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RMJ. 2016; 41(2): 175-180


Uncontrolled hypertension: Is the care optimal?

Ali Yawar Alam, Mati-ur-Rahman, Naveed Akhtar, Waqas Ahmed, Madiha Butt, Muhammad Zubair, Nabeela Tariq, Amatul Aisha Rahman.

Abstract
Objective: To determine the frequency of hypertension among the patients attending a tertiary health care facility and to investigate the factors affecting uncontrolled hypertension among known hypertensive.
Methodology: Cross sectional study on 220 participants was done in a tertiary health care facility in Islamabad, Pakistan. Blood pressure (BP) was measured and a questionnaire was filled. Univariate and multivariate logistic regression analysis was done using SPSS 17.0.
Results: Out of 220 patients, 120(54%) were found to be hypertensive (BP≥140/90). Among the 160 known hypertensive, 82(51%) had uncontrolled BP. Males, higher waist circumference, lower income quintiles, irregularity of antihypertensive intake, current smoking, usual point of care being government hospital and BP check-up between 1-6 months were associated with uncontrolled BP, in the univariate analysis. In the multivariate analysis last BP checked up to 6 months was associated with greater odds of hypertension as compared to BP checked within 7 days (OR; 95% CI 8.4;3-25), p=0.001. Usual point of care for hypertension being a government hospital was associated with greater odds 7.2 95% CI 7.2;2.7-19), p=0.001, as compared to care from a private hospital.

Conclusion: Uncontrolled BP was statistically significantly associated with patients getting usual care from government health facilities and last BP checked between 1-6 months. Blood pressure monitoring during patient-doctor interaction and patient education on medication compliance and healthy lifestyle was sub-optimal. Blood pressure needs to be monitored at least once a month.

Key words: Uncontrolled blood pressure, higher waist circumference, lower income quintiles, irregularity of antihypertensive intake, current smoking


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