Factors Associated with Poor Tension Control in Hypertensive Patients

Introduction: High blood pressure is a major public health issue affecting 1.28 billion people worldwide in 2019, making it the leading chronic disease. Blood pressure control remains particularly difficult, especially in sub-Saharan Africa. The objective of our study was to identify factors associated with poor blood pressure control in hypertensive patients followed up at the cardiology department of the Dalal Jamm National Hospital. Patients and methods: This was a retrospective, descriptive and analytical, single-center cross-sectional study conducted over a 12-month period from January 1, 2021 to December 31, 2021, involving hypertensive patients followed for at least 3 months. The parameters studied were sociodemographic data, cardiovascular risk factors associated with high blood pressure, clinical signs, therapeutic compliance, therapeutic aspects, blood pressure control, and factors associated with poor control. The data were analyzed using RStudio 4.6 software. Result: High blood pressure represented 26.6% (n = 722) of the reasons for consultations and 109 patients were included in the study. We found a female predominance with a sex ratio of 0.48. The mean age of the population was 61.9 years ± 12. The predominant age group was 60 - 80 years representing 67% (n = 73) of patients. Diabetics represented 30% (n = 33) all type 2, 40% (n = 43) had dyslipidemia, 58 women had reached menopause. Sedentary lifestyle was found in 76% of patients, 61% (n = 67) had a family history of hypertension. In addition, 43.5% of the population studied had more than 3 risk factors in addition to hypertension. Patient follow-up was irregular in 21.1%. The mean systolic blood pressure was 162.4 ± 21 mm Hg and diastolic 96.16 ± 13.6 mm Hg. The mean heart rate was 77.84 ± 18.01 beats per minute. Dieulafoy signs were reported in 58% of patients. The low-sodium diet was respected by 77% of patients. Dual therapy was the most prescribed protocol with 42% (n = 46). Among the complications, heart failure was the most frequent (49%), followed by stroke (30%). The Girerd test was applied to assess therapeutic compliance, 30% of patients were good adherents, 43.5% had a minimal problem of adherence and 26.5% were not at all adherent. The blood pressure control rate was 53.20%. In bivariate analysis, sedentary lifestyle (p < 0.0001), irregular monitoring (p = 0.0008), poor compliance (p < 0.0001), herbal medicine (p = 0.025), and low socioeconomic level (p = 0.007) were the factors associated with poor blood pressure