MST-Department of Public Health

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Browsing MST-Department of Public Health by Subject "Adult Hypertensive Patients"

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    Determinants of Compliance to Prescribed Antihypertensive Therapy among Adult Hypertensive Patients in Kilifi County Kenya
    (Kenyatta University, 2022) . Moss, John T. K; Harun Kimani; Isaac Mwanzo
    Hypertension/ High Blood Pressure is a condition that presents with elevated BP. Globally the overall prevalence of high BP is estimated to be 31%. Non-compliance to anti-hypertensive therapy is both public health and medical problem worldwide. Compliance to prescribed anti-hypertensive therapy is key in avoiding hypertension complications. This study aimed to evaluate the determinants of compliance to prescribed anti-hypertensive therapy among adults with hypertension condition in Kilifi County. A facility-based cross-sectional study was undertaken in four public health facilities in Kilifi County. Two hundred and thirteen patients were recruited in this study. Data was collected using a pretested questionnaire and analysed using Statistical Package for Social Sciences (SPSS) version 23. Chi-square test was utilized in establishing the associations between compliance to anti-hypertensive therapy and variables while logistic regression was adopted to determine independent risk factors of compliance. Compliance to anti-hypertensive therapy was recorded in 31(14.6%) of the hypertensive patients. A statistically significant association was established between compliance to anti-hypertensive therapy and patients’ knowledge (p<0.001); age (p=0.024); education level (p=0.05); income (p=0.013); duration on treatment (p=0.005); cost (p=0.029); health care provider advises (p=0.009); consistency of therapy (p=0.002); availability of medicines (p=0.021); and health facility distance (p=0.013). Independent risk factors for compliance to anti-hypertensive therapy were duration on treatment (OR=0.383; 95% CI 0.151-0.972); Knowledge on hypertension (OR= 2.715; 95% CI 1.598-4.615); Consistency of therapy (OR= 0.452; 95% CI 0.282-0.726); and cost of medication (OR =2.682; 95% CI 1.134-6.345). Prescribed anti-hypertensive therapy compliance among patients was low. This could be attributed to factors such as social-demographic, patient, and health service-related in nature as demonstrated in this study. Prompt public health interventions that are patient-community centered are required to improve the compliance to anti-hypertensive therapy
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    Dyslipidemia and Blood Pressure Control among Adult Hypertensive Patients at Kiambu County Hospital, Kenya.
    (Kenyatta University, 2020-09) Nderitu, Monica. N.
    Non-communicable diseases are on the rise globally. Hypertension is one of the most common non-communicable diseases. Globally, the prevalence of hypertension among adults was estimated to be 24.1% in men and 20.1% in women in 2015 and the global prevalence of raised cholesterol was found to be 39%. Across WHO regions, Africa was found to have the highest hypertension prevalence at 27%. Blood pressure control among hypertensive patients still continues to be a major challenge. Findings from several studies suggest an association between dyslipidemia and suboptimal blood pressure control among hypertensive patients. There is limited data in Kenya on whether dyslipidemia causes poor blood pressure control. This study aimed to assess the relationship between dyslipidemia and blood pressure control among hypertensive patients attending Kiambu county hospital. This was to help in early diagnosis and management of dyslipidemia in the management of hypertension thus improve blood pressure control and help reduce complications related to uncontrolled blood pressure. The main objective of this study was to assess the relationship between dyslipidemia and blood pressure control among hypertensive patients. This was an analytical cross-sectional study. The study population was hypertensive patients attending Kiambu County hospital. Structured questionnaires were administered by a clinician for data collection. Data collected was entered and stored in Microsoft Excel 2013. Data was cleaned, coded and analyzed. Blood pressure control was associated with socio-demographic characteristics, clinical factors and lipid profile using chi square tests for categorical variables and independent t test for comparison of means. Multiple logistic regression models were conducted to determine independent factors associated with poor blood pressure control. Statistical significance was determined at 5% level (p value less or equal to 0.05). 251 hypertensive patients in Kiambu hospital were studied. Their mean age was 55.7 with females being more than males at 80.9% and 19.9% respectively The mean systolic blood pressure was 145.1 mmHg and diastolic BP of 87.4 mmHg. Blood pressure was poorly controlled in 142(56.6%) (95% CI 50.6-62.9%). High LDL levels was diagnosed in 82.1% of the patients, 23.1% had low HDL levels, 31.9% had high triglycerides and 59.8% had high total cholesterol. Patients with poorly controlled hypertension had a significantly higher mean total cholesterol (221.4 mg/dl) compared to the well-controlled group (mean 193.4 mg/dl), p<0.001. Similarly, LDL levels were significantly higher in the poorly controlled group (mean 142.3 mg/dl) compared to the well-controlled group (mean 121.4 mg/dl), p=0.001. HDL and triglycerides were not significantly associated to hypertension control (p>0.05). Drug adherence, male gender and total cholesterol were independently associated with poor blood pressure control. In conclusion, majority of the patients studied had poor blood pressure control and. Dyslipidemia was a major problem and it was associated with uncontrolled blood pressure. However, more studies are recommended for correlation.