The prevalence and determinants of blood pressure control among hypertension patients in eastern Zimbabwe: A cross-sectional study

PLoS One. 2024 Mar 7;19(3):e0293812. doi: 10.1371/journal.pone.0293812. eCollection 2024.

Abstract

Background: Uncontrolled blood pressure (BP), also known as hypertension, is a leading cause of morbidity and mortality globally. Lowering the elevated BP can significantly reduce one's risk for cardiovascular diseases. This study aimed to ascertain the determinants of BP control among hypertension patients.

Methods: The data analyzed were from the exploratory survey of the Home Management of Hypertension (HoMHyper) project in eastern Zimbabwe. Hypertension patients were selected from the Chronic Disease Registers of five public health clinics using simple random sampling. A pretested interviewer-administered questionnaire was used to collect data, and the patient's BP was measured. The primary outcome, BP control, was used as a categorical variable (controlled vs. uncontrolled) to conduct a bivariate analysis. Variables significant at p<0.2 were included in the multivariable logistic regression analysis to control for confounding. Statistical significance in the final model was set at p<0.05.

Results: Data from 321 hypertension patients were analyzed; their mean age was 62.3±11.9 years. The prevalence of controlled BP was 41.4% (95% Confidence interval-CI = 36.0%-46.9%). After adjusting for confounding, patients' residence and medication stocks were associated with BP control. Patients who resided in high-density suburbs had higher odds of uncontrolled BP than those who resided in middle- and low-density suburbs (Adjusted odds ratios-AOR = 2.5; 95% CI = 1.4-4.4; p<0.01). Hypertension patients who experienced medication stockouts over the last six months had higher odds of uncontrolled BP than patients who did not experience stockouts (AOR = 1.8; 95% CI = 1.1-2.9).

Conclusion: BP control among hypertension patients was suboptimal. Patient residence and antihypertensive medication stockouts were independent predictors of blood pressure control. We recommend exploring sustainable financing through private-public partnerships to ensure the availability of subsidized antihypertensive medication.

MeSH terms

  • Aged
  • Antihypertensive Agents* / pharmacology
  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure
  • Cross-Sectional Studies
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Middle Aged
  • Prevalence
  • Zimbabwe / epidemiology

Substances

  • Antihypertensive Agents

Grants and funding

YES This work was funded by a USD$5000.00 training grant from the Partnership in Education Training and Research Advancement program (PETRA) at the University of Zimbabwe. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.