A semi-structured questionnaire was used for data collection among the known hypertensive patients. The data was entered in Microsoft Excel and analysed using SPSS software.Results: Most of the hypertensive patients were aged 45 and above (89.5%). A total of 73.5% of the participants were adherent to antihypertensive medications and adherence was more among urban (76%) as compared to rural population (71%). Knowledge regarding complications of uncontrolled hypertension was the major factor for adherence in both the areas. The mean systolic and diastolic blood pressure was controlled in patients who were adherent.Conclusions: There is a higher level of adherence to antihypertensive medications in urban population as compared to rural population of Hubballi. The findings suggest patient factors, clinical factors and socio-demographic factors play an important role in determining the adherence to the medication.

scholarly journals Non-Adherence Related Factors to Antihypertensive Medications Among Hypertensive Patients on Follow up at Nedjo General Hospital in West Ethiopia

2018 ◽  
Vol 11 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Habtamu Dame Berisa ◽  
Mohammed Gebre Dedefo
Keyword(s):  
General Hospital ◽  
Patient Adherence ◽  
Antihypertensive Medications ◽  
Related Factors ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Income Status ◽  
Cardiovascular Morbidity And Mortality ◽  
Study Participants

Background:Hypertension is an overwhelming global challenge. Increasing awareness and diagnosis of hypertension, and improving control of blood pressure with appropriate treatment are considered critical public health initiatives to reduce cardiovascular morbidity and mortality.Objective:To assess non-adherence-related factors to antihypertensive medications among hypertensive patients on follow up at Nedjo General Hospital.Methods:A cross-sectional study was conducted among hypertensive patients on follow up at Nedjo General Hospital from March 15 to May 5, 2015. A total of 172 hypertensive patients who were available during study period were included in the study. To identify the independent non-adherence-related factors, backward logistic regression analysis was used.Results:Only 54 (31.4%) of the study participants were adherent to their treatment. On multivariable logistic analysis non-adherence was more likely to occur among those with age of>55 years (Adjusted odds ratio (AOR) = 0.10, 95% CI = 0.01-0.85, p=0.035), illiteracy (AOR = 6.76, 95% CI = 1.01-45.08, p=0.049), income status of <500 Ethiopian birr (AOR = 18.51, 95% CI = 1.95-176.06, p=0.011), duration of treatments of>5 years (AOR = 5.41, 95% CI = 1.08-27.22, p=0.041), physical inactivity (AOR = 34.51, 95% CI = 4.66-255.89, p=0.001) and knowledge deficit about hypertension and its treatment (AOR = 7.67, 95% CI = 2.48-23.73, p<0.001).Conclusion:A finding of this study revealed that an adherence status of study participants was low. Thus, greater effort is needed to improve patient adherence to antihypertensive medications.

scholarly journals Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Daniela Sandoval ◽  
Miguel Bravo ◽  
Elard Koch ◽  
Sebastián Gatica ◽  
Ivonne Ahlers ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Health Program ◽  
Cardiovascular Health ◽  
Pressure Control ◽  
Diabetic Patients ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Primary Health Care Centers

Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs) in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP).Design. A cross-sectional and multicenter study.Setting. 52 primary care centers, metropolitan area of Santiago, Chile.Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients.Key Measurements. Demographic information, blood pressure (BP) measurements, and CVRF were extracted from medical records of patients followed for a 12-month period.Results. 59.7% of patients reached target BP<140/90 mmHg. More women were captured in the sampling (2.1 : 1), achieving better BP control than men. Diabetic patients (26.4%) had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control.Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics.

scholarly journals Amlodipine-Induced Pedal Edema and Its Relation to Other Variables in Patients at a Tertiary Level Hospital of Kathmandu, Nepal

2018 ◽  
Vol 35 (2) ◽  
pp. 51-55
Author(s):  
Sitaram Khadka ◽  
Rinku Joshi ◽  
Dhan Bahadur Shrestha ◽  
Drishti Shah ◽  
Niroj Bhandari ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Dose Combination ◽  
Pedal Edema

