Blood Pressure Control and Its Determinants Among Outpatient Hypertensive Subjects in Port Harcourt: A Survey of Two Teaching Hospitals

Abstract

Background: Elevated blood pressure (BP) is associated with increased cardiovascular disease mortality and all-cause mortality. Despite availability of medication for treatment of hypertension and prevention of complications, the goal of universal optimal BP control has remained elusive. This dual center study aims to assess the level of blood pressure control in hypertensive patients and its determinants. Methods: This was a descriptive cross-sectional study conducted in the Cardiology outpatient clinics of the Rivers State University Teaching Hospital and the University of Port Harcourt Teaching Hospital. A total of 426 previously diagnosed hypertensive subjects on follow up for at least 6 months were recruited via convenience sampling. Uncontrolled BP was defined as systolic BP of ≥140mmHg and/or diastolic BP of ≥90mmHg. Data was analysed using SPSS version 22. Bivariate logistic regression analysis was used to determine predictors of poor blood pressure control and p-values <0.05 were considered statistically significant. Results: The mean age of the respondents was 57.89±12.17years and 237(55.6%) were women. The mean systolic BP was 139.9±17.5mmHg, whereas the mean diastolic BP was 88.2±14.4mmHg. Controlled BP was recorded in 184(43.2%) persons, while 242(56.8%) had uncontrolled BP. Factors significantly associated with uncontrolled BP were household monthly income (p=0.024), Body Mass Index (p=0.002), poor adherence to medication (p=0.001) and physical inactivity (p=0.047). Conclusion: Uncontrolled BP was found in more than half of the patients on follow up in tertiary care. There is need to intensify health education and care of hypertensive patients as a strategy to enhance blood pressure control and mitigate cardiovascular complications.