Analysis and identification of symptoms and risk factors in a cohort of chronic hypertensive patients in a tertiary care hospital in Sri Lanka

ABSTRACT

Background: Hypertension (HT) is identified as a highly prevalent cardiovascular risk factor and also as a separate disease entity, leading to significant mortality and morbidity. The rate of HT is increasing worldwide with a faster rate identified in developing countries. Thus, it is important to evaluate epidemiological patterns of chronic HT in a developing country like Sri Lanka.

Methodology: This is a cross-sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka, to assess symptoms and risk factors among patients with chronic HT.

Results: In a cohort of 266 chronic hypertensives, the mean values for age of population, age of onset, and duration of HT, respectively, are 63, 45, and 8 years. At presentation, 24.8% were asymptomatic. The commonest presentation at diagnosis was dizziness accounting for 33.8% cases, followed by chest pain, headache, loss of consciousness, and shortness of breath accounting for 7.5%, 13.5%, 2.6%, and 4.5%, respectively. Approximately 36.5% of patients had a positive family history. Fathers of 7.1% patients, mothers of 19.2%, and both parents of 10.2% patients had HT. 38.7% of patients had one or more siblings with HT. 34.6% had diabetes mellitus.

Conclusion: Symptoms of those with HT are mostly nonspecific and should be considered as possible warning signs prior to the development of sinister complications of the disease. Family history of HT with affected siblings, or one of the parents, was, observed in more than one-third of patients. Early screening and prevention of modifiable risk factors are important in these patients to prevent debilitating complications.

KEYWORDS:

• Hypertension
• chronic
• epidemiology
• symptoms
• risk factors
• Sri Lanka

Abbreviations

NCD	=	Noncommunicable diseases
HT	=	Hypertension
DASH	=	Dietary Approaches to Stop Hypertension

Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Ethics approval was taken from the Institutional Ethical Review Committee (IERC) of the Faculty of Medicine, University of Peradeniya. Informed signed consent was taken from all the participants prior to collecting data.

Consent for publication

Consent for publication was taken from all the participants prior to data collection and from all the authors of the study.

Availability of data and material

The data of the study are available with the authors of the study and is secured with password protection for which only the authors have access to.

Authors’ information

UR [MBBS, MD, MRCP (UK), FRCP (London)] is a Senior Lecturer and Senior Consultant Physician, Department of Medicine, University of Peradeniya. NN [MBBS] is an Intern Medical officer at the professorial Medical Unit at the Teaching Hospital Peradeniya. KPJ [MBBS] and NW [MBBS] are Temporary Lecturers and Research Assistants, Department of Medicine, University of Peradeniya, Sri Lanka. ST [MBBS, PhD] is a Senior Lecturer, Department of Community Medicine, University of Peradeniya.

Acknowledgments

We all express our gratitude to all participants who consented to take part in this study.

Additional information

Funding

The study was self-funded by the authors of the study.

Notes on contributors

Udaya Ralapanawa

UR conceived the research idea and guided it. Data collection, analysis and interpretation of data and literature review were done by UR, NN, KPJ, NW and ST. UR and ST guided the other authors in data analysis, interpretation and corrected the final manuscript. All authors were involved in the study and read and approved the final manuscript.