Background: Vasodilatory edema is a frequently encountered side effect among hypertensive patients using antihypertensive drugs. This dose-dependent adverse effect is seen more commonly with amlodipine, so low-dose combination therapy is often used and preferred in practice. Pedal edema following use of amlodipine is scarcely studied in Nepalese population so far. Objectives: To find out the prevalence of amlodipine-associated pedal edema and its relation with other variables among patients presenting to a tertiary care center of Kathmandu, Nepal. Methods: A prospective cross-sectional study was conducted among hypertensive patients using amlodipine in combination with or without other antihypertensive medications under regular follow-up in an outpatient department of internal medicine of Shree Birendra Hospital, Kathmandu, Nepal, during the 7-month period from September 2017 to March 2018. The prevalence of pedal edema and its relation with amlodipine dose, duration, and other factors were studied using χ2 test and logistic regression using SPSS version 22. Results: A total of 505 patients were observed during the study period, with the mean age of the population being 61.5 ± 13.4 years. Among the cases studied, edema was present in 79 (15.6%) cases. Use of amlodipine longer than 5 years was 21.65 (confidence interval [CI] = 9.575-48.970, P ˂ .001) times more likely to exhibit pedal edema; similarly, there was 2.149 (CI = 1.209-3.820, P = .009) times higher risk of having pedal edema in hypertensive individuals with other comorbidities. Increasing the dose of amlodipine has increased the likelihood of having pedal edema, but it is not statistically significant (odds ratio = 2.804, CI = 0.423-18.584, P = .285). Conclusion and Relevance: Significant number of hypertensive patients using amlodipine developed pedal edema. Likelihood of vasodilatory edema increases with the presence of comorbidities, higher dose, along with longer duration of amlodipine use.

scholarly journals Modification of Platelet Count on the Association between Homocysteine and Blood Pressure: A Moderation Analysis in Chinese Hypertensive Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jianan Zhang ◽  
Jing Li ◽  
Shi Chen ◽  
Linglin Gao ◽  
Xiaoluan Yan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Platelet Count ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Serum Homocysteine ◽  
Low Platelet Count ◽  
High Platelet Count ◽  
Interaction Term

Background. Platelet consumption followed by homocysteine-induced endothelial injury suggests a crosstalk between platelet activation and homocysteine on hypertension. Platelet count has been found to modify the effect of folic acid on vascular health. However, whether platelet count could modify the contribution of homocysteine to blood pressure (BP) remains unclear. Methods. Leveraging a community-based cross-sectional survey in 30,369 Chinese hypertensive patients (mean age 62 years, 52% female), we examined the moderation of platelet count on the association between serum homocysteine and BP by constructing hierarchical multiple regression models, adjusting for conventional risk factors. If adding the interaction term of homocysteine and platelet count could explain more variance in BP and the interaction is significant, then we believe that moderation is occurring. Results. The association between serum homocysteine and diastolic BP was significantly stronger (β = 0.092 vs. 0.035, P=0.004) in participants with low platelet count (<210 × 109/L) than in those with high platelet count (≥210 × 109/L). Adding the interaction term of homocysteine and platelet count additionally explained 0.05% of the variance in diastolic BP (P=0.0001), and the interaction was significant (β = −0.021, P<0.001). Excluding participants receiving antihypertensive medications did not change our results. Conclusions. The association between homocysteine and BP was significantly stronger in participants with low vs. high platelet count and was partially moderated by platelet count. These results indicate that platelet count may be useful in the identification of individuals who are most beneficial to reducing-homocysteine treatments but this usefullness still needs further investigation.

scholarly journals Adverse drug reaction monitoring in patients of hypertension at a tertiary care hospital, Aurangabad, Maharashtra, India

2021 ◽  
Vol 10 (6) ◽  
pp. 720
Author(s):  
Shruti Chandra ◽  
Sukhmeen Kaur ◽  
Deepali Jayabhaye ◽  
Amol Ubale
Keyword(s):  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Tertiary Care ◽  
Term Therapy ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Long Term Therapy

Background: Hypertension is one of the highest prevailing diseases worldwide. Due to long term therapy antihypertensive drugs are commonly associated with adverse drug reactions (ADRs). Therefore, the study was conducted with the objective to examine the incidence of different types of ADRs in drug treated hypertensive patients.Methods: Present study was a prospective cross sectional observational study carried out in the outpatient of department of medicine of MGM hospital, a tertiary care teaching hospital, in Aurangabad. 320 diagnosed hypertensive patients were studied. Questionnaire was asked and their prescription were analysed and follow up was done.Results: Among 320 patient’s 75 patients were reported ADR. Males accounted for higher percent of ADRs 46 (61%) than females 29 (38.6%). Most of the patients 147 (55.9%) were on mono therapy. Calcium channel blocker was the frequently used class of drug, showed maximum number of ADR (30.6%) followed by ACE inhibitor (28%) and ARB (21.3%). As per WHO-UMC scale, type of reactions and their percentage were as certain (9.3%), Probable/ Likely (64%), possible (22.6%), and unlikely (4%). According to Naranjo scale most of the reactions were possible (64%). severity assessment is done by Hartwig and Siegel scale. No lethal ADR were reported. 4% reactions were severe, 32% were of moderate category and 64% were mild reactions.Conclusions: Such type of studies are helpful in selection of appropriate medicines for hypertensive patients, enhancing patient adherence with the therapy by selecting medicines of lesser ADR profile, reducing unnecessary economic burden to the patients due to unwanted effects of the therapy.

