[Factors associated with poor blood pressure control in 253 treated hypertensive patients]

Prevalence and risk factors associated with uncontrolled blood pressure in rural areas in Settat City, Morocco

Introduction

high blood pressure, commonly known as hypertension, is one of the most widespread chronic diseases in the world. It is a serious problem whose management is essential to maintain stable blood pressure levels in the short term, and to prevent neuro-cardio-vascular complications in the long term. This study aims firstly to explore the characteristics of uncontrolled blood pressure among patient´s residents of rural areas in Settat City, and secondly to determine its prevalence and identify associated risk factors.

Methods

this is a cross-sectional, descriptive, and analytical study which took place between March and August 2023, and targeted a population of hypertensive patients following up at primary healthcare facilities in rural areas in Settat City. A questionnaire was developed and evaluated to ensure its reliability before being administered to study participants, anthropometric measurements and blood pressure readings were also taken.

Results

four hundred hypertensive patients were surveyed, 53% (212) of whom had uncontrolled blood pressure, with a mean age of 56.94 (±13.10 years), and a marked female preponderance, illustrated by 72.3% (289) were female. The risk factors associated with uncontrolled blood pressure were: male gender (aOR: 2.53, 95% CI 1.13-5.65), monthly income (aOR: 5.64, 95% CI 3.04-10.46), diabetes (aOR: 3.16, 95% CI 1.77-5.63), monotherapy (aOR: 8.42, 95% CI 2.85-24.90), poor compliance with medication (aOR: 7.48, 95% CI 4.21-13.29), and stress (aOR: 2.22, 95% CI 1.14-4.33).

Conclusion

the level of blood pressure control was unsatisfactory in this population, underscoring the imperative of educating hypertensive patients about management measures and reinforcing the quality of primary health services.

[Factors associated with poor blood pressure control in Moroccan hypertensive patients]

STUDY AIM

Hypertension is a major public health concern worldwide and non-controlling it can lead to various cardiovascular complications. Controlling blood pressure and reducing overall cardiovascular risk are two main goals of treatment. Thus, this study aimed to determine the proportion and factors associated with uncontrolled hypertension in hypertensive patients living in the Beni Mellal city.

PATIENTS AND METHODS

The cross-sectional survey took place between June and March 2019. It involved 580 hypertensive patients attending the primary health care facilities in Beni Mellal city, using systematic sampling.

RESULTS

A total of 580 hypertensive patients were recruited, with a mean age of 55.78 (± 10.82 years) and of which 66.89% were female. The proportion of poor blood pressure control was 74.1% and was associated in multivariate analysis with a family history of hypertension(OR = 1.60; 95% CI = [1.02-2.50]), dyslipidemia (OR = 2.05; 95% CI = [1.32 -3.20]), non-adherence to a regular BP measurement (OR = 4.13; 95% CI = [2.49 -6.86]), to treatment (OR = 3.64; 95% CI = [2.34-5.65]) and regular biological monitoring (OR = 2.45; 95% CI = [1.46-4.08]).

CONCLUSION

Despite the free and available of treatment, the proportion of uncontrolled hypertension was high. This might be linked to a lack of awareness and education concerning disease self-management.

Drug non-adherence in hypertensive patients in Morocco, and its associated risk factors

AIMS

Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance.

METHODS AND RESULTS

Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26-5.10)]; (ii) monthly income per household <150$ [AOR = 4.47, 95% CI (1.22-16.34)]; (iii) monthly income per household 150-200$ [AOR = 4.44, 95% CI (1.04-18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29-3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15-3.02)].

CONCLUSION

The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.

Prevalence of uncontrolled blood pressure in Meknes, Morocco, and its associated risk factors in 2017

Background

Uncontrolled high blood pressure (UBP) can lead to various cardiovascular complications causing an estimated nine million deaths per year worldwide. In Meknes, epidemiologic data on UBP are scarce, depriving programs from evidence-based information that would allow a better management of hypertension. Hence, we aimed to assess UBP prevalence in hypertensive patients treated in Meknes and identify UBP-associated risk factors.

Methods

Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes’s primary health care facilities using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic-characteristics, lifestyle behaviours, clinical parameters and the triad care system-patient-physician. Another questionnaire was self-administered by physicians to characterize therapeutic inertia. A multivariate logistic regression analysis highlighted the risk factors associated with UBP.

Results

UBP prevalence was 73% with a mean age of 61±11 years (mean±standard deviation) and a male/female ratio of 1/3. Risk factors associated with UBP were: therapeutic inertia (adjusted odds ratio to other variables (AOR) = 18.2, 95% CI [8.35–39.84]), drug non-adherence (AOR = 1.8, 95% CI [1.07–3.04]), obesity/overweight (AOR = 1.6, 95% CI [1.03–2.58]), unemployment (AOR = 1.9, 95% CI [1.09–3.01]), low income (AOR = 2.6, 95% CI [1.01–6.86]), family history of hypertension (AOR = 1.5, 95% CI [1.07–2.08]) and male sex (AOR = 1.6, 95% CI [1.04–2.58]).

Conclusion

UBP prevalence is high in Meknes. Prevention should firstly focus on raised awareness of hypertensive patients’ self-care management. Secondly, health professionals should better comply to the guidelines of anti-hypertensive treatments. Lastly, health professionals should frequently be reminded to reach therapeutic goals to overcome therapeutic inertia.