Clinical Epidemiology and Global Health (Sep 2024)
Uncontrolled hypertension among adult patients at ambulatory primary care: Frequency and factors associated in urban and peri-urban Bobo–Dioulasso, Burkina Faso
Abstract
Introduction: This study described the different stages of uncontrolled hypertension, and assessed independently of the socio-demographic parameters, the non-modifiable and modifiable factors associated with uncontrolled hypertension at ambulatory care, in urban and peri-urban primary health care centres (PHCCs) of Bobo–Dioulasso, Burkina Faso. Methods: A sample of 380 hypertensive adults were consecutively interviewed from January to February 2022, in 20 public PHCCs, in Bobo-Dioulasso. Sociodemographic, non- and modifiable lifestyle, anthropometric and blood pressure parameters were collected. Descriptive, comparative and logistic regression tests were performed. Results: The participants’ mean age was 56.2 ± 10.4 years and frequency of uncontrolled hypertension stage I, II and III was respectively 40.3 %, 23.3 % and 7.9 %. Those with family history of hypertension was 42.4 %. Participants with monotherapy, bi-therapy and tri-therapy represented 51.6 %, 42.6 % and 2.1 % respectively, while 38.2 % declared to be uncompliant with the therapy. About 36 % were current alcohol users, 29.7 % physically inactive, 23.7 % ate less than three servings of fruits and vegetables (FV), 15.3 % were obese, and 12.9 % current tobacco users. In logistic regression analysis, the presence of family history of hypertension [adjusted odds ratio (aOR) = 2.1; p = 0.005], use of bi-/tri-therapy (aOR = 1.7; p = 0.044), daily intake of less than three FV servings (aOR = 1.9; p = 0.025); non-adherence with therapy (aOR = 3.3, p = 0.0001) and obesity (aOR = 4.5; p = 0.003) were associated with uncontrolled hypertension. Conclusion: Uncontrolled hypertension was high at ambulatory primary care. For its efficient management in secondary prevention, a tailored in-hospital strategy including permanent education for a healthier lifestyle practice is needed; and should be complementary strengthened with specific community-based interventions.