title: Patient-related barriers to hypertension control in a Nigerian population.
abstract: BACKGROUND
  Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria.
  
  
  METHODS
  This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication.
  
  
  RESULTS
  A total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants.
  
  
  CONCLUSIONS
  Poor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study.
authors: Nephrology Unit, Department of Internal Medicine, Abia State, Nigeria.
authors: Chimezie Godswill
authors: CG
authors: Okwuonu
authors: Department of Family Medicine, Federal Medical Center Umuahia, Abia State, Nigeria.
authors: Nnamdi Ezekiel
authors: NE
authors: Ojimadu
authors: Renal Unit, Department of Internal Medicine University of Benin Teaching Hospital, Benin City, Nigeria.
authors: Enajite Ibiene
authors: EI
authors: Okaka
authors: Neurology Unit, Department of Internal Medicine University of Benin Teaching Hospital, Benin City, Nigeria.
authors: Fatai Momodu
authors: FM
authors: Akemokwe
keywords: Blood pressure; diabetes mellitus; knowledge of hypertension; lifestyle modification; medication adherence; proteinuria