Key result
Among 300 Iraqi patients with hypertension, only 38.7% achieved optimal blood pressure control, with male sex, age <60 years, and diabetes mellitus identified as strong predictors of poor control.
Why the study?
Uncontrolled BP contributes to cardiovascular morbidity and mortality, but evidence on the rate and factors associated with uncontrolled BP in Iraq is scarce.
Cross-Sectional (n=300)
No
Blood pressure control among hypertensive patients in Iraq is suboptimal (38.7%), with younger age, male sex, and diabetes mellitus being significant predictors of poor control.
Suboptimal BP control in Iraqi hypertensives signals need for local strategies; leaves open generalizability of predictors pending prospective studies.
BACKGROUND: Uncontrolled blood pressure (BP) is a major contributor to cardiovascular disease-related morbidity and mortality. However, evidence regarding the rate and factors associated with uncontrolled BP in Iraq is scarce. The objectives of this study were a) to assess the magnitude of and factors associated with patient BP control and b) to investigate the patient-level prescribing patterns of antihypertensive medications, in a large Iraqi hospital. MATERIALS AND METHODS: A prospective, cross-sectional study was conducted in the primary care centers of Al-Yarmouk Hospital in Baghdad, Iraq, between April 2018 and August 2018. Eligible patients answered standard survey questions and had their BP measured. Controlled BP was defined as <130/80mm Hg for patients with diabetes and/or chronic kidney disease and <140/90mm Hg for other populations. RESULTS: During the study period, 300 patients were included; of which, 67.3% were female. The average age was 57.6 (9.2) years (range, 25-79 years). Among the 300 patients included, only 38.7% had controlled BP. In univariate analysis, poorly controlled BP was not associated with education, employment, smoking, comorbid conditions excluding diabetes, and therapeutic regimen used. In contrast, the strongest predictors of uncontrolled BP were age <60 years, male sex, and diabetes mellitus. The majority were prescribed monotherapy (53.0%), followed by dual therapy (38.7%), and triple therapy (8.3%). Angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors were the most commonly prescribed medications at 74.7%, followed by beta-blockers at 29.3%, calcium channel blockers at 28.0%, and diuretics at 23.0%. CONCLUSION: BP control was suboptimal. Effective feasible strategies should be implemented to increase BP control in Iraq to reduce hypertension-related complications.
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Nassr et al. (2019) conducted a cross-sectional in Hypertension (n=300). Antihypertensive medications was evaluated on Proportion of patients achieving appropriate blood pressure control (<130/80 mm Hg for diabetes/CKD and <140/90 mm Hg for others). Among 300 Iraqi patients with hypertension, only 38.7% achieved optimal blood pressure control, with male sex, age <60 years, and diabetes mellitus identified as strong predictors of poor control.
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