Blood Pressure Control, Left Ventricular Hypertrophy and Treatment Practice Among Hypertensive Patients in Ethiopia

Figures & data

Figure 1 Schematic flow chart of recruiting participants for analysis.

Abbreviation: ACSH, Ayder Comprehensive Specialized Hospital.

Table 1 Socio-Demographic Characteristics of Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variables		Frequency	Percent
Sex	Female	143	64.1
	Male	80	35.9
Age	<60	122	54.7
	≥60	101	45.3
Religion	Orthodox	203	91.0
	Muslim	15	6.7
	Protestant	3	1.3
	Catholic	2	0.9
Ethnicity	Tigray	221	99.1
	Amara	1	0.45
	Afar	1	0.45
Residence	Urban	196	87.9
	Rural	27	12.1
Marital status	Single	6	2.7
	Married	148	66.4
	Divorced	37	16.6
	Widowed	32	14.3
Educational level	No formal education	103	46.2
	Primary school	56	25.1
	Secondary school	19	8.5
	College/university	45	20.2
Work status	House wife	107	48.0
	Government employee	78	35.0
	Unemployed	2	0.9
	Private	21	9.4
	Farmer	12	5.4
	Student	2	0.9
	Retired	1	0.4
*Income (ETB)	very low	33	14.8
	Low	139	62.3
	Middle	25	11.2
	High	26	11.7

Notes: *Very low <1000, Low 1000–3000, middle >30005000, high>5000. This income is categorized based on quartiles.

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; ETB, Ethiopian Birr

Table 2 Life Style and Anthropometric Related Characteristics of Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variable		Frequency	Percent
Smoking	No	220	98.7
	Yes	3	1.3
Salt reduction	No	58	26.0
	Yes	165	74.0
Physical activity	Inactive	47	21.1
	Active	176	78.9
Alcohol consumption	No	211	94.6
	Yes	12	5.4
Coffee drinking	No	63	28.3
	Yes	160	71.7
Khat chewing	No	223	100.0
Waist circumference for females	≤80cm	36	25.2
	>80cm	107	74.8
	Total	143	100
Waist Circumference for males	≤94cm	64	80
	>94cm	16	20
	Total	80	100
Body mass index (in kg/m2)	Under weight	14	6.3
	Normal weight	138	61.9
	Over weight	59	26.5
	Obese	12	5.4

Abbreviation: ACSH, Ayder Comprehensive Specialized Hospital

Table 3 Clinical Characteristics of Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variable		Frequency	Percent
Family history of HTN	No	194	87.0
	Yes	29	13.0
Comorbidities	Diabetes	7	3.1
	Kidney disease	8	3.6
	HHD	18	8.1
	Thyroid disease	3	1.3
	PAD	3	1.3
	Stroke	21	9.4
	Dyslipidemia	6	2.7
	Others*	10	4.5
	No comorbidities	147	65.9
Duration of HTN	<5 years	116	61.0
	≥5 years	107	48.0
Duration of treatment	<5 years	136	61.0
	≥5 years	87	39.0
BP measurement Frequency	≤2weeks	30	13.45
	>2 −4weeks	163	73.10
	>4 weeks	30	13.45

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; BP, blood pressure; HTN, hypertension; HHD, hypertensive heart disease; PAD, peripheral arterial disease.

Note: *, HIV, Tuberculosis, Bronchial asthma, and Deep Vein Thrombosis.

Table 4 Prescribing Pattern of Antihypertensive Drugs and Common Side Effects Among Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variable		Frequency	Percent
Mono-therapy		90	40.40
Specific mono-therapy	Hydrochlorothiazide	46	20.6
	Enalapril	12	5.4
	Nifedipine	21	9.4
	Amlodipine	9	4.0
	Metoprolol	1	0.4
	Atenolol	1	0.4
Dual therapy		118	52.91
Specific dual therapy	HCT+Enalapril	50	22.4
	HCT+ Nifedipine	30	13.5
	HCT+Amlodipine	11	4.9
	Enalapril+ Nifedipine	11	4.9
	Enalapril+Amlodipine	6	2.7
	Enalapril + Metoprolol	4	1.8
	Enalapril + Atenolol	2	0.9
	Enalapril+Propranolol	2	0.9
	Nifedipine +Metoprolol	2	0.9
Triple therapy		15	6.73
Specific triple therapy	HCT+Enalapril+nifediine	11	4.9
	HCT+Enalapril+Amlodipine	4	1.8
Side effects of drugs	No	184	82.5
	Yes	39	17.5
Specific side effects of drugs	Peripheral edema	18	8.1
	Headache	11	4.9
	Cough	8	3.6
	Fatigue	1	0.4
	Hypotension	1	o.4
Medication adherence status	Adherent	160	71.7
	Non-adherent	63	28.3

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; HCT, hydrochlorothiazide.

