How to help patients to control their blood pressure? Blood pressure control and its predictor

Abstract

Introduction: Good blood pressure (BP) control is one of the aims of hypertension disease management. Consistently achieving the targeted BP could reduce patient′s risk of developing the complication of hypertension. Materials and Methods: This study is a prospective cohort study aimed to investigate the blood pressure reading among in patients in a public tertiary hospital in northern Malaysia and to determine predictor of good BP control among patients. Patients were followed from their admission day until discharge. Data were collected by the researcher from the medical records. Information collected were BP reading on admission, day 1 and discharge. Other information includes demographic data, social factors, medication name and number, co-morbidities, target organ damage, cardiovascular risk factors. Descriptive analysis was done to determine the characteristic of patients and logistic regression was done to identify factors associated with BP control. Results: A total of 400 patients were followed up from admission till discharge. BP was controlled in 24% on admission and in 54% of patients on discharge. Multivariate analysis on admission revealed that the predictors of BP control were the use of diuretics and statin. Factors identified to be associated with poor BP control were diabetes mellitus, cerebrovascular disease and retinopathy. Multivariate analysis on discharge showed that the predictors of good BP control were diuretics and beta-blockers and the predictors of poor BP control were diabetes, chronic kidney disease, diabetic nephropathy, cerebrovascular disease and number of comorbidity. Conclusion: These results demonstrated that hypertension was poorly controlled among in-patients and that BP control was better on discharge than on admission. Patients with diabetes mellitus, renal disease and cerebrovascular disease were more likely to have poor hypertension control.

Keywords

• Blood pressure monitoring and measurement
• cardiovascular disease
• diabetes complications