Determinants of uncontrolled blood pressure among hypertensive patients on follow-up taking antihypertensive medication

Abstract Background: Uncontrolled blood pressure in individuals with hypertension is a serious public health risk in both developed and developing countries, which lead to premature mortality and disability on an international level. However, limited studies have been conducted on determinants of uncontrolled hypertension in Ethiopia. Therefore, this study was aimed to identify the determinants of uncontrolled blood pressure among hypertensive patients on medication at Adama Hospital Medical College. Methods: An unmatched case-control study design with 1:1 ratio was conducted among 388 hypertensive patients receiving treatment from Adama Hospital Medical College from May 15- July 1. Participants were selected by systematic random sampling. Data was collected using pretested questionnaires and using face-to-face interview and entered using Epi data 4.6 as well as analysis was performed by using SPSS version 26. Descriptive statistics was done and presented using text, frequency tables, charts and graphs. Biviariable logistic regression was done and variables with p- value less than 0.25 were eligible for the final model, in multivariable logistic regression model (AOR, 95% CI, and p value 0.05) was used to declare determinants of uncontrolled blood pressure. Results: In this study, 398 participants (194 cases and 194 controls) were involved, which gives a 97.2% response rate. The odds of uncontrolled hypertension were significantly associated with medical comorbidity (AOR = 3.12; 95% CI 1.73, 5.63), having poor knowledge (AOR = 2.71; 95% CI 1.60, 4.58), participants who were non-adherent to medication (AOR = 1.85; CI 1.05, 3.24), those participants who were 60 years or above (AOR = 2.19; 95% CI 1.27, 3.79), those who did not follow a low-sodium diet (AOR = 3.78; 95% CI 1.92, 7.43), and participants who were moderately to severely distressed (AOR = 4.94; 95% CI 2.14, 11.41) to (AOR = 6.71; 95% CI 2.79, 16.15), respectively. Conclusion: This study showed a statistically significant association between uncontrolled hypertension and older age, concomitant comorbidity, lack of restriction of salt consumption, moderate to severe distress, inadequate knowledge, and poor medication adherence. Attention should be paid to hypertension, particularly uncontrolled blood pressure, and its related factors by the government, healthcare institutions, and medical personnel.