An appraisal of blood pressure control and its determinants among patients with primary hypertension seen in a primary care setting in Western Nigeria

Abstract

Background: Achieving guideline-recommended blood pressure is imperative in reducing the rising tide of uncontrolled hypertension and its attendant sequelae, which are major causes of morbidity and mortality globally. The aim of the study was to describe the pattern of blood pressure control and identify the factors influencing blood pressure control among patients with primary hypertension seen at family medicine clinics of FMC, Abeokuta. Methods: This was a descriptive cross-sectional hospital-based study. A systematic random sampling technique was used in selecting 360 hypertensive respondents over four months. Data were collected through a pre-tested interviewer-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) version 17.0 was used to analyse data. Results: Blood pressure was controlled in 167 (46.4%) of the respondents. The independent predictors of blood pressure control were female gender (p = 0.001, OR = 2.494, 95% confidence interval (CI) = 1.477–4.214), regular use of medication (p = 0.001, OR = 2.900, 95% CI = 1.508–5.577), regular clinic attendance (p < 0.001, OR = 3.512, 95% CI = 1.772–6.960), and absence of diabetes mellitus (p < 0.001, OR = 7.357, 95% CI = 3.190–16.966). Conclusions: The rate of blood pressure control among the hypertensive respondents was low. Multiple independent predictors of controlled blood pressure call for a team-based approach as well as multiple approaches including education of patients, expansion of a community-based health insurance programme and intensification of treatment efforts when managing hypertensive patients.