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高血压患者血压控制的预测因素:尼日利亚一家三级医疗机构的横断面研究

Predictors of blood pressure control among patients with hypertension: a cross-sectional study in a Nigerian tertiary health facility.

作者信息

Ukpeh Ido Edem, Akpan Margaret Inemesit, Ugbe Ugbe Maurice-Joel, Enyievi Peter Bassey, Osuchukwu Nelson Chukwudi, Bassey Ekpenyong Eyo, Yolo Smith Bakumor

机构信息

Cardiology Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria.

Faculty of Clinical Sciences, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria.

出版信息

BMJ Open. 2025 Mar 18;15(3):e091010. doi: 10.1136/bmjopen-2024-091010.

Abstract

BACKGROUND

Adequate blood pressure control improves clinical outcomes in patients with hypertension. Poor blood pressure control is linked with cardiovascular diseases and poor quality of life.

AIM

To identify the predictors of blood pressure control among patients with hypertension treated at the University of Calabar Teaching Hospital, Calabar, Nigeria.

METHODS

This was a descriptive, cross-sectional study that recruited 441 hypertensive adults who were on medications for at least 6 months through systematic random sampling. Data were analysed using bivariate and multivariate methods at 95% CI and α=0.05. Blood pressure was measured twice using a mercury sphygmomanometer, with averages recorded.

RESULTS

The average age of participants was 55.46 years±12.91. About 48.1% of respondents achieved adequate blood pressure control. Major reported risk factors of inadequate blood pressure control were sedentary lifestyle (67.8%), use of caffeinated drinks (51.9%) and family history of hypertension (47.5%). The major comorbidities of hypertension were gastrointestinal symptoms (46.72%) and diabetes (31.39%). The predictors of adequate blood pressure control were higher income (adjusted OR (AOR)=2.94, p0.026), full health insurance (AOR=2.32, p0.030), non-usage of caffeinated drinks (AOR=4.13, p0.001) and normal body mass index (AOR=1.63, p0.026). Predictors of inadequate blood pressure control were older age (AOR=0.30, p0.001), living with a spouse (AOR=0.14, p0.014), non-compliance with antihypertensive medications (AOR=0.53, p0.040) and moderate obesity (AOR=0.29, p0.032).

CONCLUSION

Addressing prevalent risk factors like sedentary lifestyle and dietary habits, as well as structural initiatives like accessibility to health insurance, presents opportunities for targeted interventions to enhance well-being and improve outcomes that will strengthen public health, clinical practice and research.

摘要

背景

血压得到充分控制可改善高血压患者的临床结局。血压控制不佳与心血管疾病及生活质量差相关。

目的

确定在尼日利亚卡拉巴尔大学教学医院接受治疗的高血压患者中血压控制的预测因素。

方法

这是一项描述性横断面研究,通过系统随机抽样招募了441名服用药物至少6个月的高血压成年人。数据采用双变量和多变量方法在95%置信区间及α=0.05水平进行分析。使用汞柱式血压计测量血压两次,并记录平均值。

结果

参与者的平均年龄为55.46岁±12.91岁。约48.1%的受访者血压得到充分控制。报告的血压控制不佳的主要危险因素为久坐不动的生活方式(67.8%)、饮用含咖啡因饮料(51.9%)和高血压家族史(47.5%)。高血压的主要合并症为胃肠道症状(46.72%)和糖尿病(31.39%)。血压得到充分控制的预测因素为较高收入(调整后比值比[AOR]=2.94,p<0.026)、拥有全额健康保险(AOR=2.32,p<0.030)、不饮用含咖啡因饮料(AOR=4.13,p<0.001)和正常体重指数(AOR=1.63,p<0.026)。血压控制不佳的预测因素为年龄较大(AOR=0.30,p<0.001)、与配偶同住(AOR=0.14,p<0.014)、不遵医嘱服用降压药(AOR=0.53,p<0.040)和中度肥胖(AOR=0.29,p<0.032)。

结论

解决久坐不动的生活方式和饮食习惯等普遍存在的危险因素,以及诸如获得健康保险等结构性举措,为有针对性的干预措施提供了机会,以增进健康并改善结局,从而加强公共卫生、临床实践和研究。

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