What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=1055). Intervention: Antihypertensive management in NCD clinics. Primary outcome: Blood pressure control (SBP < 140 mmHg and DBP < 90 mmHg sustained over four consecutive months).

February 3, 2025Open Access

Assessment of Blood Pressure Control Status Among Hypertensive Patients Attending Rwandan District Hospital NCD Clinics: A Retrospective Follow-Up Study

Q: What are the key findings of this study?

Blood pressure control was achieved in 41.5% of hypertensive patients attending Rwandan district hospital NCD clinics, with obesity, ACE inhibitor use, and missed appointments linked to poor control.

Key Result

Blood pressure control was achieved in 41.5% of hypertensive patients attending Rwandan district hospital NCD clinics, with obesity, ACE inhibitor use, and missed appointments linked to poor control.

Study Design

Type

Cohort (n=1,055)

Multicenter

Yes

Structured PICO

Population

1,055 adult hypertensive patients attending non-communicable disease (NCD) clinics in five Rwandan district hospitals, mean age 62, majority women, 79.9% rural.

Outcome

Blood pressure control (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg measured within the last four months)surrogate

Blood pressure control rates among hypertensive patients in Rwandan district hospitals remain low at 41.5%, highlighting the need for improved medication adherence and patient counseling.

Limitations

Retrospective design relying on routinely collected medical data introduces potential bias due to missing information in the EMR.
Study design did not allow for the determination of temporal or causal relationships between dependent and predictor variables.
Did not include potentially significant variables such as medication dispensing and prescription patterns.

Abstract

Abstract Background Hypertension is a major public health issue and a leading risk factor for cardiovascular disease (CVD). We assessed blood pressure (BP) control among adult hypertensive patients attending non-communicable disease (NCD) clinics in five Rwandan district hospitals. Methods We extracted data on hypertensive management from five Rwandan district hospitals from June 2016 to August 2021. BP control was defined as systolic blood pressure (SBP) 60 years (mean age 62; n = 663/1,055; 62.8%), and women, with approximately three-quarters of patients ( n = 796/1,055; 75.5%) had a BMI between 18.5 and 24.9 Kg/m 2 and the majority ( n = 843/1,055; 79.9%) resided in rural districts. More than half ( n = 585/1,055; 55.5%) were taking two antihypertensive medications. Factors significantly associated with uncontrolled BP included BMI ≥ 30 kg/m 2 ( p < 0.001), use of Angiotensin-converting enzyme (ACE) inhibitors ( p = 0.01), use of four antihypertensive drugs ( p = 0.013), and missing an NCD clinic appointment ( p < 0.001). Conclusions BP control rates among hypertensive patients attending NCD clinics remain low. Strengthening patient counseling, encouraging physical activity, and improving medication adherence are critical. Building the capacity of healthcare staff at both hospital and health centre levels is vital to improving hypertension management in NCD clinics.

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