The impact of medication intensification and other Associated factors on blood pressure control of patients With uncontrolled hypertension at jimma medical center, South west ethiopia

Abstract

Background: Rate of blood pressure control is poor globally. Uncontrolled hypertension is the leading cause of morbidity and mortality among noncommunicable diseases. No studies have been conducted on the impact of medication intensification and other associated factors on patients with uncontrolled hypertension in Ethiopia. Objective: The aim of this study was to assess the impact of medication intensification and other associated factors on blood pressure control of patients with uncontrolled hypertension at chronic follow up clinic of Jimma Medical Center. Methods: A hospital based prospective observational study was conducted among adult hypertensive patients at Jimma medical center chronic care clinic from January 2022 to April 2022. Samples were chosen by using a consecutive sampling method. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Data were collected using semi structured data collection tool. The collected data was analyzed using the statistical software version 26.0. Bivariate and multivariate logistic regression analysis was used to identify independent variables influencing blood pressure control. P-values of less than 0.05 were taken as statistically significant. Result: Out of 244 study participants, the majority were male 147 (60.2%) and the mean age of the patients was 53.96 ± 11.573 years. Above half, 127 (52.0%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin- converting enzyme inhibitors 153 (62.7%). The proportion of participants with uncontrolled BP was 49.2%. Age < 60 years (AOR: 2.192, 95% CI: 1.075-4.470), duration of hypertension diagnosis > 10 years (AOR: 6.167, 95% CI: 1.606–23.676), drinking alcohol (AOR: 2.849, 95% CI: 1.099–7.386), non-adherence (AOR: 2.968, 95% CI: 1.479–5.957), duration of therapy < 2 years (AOR: 13.087, 95% CI: 2.674–64.046) and medication un intensification (AOR: 2.971, 95% CI: 1.466–6.018) were independent predictors of uncontrolled BP. Conclusion: Medication un-intensification was an independent predictor of uncontrolled BP. In addition, alcohol consumption, nonadherence, duration of hypertension diagnosis >10 years, duration of therapy < 2 years, and younger age appears to affect the hypertension control. Intensification of antihypertensive medications, enhanced adherence and limiting the amount of alcohol intake might improve control of hypertension.