Determinants of Hypertensive Heart Diseases among adult hypertensive patients in Adama Hospital Medical College and Bishoftu General Hospital: A Matched Case-control study

Abstract

Background: Hypertensive heart disease is the target organ (heart) response of chronically raised blood pressure and it continued to be the major public health challenge globally. During the last two decades, morbidities and mortalities associated with hypertensive heart diseases are significantly increasing in Ethiopia. But there are inadequate evidences on specific concomitant risk factors predisposing hypertensive patients to develop this complication. Therefore, this study provides evidences to guide risk driven prevention approaches in hypertensive patients. Objective: To identify determinants of hypertensive heart diseases among adult hypertensive patients in Adama Hospital Medical College and Bishoftu General Hospital. Methods: The hospital-based age matched case-control study was conducted in Adama Hospital Medical College and Bishoftu General Hospital from August-October, 2021 among adult hypertensive patients. Cases are hypertensive patients with hypertensive heart diseases and controls are hypertensive patients without hypertensive heart diseases. 71 cases and 142 matched controls were included in the study using consecutive sampling method. Data were collected using a secondary data review checklist and an interviewer administered questionnaire. Data was entered in to Epidata V-3.2 and exported to Stata SE V-14 for analysis. Variables with P value of < 0.05 in multivariate conditional logistic regression analysis were considered determinants for hypertensive heart diseases. Results: The mean age of the respondents 52.22 ± 14.52 years (52.28 for cases vs 52.19 for controls). Determinanats of hypertensive heart diseases were found to be famiy history of cardiovascular diseases (mAOR= 3.47, 95% CI; 1.08-11.19), urban residence (mAOR = 3.51, 95% CI; 1.17-10.52), having ≥ stage II baseline blood pressure (mAOR= 4.83, 95% CI; 1.28- 18.20), non-adherence to antihypertensive drugs (mAOR= 3.76 95% CI;1.01-14.09), consumption of excessive salt (mAOR= 3.57, 95% CI; 1.34-9.48) and being male (mAOR =3.12, 95% CI; 1.05-9.21). Conclusions and recommendations: Both modifiable and non-modifiable risk factors were found to be determinant factors of hypertensive heart diseases. Therefore, health care providers at different level of the health care should give due emphasis to lifestyle modification counseling ii including salt reduction and medication adherence. Early screening for identification and management of hypertensive heart diseases should be emphasized.