Determinants of Poor Blood Pressure Control in Hypertensive Patients: Findings from the Baseline Survey in West Bank, Palestine
Publication Type
Original research
Authors
  • Hussein Hallak
  • Maher. Khdour
  • Hamzeh Al Zabadi
  • Anan. Jarab
  • Qusai. Al-Shahed
  • Tareq. Mukattash
Hypertension remains poorly controlled in Palestine. Improvement of its management will re-quirean understanding of the patient characteristics and treatment factors associated with uncon-trolled hypertension. A cross-sectional analysis
using data from prevalence of hypertension study
in West Bank (N=2077) using two-stage stratifie
d sampling method. We studied antihypertensive
medication use, comorbidity, and blood pressure measurements for 573 hypertensive patients in 3
different primary care settings across Palestine.
We concomitantly conduc
ted comprehensive pa-
tient interviews covering demogra
phic and clinical factors. Mean age of the patients was 57.5 ± SD
9.7 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were
149±12 mm Hg and 91.2±9 mm Hg (respectively). Only 33.2% (190/573) of patients had mean
blood pressure < 140/90 mm Hg during the study pe
riod. Those who are "uncontrolled" had high
systolic blood pressure rather than diastolic pr
essure (59 vs 41%; P<0.01)
. 60% of uncontrolled
hypertension found to be non-adherent to their dr
ug regimen, 28% experience adverse effects and
56% were found to be on monotherapy. There was no
statistically significant in difference in sex
distribution, marital status and educational leve
l between controlled and
uncontrolled hypertension.
Multivariate analysis revealed several independent
predictors of poor hypertension control; being
on monotherapy regimen [OR=2.14, 95% CI 1.51-
2.59], being obese BMI >25 [OR=1.80, 95% CI
1.44-2.46], being non adherence to antihypertensiv
e drugs [OR=2.67, 95% CI 2.34-3.11] and older
age > 65 [OR=2.12, 95% CI1.78-2.86]. Hypertension remains poorly controlled in clinical Practice
in West Bank. Physicians should aggressively treat
elevated systolic BP. A number of factors con-
tribute to poor control of hypertension including
Non-adherence to drug regimens, frustration with
treatment and obesity. Further identification of patients at risk of poor control can lead to targeted
interventions to improve management.
Journal
Title
Palestinian Medical and Pharmaceutic al Journal (PMPJ).
Publisher
An-Najah National University
Publisher Country
Palestine
Publication Type
Both (Printed and Online)
Volume
2
Year
2017
Pages
25-34