Characterizing Patients with Uncontrolled Blood Pressure at an Urban Hospital in Hanoi, Vietnam

Lifestyle practices and associated factors among adults with hypertension: Conquering Hypertension in Vietnam-solutions at the grassroots level study

BACKGROUND

Vietnam is experiencing an increasing prevalence of hypertension in its adult population. In addition to medical therapy, modifying adverse lifestyle practices is important for effective blood pressure control. There are limited data on unhealthy lifestyle practices in patients with chronic diseases, however, particularly among hypertensive patients living in rural Vietnam. Our study objectives were to examine the prevalence of unhealthy lifestyle practices and associated factors among rural Vietnamese adults with uncontrolled hypertension.

METHODS

Data from the baseline survey of a cluster randomized trial among hypertensive Vietnamese adults (2017-2022) were utilized. Information on unhealthy lifestyle practices including smoking, excessive alcohol consumption, physical inactivity, and inadequate fruit and vegetable intake was collected from study participants. The primary study outcome was having ≥2 unhealthy lifestyle practices. A multivariable logistic regression model was used to examine factors associated with the primary study outcome.

RESULTS

The mean age of the 671 patients was 67 years and 45.0% were men. Nearly three out of every four participants had one or fewer unhealthy practices, 24.0% had two, and 3.3% had three or all four unhealthy lifestyle practices. Men, individuals who did unpaid work or were unemployed, and individuals with hypertension level III were more likely to have ≥2 unhealthy lifestyle practices, whereas individuals with higher education were less likely to have ≥2 unhealthy lifestyle practices compared with respective comparison groups.

CONCLUSIONS

We observed a high prevalence of unhealthy lifestyle practices among rural Vietnamese patients with uncontrolled hypertension. Several demographic factors were associated with a greater number of unhealthy lifestyle practices. Newer interventions and educational programs encouraging lifestyle modification practices are needed to control hypertension among adults living in rural settings of Vietnam.

High Prevalence of Uncontrolled Hypertension Among Afghan Hypertensive Patients: A Multicenter Cross-Sectional Study

Background

Despite striking advances in the management of hypertension, blood pressure (BP) control remains suboptimal worldwide. Sustainable Development Goals (SDGs) call for 80% control rates by 2030, highlighting the urgency for improvements in hypertension control.

Objective

We aimed to determine the prevalence of uncontrolled hypertension (≥140/90 mmHg) and assess its associated factors in Afghan hypertensive patients.

Methods

We conducted this multicenter cross-sectional study at three Afghan public hospitals in Afghanistan. We recruited hypertensive patients (n=950) on antihypertensive medications (AHMs) from August to December 2022. We analyzed only complete datasets (853). We employed the 14-item Hill-Bone compliance scale to assess compliance with AHMs. We performed multivariable logistic regression analyses to determine factors associated with uncontrolled hypertension.

Results

The mean age (±SD) of the patients was 47.5 (± 9.5) years and males constituted 50.5% (431) of the study sample. The prevalence of uncontrolled hypertension in this study was 77.3% (95% CI: 74.2-79.9%). Factors associated with uncontrolled hypertension and their adjusted OR (95% CI) were physical inactivity: 3.45 (1.87-6.35), current smoking: 3.04 (1.50-6.15), high salt intake: 3.57 (1.9-6.7), presence of comorbid medical disease: 2.22 (1.20-4.08), higher BMI: 3.32 (1.12-9.88), poor compliance to AHMs: 8.50 (4.62-15.6), and presence of depressive symptoms: 1.99 (1.2-3.27).

Conclusion

The prevalence of uncontrolled hypertension was high in the present study. Factors associated with uncontrolled hypertension may epitomize potential targets for public/individual health interventions in Afghanistan.

Self-Care Management for Hypertension in Southeast Asia: A Scoping Review

Background

Self-care practices such as lifestyle modifications in diet, exercise, and stress management are effective in reducing the incidence of and enhancing better management of hypertension. However, little is known about the self-care management practices of people with hypertension in Southeast Asia (SEA) countries where the prevalence of hypertension is sharply increasing.

Methods

A scoping review of research and grey literature (2006-2021) was performed using Scoping Review Frameworks by Arkey and O'Malley. For the research literature, ten databases were searched followed by a manual search of the reference lists of relevant topical papers. Criteria for inclusion included both qualitative and quantitative primary data studies, focused on adult (18 years and over) hypertensive patients, self-care management methods, conducted in SEA. The study protocol has been registered at Open Science Framework (https://osf.io/s4nvk/).

Results

Out of 1667 studies examined, there were 57 studies that met criteria and were included in this review. Results indicate a paucity of relevant literature. Moreover, most studies reviewed showed an incident rate of 50% or more incidence of behavioural risk factors in people diagnosed with hypertension, including overweight/obesity, poor physical exercise, poor/low-quality dietary intake, and not adhering to medication. Few studies indicated adequate traditional self-care practice among SEA hypertension populations. Use of a non-prescription herbal as the medication is identified in some studies. Several reviewed articles indicated that there is individual variation in the facilitators and barriers to implementing self-care practices and we put it into a working framework. The facilitators and barriers are relevant to personal choice (internal factors) or to the environment or context (external factors).

Conclusion

Enhancing self-care management of hypertension in SEA may require a multi-focused approach including targeting personal choice as well as external factors such as cultural relevance, environment, and resources.

Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals, Eastern Ethiopia: A multicenter study

Objective:

The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals in Eastern Ethiopia.

Methods:

A hospital-based cross-sectional study was conducted among 415 hypertensive patients in Eastern Ethiopia from June 15 to July 15, 2021. A systematic random sampling technique was used to select the study participants. Data were collected through face-to-face interviews and reviewing patients’ charts. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with uncontrolled hypertension.

Results:

This study revealed that magnitude of uncontrolled hypertension was 48% (95% confidence interval = 43.1%−52.8%). Being male (adjusted odds ratio = 2.05, 95% confidence interval = 1.29–3.26), age ⩾55 years (adjusted odds ratio = 3.16, 95% confidence interval = 1.96–5.08), non-adherence to medication (adjusted odds ratio = 1.83, 95% confidence interval = 1.14–2.94), low diet quality (adjusted odds ratio = 4.04, 95% confidence interval = 2.44–8.44), physically inactive (adjusted odds ratio = 3.20, 95% confidence interval = 1.84–5.56), and having comorbidity (adjusted odds ratio = 3.04, 95% confidence interval = 1.90–4.85) were significantly associated with uncontrolled hypertension.

Conclusions:

In our sample of hypertensive patients on follow-up at public hospitals in Eastern Ethiopia, half had uncontrolled hypertension. Older age, male sex, non-adherence to antihypertensive medication, low diet quality, physically inactive, and having comorbidity were found to be predictors of uncontrolled hypertension. Therefore, sustained health education on self-care practices with special emphasis on older, males, and patients with comorbid conditions.