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November 2, 2014South African Family Practice12 citationsOpen Access

Determinants of blood pressure control in rural KwaZulu-Natal, South Africa

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PDPolly DuncanLHLaura D HoweZMZibonele Manakusa

Key Result

Among adults prescribed antihypertensive medication, only 33.3% had adequately controlled blood pressure (<140/90 mmHg), with poor control associated with being prescribed multiple medications.

Study Design

Type

Cross-Sectional (n=500)

Structured PICO

What proportion of patients prescribed antihypertensive medication have controlled blood pressure and what factors are associated with poor control in rural South Africa?

P
Population
500 clinic-attending adults in rural South Africa prescribed antihypertensive medication, with a mean age of 58 years and 78% female.
E
Exposure
Antihypertensive medication (observational)
O
Outcome
Proportion of patients with adequately controlled blood pressure (< 140/90 mmHg)surrogate

Only one third of treated hypertensive patients in rural South Africa achieve adequate blood pressure control, emphasizing the need for improved health education and consistent medication access.

Abstract

Background: Hypertension is a common problem in South Africa and is known to be inadequately treated and poorly controlled.Objectives: The objective of the study was to investigate what proportion of patients prescribed antihypertensive medication had controlled blood pressure (BP) and to identify factors associated with poor control.Method: In May and June 2012, clinic-attending adults who had been prescribed antihypertensive medication were recruited into this cross-sectional study. A questionnaire administered by field assistants investigated participants’ socio-demographic characteristics, medical history, perception of health, use of traditional healers, illness perceptions, beliefs about medication, compliance with the medication and suggestions as to how to improve hypertensive treatment. BP measurements were taken. Logistic regression analysis identified the determinants of poor BP control.Results: Of the 500 participants, the mean age was 58 years, 78% were female and the majority had never been to school, or had only attended primary school. One third had adequately controlled BP (< 140/90 mmHg). Factors associated with poor BP control included being prescribed more than one antihypertensive medication, self-reported asthma and poor compliance with the medication, although the latter was not significant after adjusting for other variables. Participants with diabetes and those with a family history of a stroke were more likely to have good BP control.Conclusion: Only one third of participants had adequately controlled BP, and almost half did not understand their high BP at all. Many had concerns about taking medication, but most felt that it was necessary. Participants suggested that better health education and ensuring that medication was available in the clinics could improve BP control.

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Cite This Study

Duncan et al. (2014) conducted a cross-sectional in Hypertension (n=500). Antihypertensive medication was evaluated on Adequately controlled blood pressure (< 140/90 mmHg). Among adults prescribed antihypertensive medication, only 33.3% had adequately controlled blood pressure (<140/90 mmHg), with poor control associated with being prescribed multiple medications.

synapsesocial.com/papers/6a8ad31d210b9ed19c892c7ehttps://doi.org/10.1080/20786190.2014.975481
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