scholarly journals Prevalence of Hypertension and Diabetes Mellitus among Haemodialysis Patients at Elobied Haemodialysis Unit –West Sudan

2019 ◽  
pp. 1-5
Author(s):  
Abdelsalam Mohamed Hamed Elfaki ◽  
Samia Tarig Abdalla Mohamed
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Insulin Therapy ◽  
Blood Pressure Measurement ◽  
Diabetic Patients ◽  
Chronic Haemodialysis ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Female Ratio ◽  
Hypertensive Patients

Background and Objectives: Hypertension and diabetes mellitus are major risk factors of end – stage renal disease (ESRD). This study aimed to determine the prevalence of hypertension and diabetes mellitus among haemodialysis patients at Elobeid haemodialysis unit. Patients and Methods: The study was a single – centre cross - sectional study including 130 patients on chronic haemodialysis in Elobeid hospital haemodialysis unit. Each patient was personally interviewed by the co-author in the haemodialysis unit using a structured questionnaire prepared by the investigators. Data collected include: socioeconomic data (gender, age, residence, and occupation), history of hypertension, diabetes mellitus, treatment of hypertension, treatment of diabetes mellitus, duration of hypertension, duration of diabetes mellitus and duration of dialysis. Hypertension was defined as blood pressure ≥ 140/90 or the use of antihypertensive medications. Diabetes mellitus is defined by use of insulin therapy. In this study both hypertension and diabetes mellitus were already diagnosed and on regular medications. Statistic package for social sciences (SPSS) version 20 was used for data analysis. Results: One hundred and thirty patients were recruited. More than two thirds of patients were males with male to female ratio of 2.2: 1. Patient’s age ranged from 12 years to 90 years. The mean age was 46.3 ± 17.8 years. Forty (32%) patients were above 56 years of age. Ninety eight (75%) patients were hypertensive, the majority of hypertensive patients were males (90%). Eighty six hypertensive patients were on calcium channel blocker (88%). Amlodipine was the commonly used antihypertensive used. Twenty five (19%) patients were diabetics and all of them were males. All diabetic patients were also hypertensive. Fourteen diabetic patients (56%) were on insulin therapy, while 11 patients were using metformin. Conclusion: The prevalence of hypertension among haemodialysis patients was high while the prevalence of diabetes is less than that reported globally. The blood pressure should be tidily controlled specially in diabetic patients and patients with impaired renal function. For early detection of chronic kidney disease and elevated blood pressure as a sequel, routine blood pressure measurement is highly recommended in adult patients attend the clinic for any reason.

scholarly journals Antihypertensive drug prescription trends in Shahrekord, Iran

2021 ◽  
Vol 11 (1) ◽  
pp. e13-e13
Author(s):  
Ahmadreza Maghsoudi ◽  
Maryam Dehghani Mobarakeh ◽  
Ali Momeni ◽  
Alireza Nematollahi ◽  
Shahin Asgari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Drug Prescription ◽  
Angiotensin Receptor ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
The Status ◽  
Receptor Blockers

Introduction: Hypertension is one of the most leading causes of death worldwide. It is an important risk factor for ischemic heart disease (IHD), chronic kidney disease (CKD) and cerebrovascular diseases. Objectives: The aim of the study was evaluation of the status of blood pressure control and trends in prescribed antihypertensive medication usage among hypertensive patients in Shahrekord, Iran. Patients and Methods: In a cross-sectional descriptive study 250 hypertensive patients were enrolled. The patients were evaluated based on the status of blood pressure (BP) control and the prescription trends and efficacy of antihypertensive drugs. The data were also evaluated in subgroups of diabetics or non-diabetics, smokers or non-smokers, patients with or without CKD, patients with or without IHD. Results: A total of 250 patients (149 women and 101 men) were enrolled in this study. The mean age of participants was 66.22±13.58 years. Mean systolic and diastolic BP were 143.4±29.4 mm Hg and 85.8±12.5 mm Hg respectively. Poor controlled BP was seen in 106 patients. The more common prescribed antihypertensive drugs were angiotensin receptor blockers (46%), diuretics (33.6%) and beta-blockers (32.8%). Conclusion: The study showed that most of the patients had poor controlled BP and physicians increasingly prescribe angiotensin receptor blockers.

