What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertensive patients aged 18 years and older diagnosed with essential hypertension for at least six months, on antihypertensive treatment, followed in primary health care facilities in Settat city, Morocco (n=1004). Primary outcome: Prevalence of uncontrolled blood pressure defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg (OR 7.24 for poor medication compliance, 95% CI 95% CI [5.09-10.31] for poor medication compliance, p=0.001 for poor medication compliance).

What does this research mean for the field?

Uncontrolled blood pressure affects 57.9% of hypertensive patients in Settat, Morocco, with significant associations to rural environment, advanced age, low income, high-salt diet, and poor medication compliance. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to estimate the prevalence of uncontrolled blood pressure and identify associated risk factors in hypertensive patients.

March 4, 2026F1000Research0 citationsOpen Access

Multicenter study of blood pressure control and its determinants in 1004 hypertensive patients followed in primary health care facilities in Settat/Morocco

MAManar AarradUniversité Hassan 1er SMSaad El Madani STSanaa TouzamiUniversité Hassan 1er

Key Result

Poor adherence to medication was strongly associated with uncontrolled blood pressure (OR 7.24; 95% CI 5.09-10.31) in hypertensive patients in Settat, Morocco, with 57.9% having uncontrolled blood pressure.

Key Points

The study aims to estimate the prevalence of uncontrolled blood pressure and identify associated risk factors in hypertensive patients.
Conducted a multicenter cross-sectional study across 21 primary care facilities.
Included 1004 hypertensive patients from both urban and rural settings.
Data collected via a validated questionnaire addressing medical, therapeutic, and knowledge aspects.
Assessed medication compliance and physical activity using standardized tests.
Uncontrolled blood pressure was observed in 57.9% of patients.
Significant associations were found with rural environment, advanced age, low monthly income, high-salt diet, and poor medication compliance.
Rural residents showed a more than three-fold risk of uncontrolled blood pressure.

Study Design

Type

Cross-Sectional (n=1,004)

Multicenter

Yes

Structured PICO

Population

1004 hypertensive patients diagnosed with essential hypertension for at least six months, aged 18 and over, on antihypertensive treatment, followed in 21 primary care facilities (12 urban and 9 rural) in Settat, Morocco. Mean age 60.08, 75.1% female.

Outcome

Prevalence of uncontrolled blood pressure (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) and identification of associated risk factorssurrogate

Unsatisfactory blood pressure control is highly prevalent (57.9%) among Moroccan primary care patients, driven strongly by poor medication adherence, rural residence, and socioeconomic factors.

Main Result

Effect estimate: OR 7.24 for poor medication compliance (95% CI 95% CI [5.09-10.31] for poor medication compliance)

Absolute Event Rate: 57.9% vs 42.1%

p-value: p=0.001 for poor medication compliance

Limitations

Cross-sectional design limits ability to assess causality
Data based on self-reported questionnaires which could introduce recall bias
Study restricted to Settat region; findings may not generalize to other regions or countries

Abstract

Background and Objectives Controlling blood pressure is a central objective in the management of hypertension. However, it is often inadequate due to environmental and/or patient-related factors. The aim of this study is to estimate the prevalence of uncontrolled blood pressure and to identify the associated risk factors in hypertensive patients followed up in health centers in Settat city. Materials and Methods A multicenter cross-sectional study was conducted from March 2023 to February 2024 in 21 primary care facilities (12 urban and 9 rural) in Settat, including 1004 hypertensive patients. Data were collected using a validated questionnaire covering medical, therapeutic and knowledge aspects of hypertension. Compliance medication was assessed by the Girerd test, and physical activity by the Global Physical Activity questionnaire recommended by the World Health Organization. Blood pressure and anthropometric measurements were taken in accordance with international standards. Results Uncontrolled blood pressure affected 57.9% (n=581) of patients. Multivariable analysis revealed a significant association with rural environment (OR = 3.13; 95% CI 2.06-4.74), advanced age (OR = 1.39; CI95% 1.09-1.63), low monthly income (OR = 1.37; CI95% 1.21-1.56), high-salt diet (OR = 1.39; CI95% 1.15-1.69) and poor compliance with medication (OR = 7.24; CI95% 5.09-10.31). Conclusion Unsatisfactory blood pressure control in Moroccan hypertensive patients has highlighted the need to take into account the sociodemographic dimension in the management of hypertension, and the role of health centers in supplying patients with antihypertensive drugs and therapeutic and behavioral education to optimize blood pressure control.

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