Blood pressure control associates and antihypertensive pharmacotherapy patterns in Tikur Anbessa General Specialized Hospital chronic care department, Addis Ababa, Ethiopia

Abstract

Background: Hypertension is defined as sustained elevation of resting systolic blood pressure (≥ 140 mm Hg), diastolic blood pressure (≥ 90 mm Hg), or both. In the United States, about 65 million people have hypertension. Only about 70% of these people are aware that they have hypertension, only 59% are being treated, and only 34% have adequately controlled blood pressure.But a population based study in Addis Ababa showed adult prevalence of hypertension is 30%. The level of blood pressure control in Tikur Anbessa General Specialized Hospital was unknown. Objectives: The objective of this study was to assess the level of blood pressure control; factors associated with poor blood pressure control and describe antihypertensive treatment patterns at Tikur Anbessa General Specialized Hospital. Methods: Hospital based cross sectional study was conducted at Tikur Anbessa General Specialized Hospital ambulatory hypertensive patients. Patients’ card was reviewed to collect a one year BP measurement and the patients were interviewed during data collection. Convenience sampling method was used and 271 patients available during the data collection period (March 3, 2013 to April 8, 2013) were included in the study. Result: Greater than half (59.9%) of the patients have uncontrolled blood pressure. Several factors like non-adherence (OR=8.41(3.084-22.927)P<0.001), long duration on treatment (OR=3.19(1.051-9.725)P=0.041),obesity(OR=2.803(1.33-5.911)P=0.007), rural residence (OR=16.8(1.754-160.8)P=0.014), high socioeconomic status (OR=6.632(1.49-29.46)P=0.013), family history of hypertension, self-reported excessive salt addition habit (OR=8.78(3.05-25.28)P<0.001), minimal activity or inactivity (OR=4.219(1.67-10.66) P=0.002),concomitant diabetes mellitus or chronic kidney disease (OR=23.85(8.19-69.39)P<0.001) and patients on multiple antihypertensive regimen were found to be associated with poor blood pressure control. Combination of ACE inhibitor and diuretic was found to be the most frequently prescribed regimen whereas combination of calcium channel blocker and diuretic follows. Conclusion:Generally the level of blood pressure control at Tikur Anbessa hospital chronic care unit was found to suboptimal, and several factors like non adherence, long duration on treatment, obesity, rural residence, high socioeconomic status, family history of hypertension, concomitant diabetes mellitus or chronic kidney disease and multiple antihypertensive regimen were found to be associated with poor blood pressure control