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Assessment of Blood Pressure Control Status Among Hypertensive Patients Attending Rwandan District Hospital NCD
Evariste Ntaganda1,2, Ziad El-Khatib3, Regine Mugeni4
1School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Insights
Blood pressure control remains low in Rwandan hypertensive patients. Interventions should focus on patient counseling, physical activity, and medication adherence to improve hypertension management.
Area of Science:
- Public Health
- Cardiovascular Disease Research
- Non-Communicable Disease Management
Background:
- Hypertension is a significant public health concern and a primary risk factor for cardiovascular disease (CVD).
- Assessing blood pressure (BP) control in adult hypertensive patients within non-communicable disease (NCD) clinics is crucial for effective disease management.
- This study focuses on hypertensive patients attending NCD clinics in five Rwandan district hospitals.
Purpose of the Study:
- To evaluate the current status of blood pressure (BP) control among adult hypertensive patients in Rwandan NCD clinics.
- To identify factors associated with uncontrolled BP in this patient population.
- To inform strategies for improving hypertension management in NCD clinics.
Main Methods:
- Data were collected from five Rwandan district hospitals between June 2016 and August 2021.
- Blood pressure control was defined as systolic BP < 140 mmHg and diastolic BP < 90 mmHg.
- Statistical analyses included chi-square and multivariate regression with 95% confidence intervals.
Main Results:
- Only 41.5% of the 1,055 hypertensive patients achieved BP control.
- Factors associated with uncontrolled BP included higher BMI (≥30 kg/m²), use of Angiotensin-converting enzyme (ACE) inhibitors, use of four antihypertensive drugs, and missed NCD clinic appointments.
- The majority of patients were over 60 years old, female, had a normal BMI (18.5-24.9 Kg/m²), and resided in rural districts, with over half on two antihypertensive medications.
Conclusions:
- Blood pressure control rates in hypertensive patients attending NCD clinics are low.
- Enhancing patient counseling, promoting physical activity, and improving medication adherence are essential.
- Capacity building for healthcare staff at all levels is vital for better hypertension management.
Background:
Hypertension is a major public health issue and a leading risk factor for cardiovascular disease (CVD). We assessed blood pressure (BP) control among adult hypertensive patients attending non-communicable disease (NCD) clinics in five Rwandan district hospitals.
Methods:
We extracted data on hypertensive management from five Rwandan district hospitals from June 2016 to August 2021. BP control was defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg measured within the last four months. We performed statistical analysis using chi-square tests and multivariate regression analyses with 95% confidence intervals (CI).
Results:
Blood pressure control was achieved in 41.5% of hypertensive patients (n = 438/1,055). The majority were aged > 60 years (mean age 62; n = 663/1,055; 62.8%), and women, with approximately three-quarters of patients (n = 796/1,055; 75.5%) had a BMI between 18.5 and 24.9 Kg/m2 and the majority (n = 843/1,055; 79.9%) resided in rural districts. More than half (n = 585/1,055; 55.5%) were taking two antihypertensive medications. Factors significantly associated with uncontrolled BP included BMI ≥ 30 kg/m2 (p < 0.001), use of Angiotensin-converting enzyme (ACE) inhibitors (p = 0.01), use of four antihypertensive drugs (p = 0.013), and missing an NCD clinic appointment (p < 0.001).
Conclusions:
BP control rates among hypertensive patients attending NCD clinics remain low. Strengthening patient counseling, encouraging physical activity, and improving medication adherence are critical. Building the capacity of healthcare staff at both hospital and health centre levels is vital to improving hypertension management in NCD clinics.
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