Blood Pressure Control, Left Ventricular Hypertrophy and Treatment Practice Among Hypertensive Patients in Ethiopia
Received 29 July 2020
Accepted for publication 1 October 2020
Published 20 October 2020 Volume 2020:13 Pages 903—916
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Daniel Gebrehawaria Kinfe,1 Gebretsadik Berhe,2 Kibreab Gidey,3 Gebre Teklemariam Demoz4
1Department of Internal Medicine, School of Medicine, Aksum University, Aksum, Ethiopia; 2Department of Epidemiology, School of Public Health, Mekelle University, Mekelle, Ethiopia; 3Department of Internal Medicine, School of Medicine, Mekelle University, Mekelle, Ethiopia; 4Department of Clinical Pharmacy, School of Pharmacy, Aksum University, Aksum, Ethiopia
Correspondence: Gebre Teklemariam Demoz
Department of Clinical Pharmacy, School of Pharmacy, Aksum University, Aksum 298, Ethiopia
Background: Globally, hypertension is the most important public health issue and is a increasing health problem in Ethiopia. Blood pressure (BP) control is an ultimate therapeutic goal of hypertensive patients in reducing early complications of hypertension. Hence, this study was sought to examine the magnitude of uncontrolled BP, left ventricular hypertrophy (LVH), and treatment practice. Predictors of uncontrolled BP and LVH were also investigated.
Methods: A hospital-based cross-sectional study was conducted among 223 outpatients with hypertension on follow-up at Ayder Comprehensive Specialized Hospital (ACSH). Hypertensive patients with ≥ 18 years old who had been on follow-up care for at least 3 months were included in the study. Severely ill patients requiring urgent medical care and wheelchair-bound individuals or persons who had difficulty standing steady and pregnant women were excluded. Data were collected using a structured questionnaire and patients’ chart review. Data were entered and analyzed using SPSS version 22.0. To identify predictors, binary logistic regression model analysis was performed. Statistical significance was set at P-value of < 0.05.
Results: The magnitude of uncontrolled BP (> 140/90mmgH) and LVH was found to be 31.4% and 39.5%, respectively. More than half (53%) of participants were on at least two antihypertensive drug combinations of different classes. Uncontrolled BP was significantly associated with poor adherence to salt reduction in meal (Adjusted Odds Ratio (AOR) =8.552, 95% CI: 2.853, 15.638, P< 0.001), non-adherence to medications (AOR =2.886, 95% CI: 1.710, 3.935, P< 0.001), and taking triple-drug therapy (AOR=7.228, 95% CI: 1.110, 10.57, P=0.039). Presence of LVH was significantly associated with abdominal obesity (AOR= 2.2, 95% CI: 1.399, 4.69, P=0.003), age of ≥ 60 years (AOR= 2.421, 95% CI: 1.263, 4.639, P=0.008), and uncontrolled BP (AOR= 3.16, 95% CI: 1.208, 5.232, P=0.021).
Conclusion: In this study, a significant proportion of patients with uncontrolled BP and LVH were found. Abdominal obesity, older age and uncontrolled blood pressure were predictors of LVH. Therefore, tailored interventions targeting BP control to reduce the magnitude of LVH and other early complications of hypertension deemed to be compulsory.
Keywords: blood pressure, hypertension, left ventricular hypertrophy, predictors, Ethiopia
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