Abstract
Background: Blood pressure (BP) is poorly controlled in sub-Saharan Africa and this is due to poor utilization of antihypertensive drugs among other factors. Evaluation BP control will provide basis for recommendation for appropriate therapeutic measures for achieving target BP.
Aim: To determine the pattern of BP control as a measure of impact of antihypertensive usage among treated hypertensive patients in University of Ilorin Teaching Hospital in Nigeria.
Methodology: This is a descriptive-analytical study of 605 treated adult hypertensive patients who have been attending our specialist clinics for at least one year. Definition of blood pressure control was according to the World Health Organization criteria.
Results: The results showed that the mean age was 58.48±11.65 with 211(34.9%) males (M:F =1:1.87). Median duration of follow up was 4(1-27) years. 152(25%) were diabetic, 381(63% ) were taking antiplatelet aspirin and 213(35.2%) had cardiovascular events. There was a significant difference between the first visit BP (initial BP) and last BP observed during the study (SBP[initial])=154±28mmHg, SBP(last)=133±21mmHg(p<0.001); DBP[initial]=95±17mmHg, DBP[last]=80±12mmHg (p<0.001)).The pattern of BP control was: SBP+DBP controlled 322(53.3%); SBP+DBP uncontrolled 149(24.6%); SBP controlled/DBP uncontrolled 39(6.4%); DBP controlled/SBP uncontrolled 95(15.7%).The control rate among the diabetic subgroup was 23.7%.
Conclusion: BP control rate among treated hypertensive patients in our institution is significantly higher than reports from similar patient populations in similar healthcare centres in Nigeria and sub-Saharan Africa which reflects an improved and appropriate usage of antihypertensive drugs recently observed in our institution. The rate of control among diabetics is still very poor.
Keywords: Blood pressure control, antihypertensive, sub-Saharan Africa, Nigeria
Résumé
La tension artérielle (TA) est moins contrôlée en Afrique Sub-saharienne par la faible utilisation des médicaments antihypertenseurs parmi tant d’autres facteurs. L’évaluation de la pression artérielle apportera une base pour recommander des mesures thérapeutiques appropriées pour atteindre la TA désirée. Le but de cette étude était de déterminer la fréquence de la TA contrôle comme une mesure de l’impact de l’usage d’antihypertenseur parmi les patients traités au Centre Universitaire et Hospitalier d’ Ilorin, Nigeria. Cette étude analytique descriptive sur 605 adultes hypertensifs admis et traits dans nos clinques pour au moins un an. La définition de la pression artérielle contrôlée était selon les critères de l’organisation mondiale de la sante. Les résultats montraient que la moyenne d’âge était de 58.48±11.65 avec 211(34.9%) males (M:F =1:1.87). la durée médiane de suivi était de 4(1-27) ans. 152(25%) étaient des diabétiques, 381(63%) prenaient l’aspirine comme anti plaquettes et 213(35.2%) avaient des problèmes cardiovasculaires. Il y avait une différence significative entre la première tension artérielle ( TA initiale) et la dernière TA observée durant cette étude (SBP[initiale])=154±28mmHg, SBP[derniere]=133±21mmHg(p<0.001); DBP[initiale]=95±17mmHg, DBP[derniere]=80±12mmHg (p<0.001)).La fréquence de la TA contrôlée était de SBP+DBP contrôlée 322(53.3%); SBP+DBP non-contrôlée 149(24.6%); SBP contrôlée/DBP non-contrôlée 39(6.4%); DBP contrôlée/SBP non-contrôlée 95(15.7%). Le taux de contrôle parmi les
sous groupes des diabétiques était de 23.7%. En conclusion, la TA contrôlée taux parmi les patients hypertensive traits dans notre institution était significativement plus élevée que les autres études semblables dans d’autres centre de santé au Nigeria et au sud du Sahara qui reflète l’usage approprié et intensif et récent. Le taux de contrôle parmi les patients diabétiques est encore très faible.
Correspondence: Dr. T.O. Olanrewaju, Division of Nephrology, Department of Medicine, Universty of Ilorin Teaching Hospital, PMB 1459, Ilorin, Nigeria. E-mail: timothysegun@yahoo.com
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