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Appearance and potential predictors of poorly controlled hypertension at the primary care level in an urban community

Authors Visanuyothin S, Plianbangchang S, Somrongthong R

Received 8 November 2017

Accepted for publication 16 January 2018

Published 23 February 2018 Volume 2018:11 Pages 131—138

DOI https://doi.org/10.2147/JMDH.S156518

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Sawitree Visanuyothin,1,2 Samlee Plianbangchang,2 Ratana Somrongthong2

1Social Medicine Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand; 2College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand

Purpose: Hypertension (HT) is the major risk factor for cardiovascular diseases because of its poor control. To control HT at the primary care level in urban communities, there is a demand for deeper comprehension of the manifestations of poorly controlled HT. This study aimed to examine appearance of HT, including the association between the appearance and home blood pressure (HBP) control at the primary care level in urban communities.
Patients and methods: A cross-sectional study was conducted in July–October 2017 in an urban community in Thailand. The total sample size from randomization was 125 poorly controlled HT patients who were diagnosed with an average clinic blood pressure ≥140/90 mmHg in their last three visits. Data were collected by face-to-face interviews, HBP monitoring (HBPM), and blood and urine testing. Data analysis was conducted via descriptive statistics and the chi-square tests, with a significance level of p<0.05.
Results: HBPM revealed that 58.4% of patients with poorly controlled blood pressure from clinic measurement had a systolic blood pressure and diastolic blood pressure that were below the HBP target. Most patients were overweight/obese, but they were nonsmokers and nondrinkers. As comorbidities, they had hyperlipidemia (64.0%) and diabetes mellitus (53.0%). One-quarter of them had good levels of knowledge and literacy. Nearly half had good health self-care literacy. Only 13% exhibited adequate self-management behaviors, but more than half had biochemistry results within normal limits. There were significant associations of smoking history and having hyperlipidemia as a comorbidity with HBP control (p =0.010 and 0.046, respectively).
Conclusion: The role of HBPM is important in practice when it comes to monitoring HT control at the primary care level in an urban context. Smoking cessation and control of the blood lipid levels should be highlighted not only at the practice, but also at the policy level.

Keywords: characteristics, risk factors, association, home blood pressure, knowledge, health literacy, self-management behaviors, biochemistry

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