Elias Tamrat Petros, Minyilshewa Asteraye Tsige, Tekle Mengesha Akale, Gebreamlak Tsegaye Wesenseged, Adde Binyam Lukas
Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Int J Hypertens. 2025 Aug 28;2025:1055517. doi: 10.1155/ijhy/1055517. eCollection 2025.
Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is key to controlling blood pressure. This study aimed to assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in selected public hospitals under the Addis Ababa City Administration. A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected public hospitals under the Addis Ababa City Administration from November 1, 2022, to February 28, 2023. The study population included 393 patients who fulfilled the eligibility criteria and were selected by systematic random sampling. Data collection was conducted from the electronic medical records and by interviewing patients with a structured questionnaire. The data were entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to determine the associations between the dependent and independent variables. The rates of antihypertensive drug adherence and blood pressure control were 72.5% and 23.4%, respectively. Participants with uncontrolled blood pressure were 41.7% less adherent than those with controlled blood pressure (AOR = 0.59; 95% CI, 0.36-0.97). Nonadherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR = 3.85; 95% CI, 1.41-10.52) were associated with good adherence, whereas the use of a single antihypertensive drug (AOR = 0.53; 95% CI, 0.30-0.94) and nonadherence to moderate physical exercise (AOR = 0.30; 95% CI, 0.20-0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR = 1.95; 95% CI, 1.04-3.28) and blood pressure measured at home (AOR = 0.59; 95% CI, 0.36-0.99) were found to be independent predictors of controlled blood pressure. Drinking alcohol (AOR = 1.92; 95% CI, 1.05-3.49) was inversely associated with blood pressure control. Although adherence to antihypertensive medications was relatively good, blood pressure control remained low, indicating that medication adherence alone is insufficient. Public health policies should focus on strengthening primary care systems to deliver integrated hypertension management, including lifestyle counseling, dietary support, and improved access to medications and monitoring tools.
高血压或血压升高是一种严重的医学病症，会显著增加心脏、大脑、肾脏和其他器官患病的风险。坚持服用抗高血压药物是控制血压的关键。本研究旨在评估亚的斯亚贝巴市管理下选定公立医院中高血压患者抗高血压药物依从性及血压控制的相关因素。2022年11月1日至2023年2月28日，在亚的斯亚贝巴市管理下随机选取的公立医院中，对接受随访的高血压患者进行了一项基于医院的横断面研究。研究人群包括393名符合入选标准并通过系统随机抽样选取的患者。数据收集通过电子病历以及使用结构化问卷对患者进行访谈来进行。数据录入Epi-Info 7.2.1，并导出到SPSS 25版软件进行分析。进行逻辑回归分析以确定自变量与因变量之间的关联。抗高血压药物依从率和血压控制率分别为72.5%和23.4%。血压未得到控制的参与者的依从性比血压得到控制的参与者低41.7%（调整后比值比[AOR]=0.59；95%置信区间[CI]，0.36 - 0.97）。不遵守饮食限制（AOR，3.31；95%CI，1.84 - 5.96）和患有慢性肾病（AOR = 3.85；95%CI，1.41 - 10.52）与良好依从性相关，而使用单一抗高血压药物（AOR = 0.53；95%CI，0.30 - 0.94）和不坚持适度体育锻炼（AOR = 0.30；95%CI，0.20 - 0.65）与抗高血压药物依从性差相关。男性（AOR = 1.95；95%CI，1.04 - 3.28）和在家测量血压（AOR = 0.59；95%CI，0.36 - 0.99）被发现是血压得到控制的独立预测因素。饮酒（AOR = 1.92；95%CI，1.05 - 3.49）与血压控制呈负相关。尽管抗高血压药物的依从性相对较好，但血压控制率仍然较低，这表明仅靠药物依从性是不够的。公共卫生政策应侧重于加强初级保健系统，以提供综合高血压管理，包括生活方式咨询、饮食支持以及改善药物和监测工具的可及性。
