Adequacy of blood pressure control and management patterns among hypertensive adult patients attending a sub-county hospital in central Kenya: a cross-sectional study

Abstract

Introduction: there is scarcity of published data on blood pressure (BP) management patterns in rural health facilities in resource constrained settings. The objective was, therefore, to characterize the hypertension management patterns among adult hypertensive outpatients in a sub-county hospital in Kenya. Methods: cross-sectional study was undertaken among 167 adult patients undergoing hypertension management in Murang'a south sub-county hospital in central Kenya. Patients' sociodemographic characteristics and lifestyles activities were obtained through face-to-face interviews. The level of BP and details of antihypertensive drugs prescribed were acquired from medical files. Statistical associations between adequacy of BP control and sociodemographics as well as management patterns were computed at p≤0.05 using STATA® version 14 software. Results: adequate blood pressure control was achieved by 40.7% patients. Renin inhibitors (81.5%) and thiazide diuretics (74.3%) were the most prescribed antihypertensive agents, with enalapril-hydrochlorothiazide combination being the preferred dual therapy (34.0%). Adequate BP control was significantly associated with restriction of salt and red meat consumption (p=0.001), living with hypertension for less than five years and use of ≤2 antihypertensives (p=0.05). Patients who restricted salt intake were 2.92 times more likely to have their BP controlled compared to those who did not (AOR=2.92, 95% CI=0.96-8.80), p=0.058) while prescription of a three or more-drug combination reduced the likelihood of BP control by 14% (AOR=0.86, 95% CI=0.69-1.07, p=0.176). Conclusion: there was poor overall BP control rate among adult outpatients in Murang'a south sub-county hospital. Clinicians should use the fewest number of antihypertensive pharmacotherapies and encourage hypertensive patients to continually engage in lifestyle activities.