Laboratoire Sciences et Technologies de la Santé, Institut Supérieur des Sciences de la Santé, Université Hassan 1er, Settat, Morocco.
Ecole Nationale de Santé Publique, Rabat, Morocco.
PLoS One. 2019 Aug 9;14(8):e0220710. doi: 10.1371/journal.pone.0220710. eCollection 2019.
Uncontrolled high blood pressure (UBP) can lead to various cardiovascular complications causing an estimated nine million deaths per year worldwide. In Meknes, epidemiologic data on UBP are scarce, depriving programs from evidence-based information that would allow a better management of hypertension. Hence, we aimed to assess UBP prevalence in hypertensive patients treated in Meknes and identify UBP-associated risk factors.
Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary health care facilities using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic-characteristics, lifestyle behaviours, clinical parameters and the triad care system-patient-physician. Another questionnaire was self-administered by physicians to characterize therapeutic inertia. A multivariate logistic regression analysis highlighted the risk factors associated with UBP.
UBP prevalence was 73% with a mean age of 61±11 years (mean±standard deviation) and a male/female ratio of 1/3. Risk factors associated with UBP were: therapeutic inertia (adjusted odds ratio to other variables (AOR) = 18.2, 95% CI [8.35-39.84]), drug non-adherence (AOR = 1.8, 95% CI [1.07-3.04]), obesity/overweight (AOR = 1.6, 95% CI [1.03-2.58]), unemployment (AOR = 1.9, 95% CI [1.09-3.01]), low income (AOR = 2.6, 95% CI [1.01-6.86]), family history of hypertension (AOR = 1.5, 95% CI [1.07-2.08]) and male sex (AOR = 1.6, 95% CI [1.04-2.58]).
UBP prevalence is high in Meknes. Prevention should firstly focus on raised awareness of hypertensive patients' self-care management. Secondly, health professionals should better comply to the guidelines of anti-hypertensive treatments. Lastly, health professionals should frequently be reminded to reach therapeutic goals to overcome therapeutic inertia.
未控制的高血压（UBP）可导致各种心血管并发症，导致全球每年约有 900 万人死亡。在梅克内斯，UBP 的流行病学数据稀缺，使项目缺乏循证信息，无法更好地管理高血压。因此，我们旨在评估梅克内斯高血压患者中 UBP 的患病率，并确定与 UBP 相关的危险因素。
2017 年 11 月至 12 月，我们采用多阶段抽样方法，对梅克内斯初级保健机构管理的 922 例高血压患者进行了横断面研究。我们面对面采访患者，收集其社会人口统计学特征、生活方式行为、临床参数和三方保健系统-患者-医生。医生还自行填写了另一份问卷，以描述治疗惰性。多变量逻辑回归分析突出了与 UBP 相关的危险因素。
UBP 患病率为 73%，平均年龄为 61±11 岁（均数±标准差），男女比例为 1/3。与 UBP 相关的危险因素包括：治疗惰性（与其他变量的调整比值比（AOR）=18.2，95%置信区间[8.35-39.84]）、药物不依从（AOR=1.8，95%置信区间[1.07-3.04]）、肥胖/超重（AOR=1.6，95%置信区间[1.03-2.58]）、失业（AOR=1.9，95%置信区间[1.09-3.01]）、低收入（AOR=2.6，95%置信区间[1.01-6.86]）、高血压家族史（AOR=1.5，95%置信区间[1.07-2.08]）和男性（AOR=1.6，95%置信区间[1.04-2.58]）。
梅克内斯的 UBP 患病率较高。预防措施应首先侧重于提高高血压患者自我保健管理的意识。其次，卫生专业人员应更好地遵守抗高血压治疗指南。最后，应经常提醒卫生专业人员达到治疗目标，以克服治疗惰性。
