Hypertension Control and Its Correlates Among Adults Attending a Hypertension Clinic in Tanzania |
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| Authors: | John Maginga MD MPH Mariana Guerrero MD Eileen Koh MD Christian Holm Hansen BSc MSc PhD Rehema Shedafa MD MMed Fredrick Kalokola MD MMed Luke R Smart MD Robert N Peck MD |
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| Institution: | 1. School of Public Health, Catholic University of Health & Allied Sciences, Mwanza, Tanzania;2. Weill Cornell Medical College, Cornell University, New York, NY;3. MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK;4. Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania;5. Department of Internal Medicine, Catholic University of Health & Allied Sciences, Mwanza, Tanzania;6. Center for Global Health, Weill Cornell Medical College, New York, NY |
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| Abstract: | Hypertension control rates are low in sub‐Saharan Africa. Population‐specific determinants of blood pressure (BP) control have not been adequately described. The authors measured BP and conducted interviews to determine factors associated with BP control among adults attending a hypertension clinic in Tanzania. Three hundred adults were enrolled. BP was controlled in 47.7% of patients at the study visit but only 28.3% over three consecutive visits. Demographic and socioeconomic factors were not associated with control. Obesity and higher medication cost were associated with decreased control. Their effect was mediated through adherence. Good knowledge of (odds ratio OR], 2.5; 95% confidence interval CI], 1.0–6.1; P=.047), attitudes towards (OR, 2.7; 95% CI, 1.0–7.1; P=.04), and practices concerning (OR, 5.4; 95% CI, 2.3–13.0; P<.001) hypertension were independently associated with increased control, even after adjusting for mediation through adherence. Good adherence had the strongest association with control (OR, 14.6; 95% CI, 5.8–37.0; P<.001). Strategies to reduce hypertension‐related morbidity and mortality in sub‐Saharan Africa should target these factors. Interventional studies of such strategies are needed. |
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