Figure 2 Level of BP control among hypertensive patients on follow-up care at ACSH, Ethiopia, 2019.

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; BP, blood pressure.

Table 5 Bivariate and Multivariate Logistic Regression Analyses of Predictors of Uncontrolled BP Among Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variable	Blood Pressure Control		Bivariate		Multivariate
			COR (95% CI)	P-value	AOR (95% CI)	P-value
	Uncontrolled (%)	Controlled (%)
Age
<60years	29(23.8%)	93(76.2%)	1
≥60years	41(40.6%)	60(59.4%)	2.191(1.232,3.897)	0.008	1.544 0(0.507,4.699)	0.445
Salt reduction
Adherent	28(17.0%)	137(83.0%)	1
No-adherent	42(72.4%)	16(27.6%)	2.844(3.347,5.989)	<0.001	8.552(2.853,15.638)	<0.001
Physical Activity
Inactive	20(42.6%)	27(57.4%)	1
Active	50(28.4%)	126(71.6%)	0.536(0.276,1.041)	0.066	0.928(0.247,3.484)	0.912
Family hX HTN
No	64 (33.0%)	130(67.0%)	1
Yes	6(20.7%)	23(79.3%)	0.530(0.206,1.366)	0.189	0.487(0.099,2.388)	0.375
Drug adherence
Adherent	14(8.8%)	146(91.3%)	1
Non-adherent	56(88.9%)	7(11.1%)	3.429(2.003,7.49)	<0.001	2.886(1.710,3.935)	<0.001
CCB
No	28(23.7%)	90(76.3%)	1
Yes	42(40.0%)	63(60.0%)	2.143(1.204,3.814)	0.010	1.601(0.554,4.625)	0.385
Number of drugs
Mono-therapy	22(24.4%)	68(75.6%)	1
Two drugs	41(34.7%)	77(65.3%)	1.646(0.892,3.035)	0.111	2.539(0.773,8.343)	0.125
Triple drugs	7(46.7%)	8(53.3%)	2.705(0.880,8.310)	0.082	7.228(1.110,10.057)	0.033
Frequency of BP measurement
≤ 2weeks	12(40.0%)	18(60.0%)	1
>24weeks	56(34.4%)	107(65.6%)	0.785(0.353,1.745)	0.553	0.727(0.170,3.114)	0.667
>4 weeks	2(6.7%)	28(93.3%)	0.107(0.021,0.536)	0.007	0.201(0.014,2.967)	0.243
Abdominal obesity
Absent	64(64.0%)	36(36.0%)	1
Present	89(72.4%)	34(27.6%)	1.472(0.834,2.599)	0.182	2.185(0.759,6.288)	0.147

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; AOR, adjusted odds ratio; CCB, calcium channel blockers; COR, crude odds ratio; CI, confidence interval; hX HTN, history of hypertension.

Figure 3 Magnitude of LVH and Proteinuria among hypertensive patients on follow up at ACSH, Ethiopia, 2019.

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; LVH, left ventricular hypertrophy.

Table 6 Predictors of LVH Among Hypertensive Patients on Follow Up at ACSH, Ethiopia, 2019

Variable	Ventricular Status		Bivariate		Multivariate
	LVH	No-LVH	COR	P-value	AOR	P-value
Age
<60	33(27.0%)	89(73.0%)	1
≥60	55(54.5%)	46(45.5%)	3.225(1.843,5.642)	<0.001	2.421(1.263,4.639)	0.006
Adherence
Non-adherent	40(63.5%)	23(36.5%)	1
Adherent	48(30.0%)	112(70.0%)	0.246(0.133,0.455)	<0.001	0.982(0.352,2.739)	0.972
Abdominal obesity
Absent	51(51.0%)	49(49.0%)	1
Present	86(69.9%)	37(30.1%)	2.419(1.396,4.192)	0.002	2.2(1.399,4.69)	0.009
HTN Status
Controlled	42(27.5%)	111(72.5%)	1
Uncontrolled	46(65.7%)	24(34.3%)	5.065(2.758,9.304)	<0.001	3.16(1.208,5.232)	0.015
Salt reduce
No	36(62.1%0	22(37.9%)	1
Yes	52(31.5%)	113(68.5%)	0.281(0.151,0.525)	<0.001	0.627(0.287,1.366)	0.240
Exercise
Inactive	25(53.2%)	22(46.8%)	1
Active	63(35.8%)	113(64.2%)	0.491(0.256,0.940)	0.032	0.833(0.387,1.791)	0.640

Abbreviations: ACSH, Ayder Comprehensive Specialized Hospital; AOR, adjusted odds ratio; COR, crude odds ratio; CI, confidence interval; HTN, hypertension; LVH, left ventricular hypertension.