What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=394). Primary outcome: Uncontrolled hypertension.

What does this research mean for the field?

Uncontrolled hypertension is present in 48% of adult hypertensive patients attending a medical outpatient clinic in Kenya, and is significantly associated with education level, source of financing for hypertensive drugs, and BMI. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 25, 2021Open Access

Prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending medical outpatient clinic, Thika level 5 hospital, Kenya

MGMagara Monyenye GladysJomo Kenyatta University of Agriculture and Technology JGJohn GachohiWashington State Department of Health AMAlex MuriithiJomo Kenyatta University of Agriculture and Technology

Key Result

Uncontrolled hypertension was present in 48% of adult hypertensive patients attending a medical outpatient clinic in Kenya, and was significantly associated with education level and BMI changes.

Study Design

Type

Cross-Sectional (n=394)

Multicenter

Structured PICO

What are the prevalence and factors associated with uncontrolled hypertension among hypertensive patients attending a medical outpatient clinic in Kenya?

Population

394 adult hypertensive patients on antihypertensive treatment for at least one year before the study, attending a medical outpatient clinic at Thika level 5 Hospital, Kenya.

Outcome

Prevalence of uncontrolled hypertension (defined as systolic and/or diastolic blood pressure ≥140 and/or ≥90 in one or both previous and current readings during clinic visits) and associated factorssurrogate

Uncontrolled hypertension is highly prevalent (48%) among treated patients in this Kenyan outpatient clinic, with education level and BMI changes identified as significant associated factors.

Limitations

Cross-sectional design makes causal inferences difficult
Reliance on self-reported measures introduces the possibility of recall bias
Single or double-occasion blood pressure measurements could overestimate true hypertension

Abstract

Background: Uncontrolled hypertension is a key risk factor for stroke and heart and kidney disease. A study was conducted to determine the factors associated with the prevalence of uncontrolled hypertension among hypertensive patients (study participants) attending a medical outpatient clinic, Thika level 5 Hospital (TL5H), Kenya.Methods: The study adopted a cross-sectional study design and a mixed-methods approach. While the quantitative arm sampled 394 study participants using systematic random sampling, purposive sampling selected 18 health care workers who served as key informant sand 35 study participants took part in focus group discussions in the qualitative arm. Uncontrolled hypertension was defined as systolic and or diastolic blood pressure ≥140 and or ≥90 in one or both previous and current readings during clinic visits. Quantitative data including socio-demographic, socioeconomic, and clinical characteristics of study subjects were collected using interviewer-administered questionnaires. Qualitative data were collected using guides and checklists. Data were analysed descriptively and inferentially using Pearson’s chi-square statistics, Fishers exact tests and regression modelling to determine associations between independent variables and uncontrolled hypertension using STATA 14. Qualitative data were organized thematically using NVIVO.Results: 48% of the study participants had uncontrolled hypertension at the time of the study. Univariable analyses returned level of education (p=0.017), source of financing for hypertensive drugs (p=0.011), BMI (p=0.005) as significant factors.Conclusions: The study recommends community health promotion activities to increase awareness of how to modify these significant factors to reduce hypertension.

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