Factors associated with uncontrolled hypertension in patients attending a medical clinic of a tertiary care hospital in Sri Lanka
Abstract
Objectives: Uncontrolled hypertension is common. Objective of this study was to describe factors associated with uncontrolled hypertension in a group of patients on treatment for hypertension.
Method: A cross-sectional descriptive study was conducted in a medical clinic of a tertiary care hospital in Sri Lanka. Consecutive patients on treatment for hypertension had two readings of blood pressure (BP) 1-2 minutes apart and lower of the two was taken, as the current BP. All patients not achieving a systolic BP of <140mmHg and/or a diastolic BP of <90 mmHg, were recruited. Sociodemographic and clinical data were collected by an interviewer-administered questionnaire. Level of adherence to medications was assessed by Voils two-part measure of medication non-adherence.
Results: 260 patients were studied (women: 61.2%; mean age: 64.9±9.5years). Mean systolic and diastolic BP were 160.5±16.3mmHg and 91±11.1mmHg, respectively. Mean duration of treatment was 8.5±7.2years. Mean number of anti-hypertensive medications per patient was 2.1±0.8. 70.4% were non-adherent to medications. 13.5% were on concomitant medications known to increase BP. 89.2% had one or more non-medication related factor contributing to uncontrolled BP. 64.6% lacked adequate physical activity. 45% had BMI ≥25kg/m2. Self-reported salt consumption was high among 13.1%. 38.5% admitted adding salt to rice cooked at home. 31.5% had inadequate sleep duration. 43.8% reported snoring during sleep. 8.9% of menreported excess and/or binge consumption of alcohol. 6.9% had chronic kidney disease. Clinician inertia was identified as the cause in 4.6%. True resistant hypertension was observed only in 2.7%.
Conclusion: In the study population, majority had correctable factors associated with uncontrolled hypertension. Non-adherence to medications was a major problem. Among the others the main contributing factors were inadequate physical activity, obesity, inadequate sleep and excess salt consumption. True resistant hypertension was seen only in a small proportion.
Method: A cross-sectional descriptive study was conducted in a medical clinic of a tertiary care hospital in Sri Lanka. Consecutive patients on treatment for hypertension had two readings of blood pressure (BP) 1-2 minutes apart and lower of the two was taken, as the current BP. All patients not achieving a systolic BP of <140mmHg and/or a diastolic BP of <90 mmHg, were recruited. Sociodemographic and clinical data were collected by an interviewer-administered questionnaire. Level of adherence to medications was assessed by Voils two-part measure of medication non-adherence.
Results: 260 patients were studied (women: 61.2%; mean age: 64.9±9.5years). Mean systolic and diastolic BP were 160.5±16.3mmHg and 91±11.1mmHg, respectively. Mean duration of treatment was 8.5±7.2years. Mean number of anti-hypertensive medications per patient was 2.1±0.8. 70.4% were non-adherent to medications. 13.5% were on concomitant medications known to increase BP. 89.2% had one or more non-medication related factor contributing to uncontrolled BP. 64.6% lacked adequate physical activity. 45% had BMI ≥25kg/m2. Self-reported salt consumption was high among 13.1%. 38.5% admitted adding salt to rice cooked at home. 31.5% had inadequate sleep duration. 43.8% reported snoring during sleep. 8.9% of menreported excess and/or binge consumption of alcohol. 6.9% had chronic kidney disease. Clinician inertia was identified as the cause in 4.6%. True resistant hypertension was observed only in 2.7%.
Conclusion: In the study population, majority had correctable factors associated with uncontrolled hypertension. Non-adherence to medications was a major problem. Among the others the main contributing factors were inadequate physical activity, obesity, inadequate sleep and excess salt consumption. True resistant hypertension was seen only in a small proportion.
DOI: https://doi.org/10.4038/jccp.v51i2.7903 | Journal eISSN: 2448-9514
Language: English
Page range: 96 - 105
Published on: Dec 14, 2020
Published by: Ceylon College of Physicians
In partnership with: Paradigm Publishing Services
Keywords:
© 2020 C. N. Wijekoon, M. T. Samarawickrama, G. S. C. Mendis, J. K. P. Wanigasuriya, P. W. M. C. S. B. Wijekoon, published by Ceylon College of Physicians
This work is licensed under the Creative Commons Attribution 4.0 License.