ABSTRACT

Objective: To identify patient-related factors that act as barriers to hypertension control.

Methods: A cross-sectional study of 365 patients diagnosed with primary hypertension attending primary healthcare facilities. Pre-tested questionnaire was administered; Blood Pressure and Body Mass Index were ascertained. Inferential statistics interpreted data; Chi-square and Fischer’s exact tests analysed differences in dichotomous variables. A p-value of ≤ 0.05 held statistical significance. Two Focus Group Discussions and ten in-depth interviews provided qualitative data.

Results: Of the 365 participants, only 30.1% had blood pressure readings within normal limits. Blood pressure was significantly higher in persons who last smoked under one year (p=0.018), persons who consumed alcohol (p=0.021), those reporting high stress levels (p=0.020) and those with weak support system (p=0.012; r=0.131).  Knowledge deficit was also significant where 55% believed that hypertension can be cured or was unsure and 28% denied personal responsibility in achieving control. Persons who were diagnosed 11 years or more were more likely to be uncontrolled (p = 0.010). Medication adherence (p=0.056), alternative medicine (p=0.476), diet (p=0.108), exercise (p=0.568) and obesity (p=0.941) showed no significant relationship.

Conclusion: Smoking, alcohol consumption, stress, level of awareness and support system are significant modifiable determinants to blood pressure control.  Clinicians oftentimes place much emphasis on medication adherence, diet and exercise however; these modifiable contributing factors are often overlooked in management of the condition. Addressing these issues could result in significant improvement in blood pressure control.