Sociodemographic and Clinical Correlates of Uncontrolled Hypertension in Patients on Treatment for Hypertension in a family Practice

Abstract

Background

Hypertension is a leading cause of cardiovascular morbidity globally, particularly in Africa. Despite clinic attendance and treatment, many hypertensive patients experience suboptimal blood pressure (BP) control. In Nigeria, hypertension is associated with high rates of multi-organ complications. Understanding the profiles of patients with uncontrolled hypertension is crucial for optimizing management strategies.

Objective

To describe the socio-demographic and clinical profile of hypertensive outpatients with uncontrolled blood pressure despite regular follow-up and instituted treatment.

Methods

A consecutive sampling of 78 registered hypertensive patients was conducted. Inclusion criteria were:

• Diagnosed with hypertension ≥6 months prior to recruitment

• Clinic BP ≥140/90 mmHg on at least two consecutive visits

Participants were recruited as part of an ongoing interventional study. Data were collected using a semi-structured questionnaire that incorporated the Hillbone Compliance to High Blood Pressure Scale. Sociodemographic and clinical variables were analyzed.

Results

• Gender distribution: 66.7% female (n = 52), 33.3% male (n = 26)

• Mean age: 54.3 ± 11.48 years

• Education: 62.3% had post-secondary education, 6.5% had no formal education

• Marital status: 80% married

• Income: Most earned above the Nigerian minimum wage

• Mean initial BP: 143.92/89.21 mmHg (SBP range: 93–185, DBP range: 61.5–136)

• Obesity: 40.3% of respondents

• Lifestyle: Low prevalence of alcohol and tobacco use

• Medication adherence: 71.4% adherent

A significant positive correlation was observed between poorer medication adherence and higher diastolic blood pressure (R = 2.57, p = 0.024).

Conclusion

Even patients with good medication adherence may exhibit suboptimal BP control. Physicians should recognize the patterns of uncontrolled hypertension regardless of favorable sociodemographic or clinical profiles and implement appropriate interventions to optimize management.