Abstract P332: Dietary Salt Intake and Blood Pressure Control in Hypertensive Individuals Under Antihypertensive Treatment During 7 Years

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Kazuto Ohno ◽  
Hiroyuki Takase ◽  
Masashi Machii ◽  
Daishi Nonaka ◽  
Tomonori Sugiura ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Treatment ◽  
Salt Intake ◽  
Antihypertensive Drugs ◽  
Dietary Salt ◽  
Antihypertensive Medications ◽  
Salt Restriction ◽  
Hypertensive Patients ◽  
Dietary Salt Intake ◽  
Excess Salt Intake

Purpose: Excess salt intake is one of the most important causes of hypertension. Salt restriction is a key strategy in the management of hypertension and, thus, should be instructed for hypertensive patients under medical treatment. We investigated recent changes in dietary salt intake and blood pressure (BP) levels in hypertensive patients. Methods: Total of 12422 hypertensive subjects (male 71.0% [8814 of 12422], 64.6±9.2 year-old) under medical treatment who visited our hospital for a physical checkup from 2010 to 2016 were enrolled. They were divided into 3 groups according to the number of antihypertensive drugs prescribed (1, 2 and ≥3 drugs). Cross-sectional analyses were performed using data in each year and changes during the 7 years were investigated. Individual salt intake was estimated using a spot urine by a previously reported method. Results: BP levels and the accomplishment rate of the target BP (<140/90mmHg) were improved in each group during the 7 years without significant difference among the groups (Overall 2010 to 2016; BP 132.7±13.6/80.0±8.9 to 128.8±13.7/76.3±9.6 mmHg and accomplishment ratio 65.6 [968 of 1475] to 76.4% [1433 of 1875]). However, individual salt intake was gradually increased in all groups (2010 to 2016 in 1, 2, and ≥3 drugs; 11.7±3.7 to 12.2±4.0, 11.9±3.7 to 12.7±3.9, and 12.2±3.9 to 12.9±4.1 g/day, respectively) and the accomplishment rate of salt restriction (<6g/day) was significantly reduced in subjects with increased number of antihypertensive drugs (3.5 [225 of 6435], 2.8 [125 of 4564], and 2.3% [33 of 1423] in groups with 1, 2, and ≥3 drugs, respectively). The accomplishment rate of the target BP was significantly higher in patients who achieved salt restriction than in those who did not achieve salt restriction in all groups (Over all; 80.2 [307 of 383] vs. 73.3% [8829 of 12039]). Conclusions: The control of BP in individuals with antihypertensive medications was improved in the last 7 years. However, salt restriction has not been successfully achieved especially in hypertensive patients with multiple antihypertensive medications. Excess salt intake may induce resistance to antihypertensive treatment and, thus, increases the number of antihypertensive drugs for BP control.

scholarly journals Drug compliance among hypertensive patients in Kassala, Eastern Sudan

2000 ◽  
Vol 6 (1) ◽  
pp. 100-105
Author(s):  
A. G. El Zubier ◽  
A. A. Husain ◽  
I. A. Suleimati ◽  
Z. A. Hamid
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Compliance Rate ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Drug Compliance ◽  
Cross Sectional ◽  
Uncontrolled Blood Pressure ◽  
Hypertensive Patients ◽  
Eastern Sudan

A cross-sectional study of hypertensive patients was conducted and drug compliance was estimated. Factors associated with compliance, status of blood pressure control and occurrence of complications were assessed. Compliance was 59.6% as measured with the pill count method. We found 92% of compliant patients had controlled blood pressure in comparison with 18% of non-compliant patients, and 30.1% of the compliant patients had complications in comparison with 46.3% of the non-compliant patients. While the compliance rate was reasonable, 36.8% of patients were non-compliant because they could not afford to buy antihypertensive drugs. Inability to buy drugs was negatively and significantly associated with compliance. These patients experienced uncontrolled blood pressure and other complications

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