Prevalence and Associated Risk Factors of Congestive Heart Failure among Hypertensive Patients Attending Selected Health Facilities in Kiambu County, Kenya

Abstract

The study objective was to determine prevalence and associated risk factors of congestive heart failure among hypertensive patients attending selected health facilities in Kiambu County. The specific objectives were to determine the prevalence of Congestive Heart Failure (CHF), to determine the risk factors associated with development of CHF and to determine the health service delivery related factors associated with the development of CHF among hypertensive patients attending selected health facilities in Kiambu County. Several studies have been carried out in Kenya regarding CHF but minimal published research has been carried out in Kenya and in Kiambu County on CHF amongst hypertensive patients. This study therefore aimed to bring knowledge on the disease burden of CHF and the determinants of CHF among the hypertensive patients. The sample population was patients seen in the Medical Out-patient Clinic every week and key informants. The total sample size was 239. Data was obtained using questionnaires and key informant interviews after obtaining written consent from the research participants. The interview took place in two rooms within the MOPC facilities where privacy and confidentiality were upheld. Quantitative data was analyzed using means, percentages, standard deviation to summarize the data and to measure the prevalence of CHF among the hypertensive patients. Chi square and logistic regression were utilized to draw associations and predictions respectively between the risk factors and health service-related factors (independent variables) and the development of CHF among the hypertensive patients (dependent variable). Qualitative data was analyzed by identifying patterns after data collection. The study results showed that the prevalence of CHF among hypertension patients attending selected health facilities in Kiambu County was 9.6%. The risk factors associated with development of CHF were activity level (p=0.016), time spent sitting and travelling (p=0.042) and BMI (p=0.0001). Health service delivery related factors that were associated with development of CHF were availability of hypertension medicine (p=0.003), scheduled appropriate CHF clinic follow up (p=0.009) and availability of screening services for CHF risk factors in the hospital (p=0.001). The study concluded that modifiable risk factors and all the investigated health service delivery related factors were associated with CHF development. The study recommended that Kiambu County government investigate ways of lowering CHF prevalence, mitigate the modifiable risk factors to reduce CHF development, identify and address areas of weakness on the health service delivery systems like medicines availability and patient’s scheduled clinic follow up.