Factors associated with uncontrolled hypertension in Santander, Colombia: baseline findings from the RE-HOPE study

In Latin America, hypertension prevalence varies widely, and control rates remain low, particularly in low-income communities, despite the proven efficacy of recommended interventions. We aimed to describe baseline characteristics and identify individual factors associated with uncontrolled hypertension in participants of the RE-HOPE study in Santander, Colombia. A cross-sectional analysis was conducted including participants ≥18 years old with hypertension, defined by self-reported history, antihypertensive use, or systolic BP ≥ 140 and/or diastolic BP ≥ 90 mmHg. Descriptive statistics were used for baseline characteristics. Mixed-effects logistic regression models stratified by sex were applied to identify factors associated with uncontrolled hypertension, adjusting for age, diabetes, obesity, medication intake, physical activity, and smoking. A total of 3 481 participants were included, with a mean age of 60.2 years (SD 13.7); 62% were female. Mean systolic and diastolic BP were 144 ± 16 mmHg and 86 ± 10 mmHg, respectively. Despite high levels of awareness (81%) and medication use (76%), only 26% of participants had controlled hypertension ( < 140/90 mmHg), and 9.6% met the target below 130/80 mmHg. Control rates were higher in the capital city compared to peripheral and rural provinces. Being female was inversely associated with uncontrolled hypertension (OR = 0.62; 95% CI: 0.52-0.75). In contrast, age ≥ 60 years (OR = 2.19; 95% CI: 1.84-2.61) and current smoking (OR = 2.48; 95% CI: 1.54-4.00) were positively associated with poor control. This study highlights significant challenges in hypertension management, particularly early diagnosis and the identification of priority groups, and emphasizes the need for targeted public health initiatives and policy actions to enhance hypertension control.