Prevalence and Associated Risk Factors of Uncontrolled Hypertension in Urban Communities

Background: Hypertension is a major public health problem and one of the leading risk factors for cardiovascular diseases, stroke, and chronic kidney disease. Despite the availability of effective treatment, a large proportion of hypertensive patients continue to have uncontrolled blood pressure. Urbanization, unhealthy lifestyles, obesity, excessive salt intake, poor medication adherence, and inadequate health education contribute to poor hypertension control. Identifying the prevalence and associated risk factors of uncontrolled hypertension is essential for planning effective preventive and therapeutic interventions. Aim: To determine the prevalence of uncontrolled hypertension and to identify the factors associated with uncontrolled hypertension among adults residing in urban communities. Materials and Methods: A community-based cross-sectional study was conducted among 150 adults with diagnosed hypertension residing in selected urban communities. Participants were selected using convenient sampling. Data were collected using a structured and pre-tested questionnaire covering socio-demographic characteristics, dietary habits, lifestyle factors, clinical profile, medication adherence, and healthcare utilization. Blood pressure was measured using a calibrated digital sphygmomanometer following standard procedures. Participants with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg despite antihypertensive treatment were classified as having uncontrolled hypertension. Data were analyzed using SPSS version 26.0. Descriptive statistics were used to summarize the findings, while Chi-square test and multivariable logistic regression analysis were performed to identify factors associated with uncontrolled hypertension. A pvalue <0.05 was considered statistically significant. Results: Among the 150 study participants, 102 (68.0%) had uncontrolled hypertension, whereas 48 (32.0%) had controlled blood pressure. Participants aged more than 50 years showed significantly higher odds of uncontrolled hypertension (Adjusted OR=1.96; 95% CI: 1.01–3.83; p=0.047). Additional dietary salt intake (Adjusted OR=3.18; 95% CI: 1.34–7.52; p=0.009), obesity (Adjusted OR=2.67; 95% CI: 1.08–6.59; p=0.033), lack of health education (Adjusted OR=2.94; 95% CI: 1.22–7.08; p=0.016), and poor medication adherence (Adjusted OR=4.82; 95% CI: 1.61–14.40; p=0.005) were identified as significant independent predictors of uncontrolled hypertension. Poor medication adherence emerged as the strongest predictor. Lifestyle factors such as inadequate fruit and vegetable intake, smoking, alcohol consumption, and physical inactivity were associated with uncontrolled hypertension but did not achieve statistical significance. Conclusion: The prevalence of uncontrolled hypertension was high among adults in urban communities. Increasing age, obesity, additional dietary salt intake, absence of health education, and poor medication adherence were identified as significant predictors of uncontrolled hypertension. Strengthening communitybased hypertension screening, promoting healthy lifestyle modifications, improving patient education, and enhancing medication adherence may substantially improve blood pressure control and reduce the burden of cardiovascular diseases.