Key result
Poor blood pressure control affects ~75% of hypertensive outpatients, linked to poor knowledge and polypharmacy.
Why the study?
The study was conducted to determine the rate of BP control and analyse patient-related, medication-related, and healthcare system-related factors associated with poor BP control in outpatients with hypertension.
What is the rate of blood pressure control and which factors are associated with poor control in outpatients with hypertension?
Cross-Sectional (n=581)
Yes
What is the rate of blood pressure control and which factors are associated with poor control in outpatients with hypertension?
A high prevalence of uncontrolled hypertension highlights the need for targeted patient education and interventions, especially for those on multiple drugs or with complications.
Answers are grounded in this paper and cite their sources.
Uncontrolled hypertension in outpatients supports targeted education; leaves open whether knowledge or regimen changes improve control in prospective studies.
OBJECTIVES: To determine rate of blood pressure (BP) control and to analyse patient-related, medication-related and healthcare system-related factors associated with poor BP control in outpatients with hypertension (HT). DESIGN: Cross-sectional study. SETTING: Two study sites with different levels of healthcare (primary healthcare (PHC) and secondary level of healthcare (SHC)) in Vojvodina, Northern Serbia. PARTICIPANTS: A total of 581 patients (response rate 96.8%) visiting their primary care physician between July 2019 and June 2020 filled out a pretested semistructured questionnaire and had a BP reading during their regular appointments. PRIMARY AND SECONDARY OUTCOME MEASURES: Data on demographics, medication, BP control (target systolic BP≤140 mm Hg and∕ or diastolic BP≤90 mm Hg) and knowledge on HT was collected. Based on the median of knowledge score, patients were classified as having poor, average and adequate knowledge. RESULTS: Majority of the respondents (74.9%) had poorly controlled BP and had HT longer than 10 years. Larger number of patients at PHC site was managed with monotherapy while at the SHC majority received three or more antihypertensive drugs. Respondents from SHC showed a significantly lower knowledge score (9, 2-15) compared with the respondents from PHC (11, 4-15, p=0.001). The share of respondents with adequate knowledge on HT was significantly higher in the group with good BP control (26% and 9.2%, respectively). In a multivariate regression analysis, factors associated with poor BP control were knowledge (B=-1.091; p<0001), number of drugs (B=0536; p<0001) and complications (B=0898; p=0004). CONCLUSIONS: Poor BP control is common in outpatients in Serbia, irrespective of the availability of different levels of healthcare. Patients with poor knowledge on HT, with complications of HT and those with multiple antihypertensive drugs, were at particular risk of poor BP control. Our study could serve as a basis for targeted interventions to improve HT management.
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Horvat et al. (2022) conducted a cross-sectional in Hypertension (n=581). Patient, medication, and healthcare-related factors was evaluated on Poor blood pressure control (systolic ≥140 mm Hg and/or diastolic ≥90 mm Hg). Poor blood pressure control was present in 74.9% of outpatients with hypertension and was significantly associated with poor knowledge, use of multiple antihypertensive drugs, and complications.
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