Factors associated with control of arterial hypertension in Francisco Morazán, Honduras

Hypertension constitutes a major public health problem in Honduras. In 2019, 34% of Hondurans had hypertension, but only one-third achieved blood pressure control. In limited-resource settings, health system limitations complicate chronic disease oversight. This study aimed to identify individual and facility-level factors associated with blood pressure control among patients with hypertension attending primary care centers in Francisco Morazán, Honduras. A cross-sectional study was conducted with 486 patients with hypertension from eight primary health care centers. Medical records from the six months preceding the November-December 2024 collection period were evaluated to examine hypertension control factors (< 140/90 mmHg). Multivariable logistic regression and multilevel modeling were employed to identify associated factors. Seeking other medical care outside the primary clinic was associated with higher odds of blood pressure control (adjusted odds ratio (aOR) = 5.09; p < 0.001). Referral to higher levels of care (aOR = 0.11; p < 0.001) and morbid obesity (aOR = 0.14; p = 0.005) were associated with lower odds of achieving hypertension control. Being female and exhibiting higher perceived disease severity showed positive trends; however, these decreased after multilevel adjustment. None of the facility-level variables reached statistical significance. Several patient-level factors were associated with blood pressure control, whereas no statistically significant facility-level associations were detected in this sample. Because only eight health centers were included, the facility-level analysis should be considered exploratory. Reinforcing obesity management protocols and strengthening referral systems may contribute to improving hypertension management.