Original Research

Blood pressure control in hypertensive patients attending a rural community health centre in Gauteng Province, South Africa: A cross-sectional study

Sergius C. Onwukwe, Nnabuike C. Ngene
South African Family Practice | Vol 64, No 1 : Part 2| a5403 | DOI: https://doi.org/10.4102/safp.v64i1.5403 | © 2022 Sergius Chuks Onwukwe, Nnabuike Chibuoke Ngene | This work is licensed under CC Attribution 4.0
Submitted: 29 August 2021 | Published: 28 March 2022

About the author(s)

Sergius C. Onwukwe, Department of Public Health, Faculty of Health Science, University of Liverpool, Liverpool, United Kingdom; and, Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Nnabuike C. Ngene, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Obstetrics and Gynaecology, Leratong Hospital, Krugersdorp, South Africa


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Abstract

Background: Hypertension is a major cause of morbidity and mortality and its control has important clinical and socio-economic benefits to the family and community. Unfortunately, the extent of blood pressure (BP) control and its potential predictors in hypertensive patients in many rural communities in low-resource settings are largely unknown. This study assessed the extent of uncontrolled BP and its predictors amongst hypertensive patients accessing primary health care in a rural community in South Africa.

Methods: This cross-sectional study included 422 randomly selected hypertensive patients. Demographic and clinical data were collected using structured face-to-face questionnaire supplemented by respondents’ clinical records.

Results: Obesity plus overweight (n = 286, 67.8%) and diabetes (n = 228, 54.0%) were the most common comorbidities. Treatment adherence was achieved in only 36.3% and BP was controlled to target in 50.2% of the respondents. Significant predictors of uncontrolled BP were poor treatment adherence (odds ratio [OR] = 15.88, 95% confidence interval [CI] = 8.96, 28.14, p < 0.001), obesity compared with normal weight and overweight (OR = 3.75, 95% CI = 2.17, 6.46, p < 0.001) and being a diabetic (OR = 2.83, 95% CI = 1.74, 4.61, p < 0.001).

Conclusion: Poor adherence to treatment was the major predictor of uncontrolled BP. The increase in uncontrolled BP in the presence of diabetes and/or obesity as risk predictors, indicates the need for appropriate behaviour change/interventions and management of these conditions in line with the health belief model (HBM). We also propose the use of Community-Based Physical and Electronic Reminding and Tracking System (CB-PERTS) to address poor treatment adherence.


Keywords

blood pressure control; adherence to treatment; diabetes; hypertension; obesity

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