Mpande Nomazulu, Fungai Chinamasa Camillio, Manangazira Portia, Mungati More, Takundwa Lucia, Bangure Donewell, Tafara Gombe Notion, Tshimanga Mufuta, Factors Associated with Uncontrolled High Blood Pressure amongst patients with Hypertension at Harare Central Hospital in Zimbabwe, Journal of Hypertension and Cardiology, Volume 2, Issue 2, 2016, Pages 15-24, ISSN 2329-9487, https://doi.org/10.14302/issn.2329-9487.jhc-16-1020.
(https://oap-researcharticles.org/jhc/article/310)
Abstract: Background: Hypertension is a public health problem with high mortality and morbidity globally. A rapid assessment of hypertensive patients at Harare Central Hospital Outpatients Department (OPD) in June 2013 revealed that 41% of patients had uncontrolled hypertension. We, therefore, explored the factors associated with uncontrolled hypertension among hypertensive patients at Harare Hospital. Methods: A one-on-one unmatched case-control study was conducted among 118 cases and 118 controls. A case was a person aged 18years and above on hypertensive treatment for ≥6months with mean Blood Pressure (BP) ≥ 140/90mmHg while a control was 18years and above on hypertensive treatment ≥6 months with mean BP<140/90mmHg. Interviews were used to collect information on socio-demographic, treatment, health system, condition, and patient-related factors. Written informed consent was obtained from all study participants. Medication adherence was measured with Morisky medication adherence scale-8. Results: The median ages for cases were 49 years (IQR: 41-63) and 48 years (IQR: 42-62) for controls. Almost 57% were women with 23% living in rural areas. Most cases (94%) and controls (78%) added salt to meals. Rural women were less likely to have uncontrolled BP compared to urban women (OR=0.7; 95%CI: 0.35, 1.37). Lack of exercise, adding salt to meals and eating fruits/vegetables less than three times/week were associated with uncontrolled BP. Independent factors associated with uncontrolled BP were low adherence to medication, aOR 22.03 (95%CI: 9.10,53.5), receiving health education, aOR 0.24 (95%CI: 0.11 , 0.53), exercises aOR 0.33 (95%CI: 0.15,0.73) and on medical insurance aOR 2.69 (955CI: 1.12,6.44). Conclusions: Common risk factors for hypertension were associated with uncontrolled BP. Since these are modifiable factors there is a need to implement interventions that will encourage healthy living in this population to improve treatment outcomes.
Keywords: Hypertension; adherence; medical insurance; Harare; Zimbabwe