Key result
Antihypertensive treatment controls BP in only ~33% of patients, linked to adherence and multidrug use.
Why the study?
Adequate blood pressure control is achieved in only a fraction of treated hypertensive patients despite its importance in preventing cardiovascular morbidity and mortality.
Cross-Sectional (n=100)
No
Blood pressure control remains suboptimal (33%) among treated hypertensive patients in a Nigerian tertiary center, highlighting the need for improved medication adherence and combination therapy.
Suboptimal BP control persists in treated hypertensives; leaves open effective strategies to improve outcomes in this population.
BACKGROUND: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well established that adequate BP control characterizes only a fraction of treated hypertensive patients. The importance of tight BP control has been established in preventing cardiovascular morbidity and mortality METHODS: We performed cross-sectional studies on the current status of BP control among treated hypertensive in our center. One hundred consecutive patients with essential hypertension who have been attending the out patient hypertension clinic and have been on treatment for at least 6 months were recruited. The pre treatment BP and BP records in the previous 2 visits were noted. Patients were said to have good BP control if their BPs are < 140/90 mmHg (<130/80 mmHg for high risk patients) at the time of the study and in the last visit. RESULTS: There were 49 males and 51 female (M: F; 1:1), aged 26 to 85 (mean 52.33 +/- 12.29) years. The duration of hypertension ranged 6 months to 30 (mean 7.37 +/- 7.1) years. The duration of treatment in our centre was 6 months to 10 (mean 3.22 +/- 2.23) years. Blood pressure was controlled in 33 (33%) of the patients. Pre-treatment mean blood pressure was significantly higher than the BP value at the time of the study (155.87 +/- 26.02/97.81 +/- 11.89 mmHg versus 143.40 +/- 24.14/86.53 +/- 12.71 mmHg) (p<0.05). Diuretics were the commonest antihypertensive prescribed either alone or in combination (69%), followed by a calcium antagonist (56%) and centrally acting drugs (38%). Twenty seven were on single antihypertensive, 43 (43%) on 2, 25(25%) on 3 and 5 (5%) on 4 classes of antihypertensive. Blood pressure control was associated with taking more than one antihypertensive medication and compliance. CONCLUSION: Control of BP in patients receiving antihypertensive drugs is still far from optimal in the study population in Nigeria just as in other countries. Many patients had multiple cardiovascular risk factors. Adherence to medication should be encouraged.
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Sani et al. (2008) conducted a cross-sectional in Essential hypertension (n=100). Antihypertensive medication was evaluated on Blood pressure control (<140/90 mmHg or <130/80 mmHg for high risk patients). Blood pressure was adequately controlled in only 33% of treated hypertensive patients, with control significantly associated with medication adherence and the use of multiple antihypertensive drugs.
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