Nagappa Bharathnag, Thekkur Pruthu, Majella Marie Gilbert, Nair Divya, Ramaswamy Gomathi, Chinnakali Palanivel
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Monitoring and Evaluation Officer, Centre for Operational Research, The Union, Puducherry, India.
J Family Med Prim Care. 2018 Jan-Feb;7(1):81-86. doi: 10.4103/jfmpc.jfmpc_134_17.
Uncontrolled blood pressure (BP) among hypertensive patients leads to life-threatening complications, hospitalization, and premature mortality. Knowledge on the burden of uncontrolled BP and its correlates will help in devising strategies to achieve goal BP. We aimed to determine the proportion who have not achieved goal BP and its associated factors among hypertensive patients in a Primary Health Centre (PHC).
A facility-based cross-sectional analytical study was conducted among the hypertensive patients attending chronic disease clinic of PHC at Ramanathapuram, Puducherry. BP was measured and goal BP was defined based on Joint National Committee-8 criteria. The interview was conducted using semi-structured questionnaire capturing sociodemographic details, behavioral characteristics, physical activity with the International Physical Activity Questionnaire (IPAQ), medication adherence with Morisky Medication adherence scale-8 (MMAS-8), and stress with perceived stress scale. The data were entered and analyzed using EpiData software. The proportion "not achieved goal BP" was expressed as percentage and association were measured using prevalence ratios (PRs) with 95% confidence interval (CI).
Of total 259 hypertensives studied, 140 (54.1%) were aged above 60 years, and 161 (62.2%) were females. Overall, 63 (24.3%) participants had not achieved goal BP. On univariate analysis, individuals aged 45-59 years (PR-2.1 [95% CI: 1.4-3.4]), being male (PR-1.6 [95% CI: 1.1-2.4]) and employed (PR-2.0 [95% CI: 1.1-3.5]) were associated with not achieving goal BP.
One-fourth of patients treated for hypertension in PHC failed to achieve goal BP. Considering the consequences of uncontrolled BP, cost-effective, context-specific interventions at the primary health-care level are needed.
高血压患者血压控制不佳会导致危及生命的并发症、住院和过早死亡。了解血压控制不佳的负担及其相关因素将有助于制定实现血压目标的策略。我们旨在确定初级卫生保健中心（PHC）高血压患者中未达到血压目标的比例及其相关因素。
在位于普杜切里拉马纳塔普拉姆的PHC慢性病诊所就诊的高血压患者中进行了一项基于机构的横断面分析研究。测量血压，并根据美国国家联合委员会第8版标准定义血压目标。使用半结构化问卷进行访谈，收集社会人口学细节、行为特征、通过国际体力活动问卷（IPAQ）评估的身体活动、通过莫利斯基药物依从性量表-8（MMAS-8）评估的药物依从性以及通过感知压力量表评估的压力。使用EpiData软件录入和分析数据。“未达到血压目标”的比例以百分比表示，使用患病率比（PRs）及95%置信区间（CI）测量关联性。
在总共259名研究的高血压患者中，140名（54.1%）年龄在60岁以上，161名（62.2%）为女性。总体而言，63名（24.3%）参与者未达到血压目标。单因素分析显示，年龄在45 - 59岁的个体（PR = 2.1 [95% CI：1.4 - 3.4]）、男性（PR = 1.6 [95% CI：1.1 - 2.4]）和就业者（PR = 2.0 [95% CI：1.1 - 3.5]）与未达到血压目标相关。
PHC中四分之一接受高血压治疗的患者未能达到血压目标。考虑到血压控制不佳的后果，在初级卫生保健层面需要具有成本效益且因地制宜的干预措施。
