Kinfe Daniel Gebrehawaria, Berhe Gebretsadik, Gidey Kibreab, Demoz Gebre Teklemariam
Department of Internal Medicine, School of Medicine, Aksum University, Aksum, Ethiopia.
Department of Epidemiology, School of Public Health, Mekelle University, Mekelle, Ethiopia.
Int J Gen Med. 2020 Oct 20;13:903-916. doi: 10.2147/IJGM.S273668. eCollection 2020.
Globally, hypertension is the most important public health issue and is a increasing health problem in Ethiopia. Blood pressure (BP) control is an ultimate therapeutic goal of hypertensive patients in reducing early complications of hypertension. Hence, this study was sought to examine the magnitude of uncontrolled BP, left ventricular hypertrophy (LVH), and treatment practice. Predictors of uncontrolled BP and LVH were also investigated.
A hospital-based cross-sectional study was conducted among 223 outpatients with hypertension on follow-up at Ayder Comprehensive Specialized Hospital (ACSH). Hypertensive patients with ≥18 years old who had been on follow-up care for at least 3 months were included in the study. Severely ill patients requiring urgent medical care and wheelchair-bound individuals or persons who had difficulty standing steady and pregnant women were excluded. Data were collected using a structured questionnaire and patients' chart review. Data were entered and analyzed using SPSS version 22.0. To identify predictors, binary logistic regression model analysis was performed. Statistical significance was set at P-value of < 0.05.
The magnitude of uncontrolled BP (>140/90mmgH) and LVH was found to be 31.4% and 39.5%, respectively. More than half (53%) of participants were on at least two antihypertensive drug combinations of different classes. Uncontrolled BP was significantly associated with poor adherence to salt reduction in meal (Adjusted Odds Ratio (AOR) =8.552, 95% CI: 2.853, 15.638, P<0.001), non-adherence to medications (AOR =2.886, 95% CI: 1.710, 3.935, P<0.001), and taking triple-drug therapy (AOR=7.228, 95% CI: 1.110, 10.57, P=0.039). Presence of LVH was significantly associated with abdominal obesity (AOR= 2.2, 95% CI: 1.399, 4.69, P=0.003), age of ≥60 years (AOR= 2.421, 95% CI: 1.263, 4.639, P=0.008), and uncontrolled BP (AOR= 3.16, 95% CI: 1.208, 5.232, P=0.021).
In this study, a significant proportion of patients with uncontrolled BP and LVH were found. Abdominal obesity, older age and uncontrolled blood pressure were predictors of LVH. Therefore, tailored interventions targeting BP control to reduce the magnitude of LVH and other early complications of hypertension deemed to be compulsory.
在全球范围内，高血压是最重要的公共卫生问题，并且在埃塞俄比亚，它正成为一个日益严重的健康问题。血压控制是高血压患者减少高血压早期并发症的最终治疗目标。因此，本研究旨在调查血压未得到控制、左心室肥厚（LVH）的程度以及治疗情况。还对血压未得到控制和左心室肥厚的预测因素进行了调查。
在阿伊德综合专科医院（ACSH）对223名接受随访的高血压门诊患者进行了一项基于医院的横断面研究。纳入研究的患者为年龄≥18岁、接受随访护理至少3个月的高血压患者。需要紧急医疗护理的重症患者、依赖轮椅的个体或站立不稳有困难的人以及孕妇被排除在外。使用结构化问卷和患者病历回顾收集数据。使用SPSS 22.0版本输入和分析数据。为了确定预测因素，进行了二元逻辑回归模型分析。统计学显著性设定为P值<0.05。
发现血压未得到控制（>140/90mmHg）和左心室肥厚的程度分别为31.4%和39.5%。超过一半（53%）的参与者使用了至少两种不同类别的降压药物联合治疗。血压未得到控制与饮食中减少盐摄入的依从性差显著相关（调整后的优势比（AOR）=8.552，95%置信区间：2.853，15.638，P<0.001）、不依从药物治疗（AOR =2.886，95%置信区间：1.710，3.935，P<0.001）以及接受三联药物治疗（AOR=7.228，95%置信区间：1.110，10.57，P=0.039）。左心室肥厚的存在与腹型肥胖显著相关（AOR= 2.2，95%置信区间：1.399，4.69，P=0.003）、年龄≥60岁（AOR= 2.421，95%置信区间：1.263，4.639，P=0.008）以及血压未得到控制（AOR= 3.16，95%置信区间：1.208，5.232，P=0.021）。
在本研究中，发现相当一部分患者存在血压未得到控制和左心室肥厚的情况。腹型肥胖、老年和血压未得到控制是左心室肥厚的预测因素。因此，针对血压控制的量身定制干预措施，以降低左心室肥厚的程度和高血压的其他早期并发症，被认为是必要的。
