Kebede Bekalu, Chelkeba Legese, Dessie Bekalu
Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Clinical Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
SAGE Open Med. 2021 Mar 31;9:20503121211006000. doi: 10.1177/20503121211006000. eCollection 2021.
Despite the fact that the goals for the management of hypertension are well-defined and effective therapies are available, control of hypertension remains poor in countries with low resources including Ethiopia. This study aimed to determine blood pressure control rate and its determinants among ambulatory adult hypertensive patients at Jimma University Medical Center.
A general prospective cohort study was conducted among adult hypertensive patients who had regular follow-up at Jimma University Cardiac Clinic from 20 March to 20 June 2018. Hypertensive patients who fulfilled the inclusion criteria were selected in the first month of the data collection period. Then, only those patients who visited the clinic at the first month were consequently followed-up for the next 3 months. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Patients' specific data were collected using a structured data collection tool. Data were analyzed using the statistical software package SPSS version 21.0. Bivariate and multivariable logistic regression analysis was used to identify independent variables influencing blood pressure control. -values of less than 0.05 were considered statistically significant.
From a total of 416 patients, 237 (57.0%) were male with a mean age of 56.50 ± 11.96 years. Two hundred and fifty eight (62.0%) participants had comorbid conditions and 275 (66.1%) were on combination therapy. The rate of blood pressure control was 42.8%. Age ⩾60 years was negatively associated with uncontrolled blood pressure (adjusted odd ratio = 0.52, confidence interval = 0.31-0.88, = 0.015). Medication non-adherence (adjusted odd ratio = 1.64, confidence interval = 1.04-2.58, = 0.034) and non-adherence to international guidelines (adjusted odd ratio = 2.33, confidence interval = 1.49-3.64, < 0001) were positively associated with uncontrolled blood pressure.
The rate of blood pressure control among hypertensive patients was suboptimal. Age, clinicians' non-adherence to international guidelines, and patients' non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.
尽管高血压管理目标明确且有有效的治疗方法，但在包括埃塞俄比亚在内的资源匮乏国家，高血压控制情况仍然不佳。本研究旨在确定吉姆马大学医学中心门诊成年高血压患者的血压控制率及其影响因素。
对2018年3月20日至6月20日在吉姆马大学心脏科门诊定期随访的成年高血压患者进行一项前瞻性队列研究。在数据收集期的第一个月选取符合纳入标准的高血压患者。然后，仅对第一个月就诊的患者在接下来的3个月进行随访。采用美国国家联合委员会第八版指南对血压控制和未控制情况进行分类。使用结构化数据收集工具收集患者的具体数据。数据采用统计软件包SPSS 21.0进行分析。采用二元和多变量逻辑回归分析确定影响血压控制的独立变量。P值小于0.05被认为具有统计学意义。
在总共416例患者中，237例（57.0%）为男性，平均年龄56.50±11.96岁。258例（62.0%）参与者有合并症，275例（66.1%）接受联合治疗。血压控制率为42.8%。年龄≥60岁与血压未控制呈负相关（调整后的比值比=0.52，置信区间=0.31 - 0.88，P = 0.015）。药物治疗依从性差（调整后的比值比=1.64，置信区间=1.04 - 2.58，P = 0.034）和未遵循国际指南（调整后的比值比=2.33，置信区间=1.49 - 3.64，P < 0.0001）与血压未控制呈正相关。
高血压患者的血压控制率不理想。年龄、临床医生未遵循国际指南以及患者未坚持服药是血压控制的独立预测因素。医生和临床药剂师应遵循指南，以更好地治疗和护理高血压患者。
