TREATMENT GOALS ACHIEVED AMONG HYPERTENSIVES AT THE B/A REGIONAL HOSPITAL IN SUNYANI, GHANA.
DOI:
https://doi.org/10.22159/ajpcr.2020.v13i11.38991Keywords:
Hypertensives, Treatment goal, Treatment target, Controlled blood pressure, ConsistencyAbstract
Objective: The objective of the study was to assess the current success rate of hypertensive patients in achieving blood pressure (BP) treatment goals and to investigate the extent of the consistency in the control of BP following initial achievement.
Methods: At the hypertension clinic of the B/A Regional Hospital in Sunyani, Ghana, the current BP of 400 sampled patients, aged 35–100 years was measured. In addition, a retrospective review of nine successive BPs previously recorded in patients’ medical histories was done.
Results: Of the 400 patients, women constituted 71.75%. Hypertensive aged ≥60 years represented 64.25% with the rest being ˂60 years. In 58% of patients, there were comorbidities. The adherence to clinic appointment was 54.50%. Of the ten clinic visits, 20.30% of patients ˂60 years were adequately controlled of their BPs while those ≥60 years achieved 33.80% control. In all, 29% of the 400 hypertensives met their treatment goals adequately. Consistency in maintaining a controlled BP at all times was achieved by 23.70% of the 400 patients. Regular visits to clinic was associated with adequate BP control (p˂0.001) while comorbidity was not (p=0.122).
Conclusion: Treatment goals’ achievement by hypertensives at the Regional Hospital in Sunyani, Ghana, was relatively low. Consistency in maintaining a controlled BP while on medication is poor. The lack of consistency in keeping a controlled BP may contribute to the increased cardiovascular deaths among hypertensives. Intensive mass education and treatment optimization are required to deal with treatment failures among patients.
Downloads
References
Moser M, Roccella EJ. The treatment of hypertension: A remarkable success story. J Clin Hypertens (Greenwich) 2013;15:88-91.
D’souzai SJ, Mani A, Kurian N, Jaikanth C. Assessment of professional’s adherence to joint national committee 8 guidelines in the management of hypertension. Asian J Pharm Clin Res 2019;12:101-5.
Kovell LC, Ahmed HM, Misra S, Whelton SP, Prokopowicz GP, Blumenthal RS, et al. US hypertension management guidelines: A review of the recent past and recommendations for the future. J Am Heart Assoc 2015;4:e002315.
World Health Organisation. Global Health Observatory (GHO) Data on Raised Blood Pressure, Situation and Trends. Geneva: World Health Organisation; 2019. Available from: https://www.who.int/gho/ncd/ risk_factors/blood_pressure_text/en. [Last accessed on 2019 Jun 23].
Cushman WC, Whelton PK, Fine LJ, Wright JT Jr., Reboussin DM, Johnson KC, et al. SPRINT trial results: Latest news in hypertension management. Hypertension 2016;67:263-5.
World Health Organization. Cardiovascular Diseases (CVDs): Key Facts. Geneva: World Health Organization; 2017. Avialable from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). [Last accessed on 2019 Jun 23].
Ghana Medical Association. Cardiovascular Diseases at Alarming Levels; Communiqué Issued at the 58th Conference at Ho, Ghana; 2016. Available from: http://www.myjoyonline. [Last accessed on 2019 Jun 23].
Ghana Health Service. The Health Sector in Ghana: Facts and Figures. Accra, Ghana: Ghana Health Service; 2018. Available from: https:// www.ghanahealthservice.org/downloads/facts+figures_2018.pdf. [Last accessed on 2019 Jun 23].
Orduñez-Garcia P, Munoz JL, Pedraza D, Espinosa-Brito A, Silva LC, Cooper RS. Success in control of hypertension in a low-resource setting: The Cuban experience. J Hypertens 2006;24:845-9.
Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. BMJ Open 2013;3:e003423.
