Dyslipidemia and Blood Pressure Control among Adult Hypertensive Patients at Kiambu County Hospital, Kenya.
Nderitu, Monica. N.
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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.