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Sustainable protocol-based management of hypertension in one institution in northern Malawi

Gwonde Hastings1, Raymond O'Connor2, Meadhbh Hunt3

  • 1St John's Hospital, Mzuzu, Malawi hastingsgondwe9@gmail.com.

Rural and Remote Health
|February 21, 2023
PubMed

Insights

A new once-daily medication protocol significantly improved blood pressure control in hypertensive patients in Malawi. This evidence-based regimen offers a cost-effective solution for managing hypertension in resource-limited settings.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Hypertension is highly prevalent in Africa, with significant gaps in diagnosis, treatment, and control.
  • Poor blood pressure (BP) control poses a major health challenge, particularly in sub-Saharan Africa.

Purpose of the Study:

  • To evaluate an intervention aimed at improving BP control in hypertensive patients.
  • To implement and assess a limited, once-daily antihypertensive medication protocol in Malawi.

Main Methods:

  • Developed a drug protocol based on international guidelines, local availability, cost, and effectiveness.
  • Transitioned 109 hypertensive patients to the new protocol over at least three clinic visits.
  • Assessed BP control changes from baseline to follow-up.

Main Results:

  • Median systolic BP decreased significantly from 152 mmHg to 148 mmHg (p<0.001).
  • Median diastolic BP significantly reduced from 90.0 mmHg to 83.0 mmHg (p<0.001).
  • Patients with higher baseline BP showed the greatest improvement; no significant associations with age or gender were observed.

Conclusions:

  • A limited, evidence-based, once-daily drug regimen can enhance BP control compared to standard management.
  • This approach shows promise for improving hypertension management in resource-limited settings.
  • Further reports will detail the cost-effectiveness of this intervention.
Abstract

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