Prevalence and Factors Associated With Good Blood Pressure Control Among Hypertensive Patients in a Malaysian Primary Health Clinic

Abstract Background: Good blood pressure (BP) control in hypertensive patients is essential in reducing the risk of cardiovascular diseases. Even a slight reduction in BP may significantly improve cardiovascular outcomes. Several factors have been associated with good BP control. We aimed to determine the prevalence of good BP control among hypertensive patients and its associated factors in a Malaysian primary health clinic. Method: A cross-sectional study was conducted among Malaysian adults aged 18 years and above with underlying hypertension who attended a public healthcare clinic located in a suburban area of Melaka, Malaysia, from December 2024 to February 2025. Participants were selected via systematic random sampling. Data were collected through self-administered questionnaires, medical records, and blood pressure levels, including both clinical blood pressure measurements and documented home blood pressure monitoring. BP control was categorized based on patients' co-morbidities as recommended by the Malaysian Clinical Practice Guideline. A multiple logistic regression was conducted to determine the factors associated with good blood pressure control. Results: A total of 460 hypertensive patients were included in this study, with a response rate of 96.8%. Only 41.5% of the participants (n=191) had good BP control. The median age was 64 (IQR:17) and the majority were female (57.4%, n=264). The significant factors associated with good blood pressure control among the study population were increasing age (aOR=1.038, 95% CI [1.018,1.057], p<0.001), females gender (aOR=2.103, 95% CI [1.395,3.171], p<0.001), participants who took one and two anti-hypertensive (aOR=1.922, 95% CI [1.146,3.226],p=0.013) and (aOR=2.822, 95% CI [1.632,4.881], p<0.001) respectively, participants without diabetes (aOR=1.685, 95% CI [1.109,2.560], p=0.015), and participant who had documented Home BP Monitoring (HBPM) (aOR=4.650, 95% CI [2.397,9.022], p<0.001). Conclusions: The findings suggest that the prevalence of good blood pressure control, 41.5% is still low among the study population. Factors associated with good Blood pressure control include increasing age, female gender, patients on fewer than three antihypertensive medications, hypertensive patients without diabetes mellitus, and those who have documented home blood pressure monitoring, even after controlling for confounders.