Prevalence and associated factors of uncontrolled hypertension among hypertensive patients at Soroti Regional Referral Hospital, Uganda: Cross-sectional study

Background: Uncontrolled hypertension is a major cause of premature death worldwide. Consequences of uncontrolled hypertension, including stroke, myocardial infarction, and renal failure, underscore the urgent need for effective management strategies. Despite national efforts, the prevalence of controlled hypertension remains low among those on treatment, behind the global target of 50% control rate. Objectives: This study aimed to determine the prevalence and associated factors of uncontrolled hypertension among hypertensive patients at Soroti Regional Referral Hospital (SRRH), Uganda. Design: In this cross-sectional study, we utilised a systematic random sampling of hypertensive patients aged 18 years and above who attended the hypertension clinic at the Outpatient Department of SRRH. Methods: Data collection included blood pressure measurements and the administration of a structured questionnaire to gather demographic, behavioural, and socio-economic information. To determine factors associated with uncontrolled hypertension, a modified Poisson regression analysis was conducted, and results were presented as adjusted prevalence ratios. All variables with a p < 0.2 at bivariate analysis were included in the multivariable model. A p < 0.05 was considered statistically significant. Data were then imported into and analysed using STATA 17. Results: In our study, we found a high prevalence of uncontrolled hypertension, 62.3% ( n = 236; 95% confidence intervals (CI): 57.2–67.0) which was significantly associated with being unemployed (adjusted prevalence ratio (aPR) = 1.31; 95% CI: 1.11–1.56, p = 0.001), not engaging in physical exercises (aPR = 1.19; 95% CI: 1.02–1.40, p = 0.028), having comorbidities (aPR = 1.17; 95% CI: 1.01–1.37, p = 0.034) and not adhering to good quality diet (aPR = 1.18; 95% CI: 1.01–1.37, p = 0.043). Conclusion: This study revealed a high prevalence of uncontrolled hypertension, which was associated with being unemployed, not doing physical exercises, having comorbidities, and being on a poor-quality diet. We recommend intensifying health education on feeding on locally available healthy foods, intensifying individual physical activity practices in the community and improving screening and management of comorbidities for clients with hypertension to support the achievement controlled hypertension.