What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=360). Intervention: Female sex vs. Male sex. Primary outcome: Blood pressure control (AOR 3.53, 95% CI 1.73-7.25, p=<0.01).

What does this research mean for the field?

Female sex, higher education, and the presence of comorbidities are associated with improved blood pressure control, whereas an increased pill burden significantly reduces the odds of control among hypertensive adults in Ghana. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 15, 2019Open Access

Patient-level factors influencing hypertension control in adults in Accra, Ghana

Q: What are the key findings of this study?

Female sex, higher education, and the presence of comorbidities were associated with improved blood pressure control, whereas an increased pill burden significantly reduced the odds of control (AOR 0.32) among hypertensive adults in Ghana.

Q: What does this research mean for the field?

Female sex, higher education, and the presence of comorbidities are associated with improved blood pressure control, whereas an increased pill burden significantly reduces the odds of control among hypertensive adults in Ghana. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Female sex, higher education, and the presence of comorbidities were associated with improved blood pressure control, whereas an increased pill burden significantly reduced the odds of control (AOR 0.32) among hypertensive adults in Ghana.

Study Design

Type

Cross-Sectional (n=360)

Multicenter

Yes

Structured PICO

Population

360 adult hypertensive patients (mean age 61.9, 70.8% female) attending two hospitals in the Greater Accra Region of Ghana, who have been on treatment for not less than a year.

Outcome

Hypertension control (average of 2-5 blood pressure readings <140/90 mmHg, or <130/80 mmHg for patients with diabetes or chronic kidney disease)surrogate

In a Ghanaian cohort, hypertension control was poor (23.3%), with high pill burden and poor disease knowledge acting as significant barriers to adherence and blood pressure control.

Main Result

Effect estimate: AOR 3.53 (95% CI 1.73-7.25)

Absolute Event Rate: 27.06% vs 14.29%

p-value: p=<0.01

Limitations

Information concerning knowledge and management of hypertension was self-reported lending itself to recall and information bias.

Abstract

Abstract Background : Effective control of blood pressure is necessary to avert the risk of cardiovascular diseases from uncontrolled hypertension. Despite evidence on the benefits of hypertension control, rates of control in Ghana remain low. This study assessed the patient-level factors that influence hypertension control among adults in Accra, Ghana. Methods: A total of 360 hypertensive patients from two hospitals in Accra, Ghana were enrolled in the study. Client socio-demographic characteristics were tabulated and associations between client characteristics and hypertension control were estimated using chi-square tests and logistic regression. Results: The client’s sex AOR=3.53 (95% CI:1.73-7.25, educational at junior high school AOR=3.05(95% CI 1.40-6.67), senior high school AOR=2.67 (95% CI 1.05-6.76) and presence of a comorbidity AOR=2.41 (95% CI 1.32; 4.42) predicted BP control among clients. An increased pill burden, however, was associated with reduced BP control AOR=0.32(95% CI: 0.18-0.56). The majority of patients reported forgetfulness, side effects of medication and high pill burden as reasons for missing their medications. Conclusion: Knowledge of hypertension among patients is low. Sex, formal education and the presence of comorbidity and more specifically dyslipidaemia influences blood pressure control. A high pill burden negatively affects the attainment of blood pressure control.

Mark Helpful

Bookmark

Relay

View Full Paper