Kudo N, Yokokawa H, Fukuda H, Sanada H, Miwa Y, Hisaoka T, et al. Achievement of target blood pressure levels among Japanese workers with hypertension and healthy lifestyle characteristics associated with therapeutic failure. PLoS One 2015;10:e0133641.
Sanuade OA, Boatemaa S, Kushitor MK. Hypertension prevalence, awareness, treatment and control in Ghanaian population: Evidence from the Ghana demographic and health survey. PLoS One 2018;13:e0205985.
Dosoo DK, Nyame S, Enuameh YA, Ayetey H, Danwonno H, Twumasi M, et al. Prevalence of hypertension in the middle belt of Ghana: A community-based screening study. Int J Hypertens 2019;2019:1089578.
Standard Treatment Guidelines. Republic of Ghana Ministry of Health. 7th ed. Ghana: Yamens Press Ltd.; 2017.
Armstrong C, Joint National Committee. JNC8 guidelines for the management of hypertension in adults. Am Fam Physician 2014;90:503-4.
Nwabuo CC, Dy SM, Weeks K, Young JH. Factors associated with appointment non-adherence among African-Americans with severe, poorly controlled hypertension. PLoS One 2014;9:e103090.
Akinniyi AA, Olamide OO. Missed medical appointment among hypertensive and diabetic outpatients in a tertiary healthcare facility in Ibadan, Nigeria. Trop J Pharm Res 2017;16:1417-24.
Ogedegbe G, Schoenthaler A, Fernandez S. Appointment-keeping behavior is not related to medication adherence in hypertensive African Americans. J Gen Intern Med 2007;22:1176-9.
Katsouli A, Pandey T, Goldberg D. Abstract 54: An assessment of hypertension care and consistency of blood pressure control in a general medical clinic. Circ Cardiovasc Qual Outcomes 2012;5 Suppl 1:A54.
Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR. et al. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 2004;43:10-7.
Banegas JR, López-García E, Dallongeville J, Guallar E, Halcox JP, Borghi C. et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: The EURIKA study. Eur Heart J 2011;32:2143-52.
Schmieder RE, Gitt AK, Koch C, Bramlage P, Quarrak T, Tschope D. Achievement of individualized treatment targets in patients with comorbid Type-2 diabetes and hypertension: 6 Months results of the dialogue registry. BMC Endocr Disord 2015;15:23.
Muleta S, Melaku T, Chelkeba L, Assefa D. Blood pressure control and its determinants among diabetes mellitus co-morbid hypertensive patients at Jimma University medical center, South West Ethiopia. Clin Hypertens 2017;23:29.
Noubani A, Nasreddine L, Sibai AM, Tamim H, Isma’eel H, Hussain I. Prevalence, awareness, and control of hypertension in Greater Beirut area, Lebanon. Int J Hypertens 2018;2018:5419861.
Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National health and nutrition examination survey, 2011- 2012. NCHS Data Brief 2013;133:1-8.
Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J Cardiol 2012;4:135-47.
Choi HM, Kim HC, Kang DR. Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea national health and nutrition examination survey. PLoS One 2017;12:e0178334.
Sandberg K, Ji H. Sex differences in primary hypertension. Biol Sex Differ 2012;3:7.
Everett B, Zajacova A. Gender differences in hypertension and hypertension awareness among young adults. Biodemography Soc Biol 2015;61:1-17.
Dharan DR, Moly Kt. Factors influencing compliance to therapeutic regimen among patients with hypertension. Asian J Pharm Clin Res 2017;10:286-9.
Frank J. Managing hypertension using combination therapy. Am Fam Physician 2008;77:1279-86.
Williams SK, Ravenell J, Seyedali S, Nayef S, Ogedegbe G. Hypertension treatment in blacks: Discussion of the U.S. clinical practice guidelines. Prog Cardiovasc Dis 2016;59:282-8.
Guerrero-García C, Rubio-Guerra AF. Combination therapy in the treatment of hypertension. Drugs Context 2018;7:212531.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.