title: Level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital in Central Kenya.
abstract: BACKGROUND
  Uncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Data on adequacy of blood pressure control in Kenya is scarce. This study aimed at assessing the level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital.
  
  
  METHODS
  Data regarding blood pressure, antihypertensive medication use, and comorbidities was abstracted from medical records of 452 hypertensive patients seen in Nyeri Provincial General Hospital between January and March 2013. Adequate blood pressure control was defined as a systolic pressure<140 mmHg (<130 mmHg for diabetic hypertensive patients) and a diastolic pressure<90 mmHg (<80 mmHg for diabetic hypertensive patients). Data was entered and analyzed using STATA 9 (StataCorp, Inc, Texas, USA).
  
  
  RESULTS
  Only 33.4% of patients had a blood pressure within the recommended limits. In multivariate analysis, using a calcium channel blocker was significantly associated with good blood pressure control (OR, 2.1; 95% CI, 1.4, 3.3). On the other hand, old age (≥60 years), being diabetic, and the use of three or more antihypertensive drugs were associated with reduced odds of good blood pressure control (OR, 0.64; 95% CI, 0.43; OR, 0.54; 95% CI, 0.36, 0.81; and OR, 0.41; 95% CI, 0.26, 0.64, respectively).
  
  
  CONCLUSIONS
  Poorly controlled blood pressure is an important public health concern among hypertensive patients in this region. Elderly patients, those with diabetes, and those on multidrug regimens are at higher risk for poor blood pressure control and warrant closer attention.
authors.affiliation: School of Health Sciences, Dedan Kimathi University of Technology, Nyeri, Kenya.
authors.forename: Ernest Muthami
authors.initials: EM
authors.lastname: Mutua
authors.affiliation: School of Health Sciences, Dedan Kimathi University of Technology, Nyeri, Kenya.
authors.forename: Moses Mwangi
authors.initials: MM
authors.lastname: Gitonga
authors.affiliation: Nyeri Provincial General Hospital, Nyeri, Kenya.
authors.forename: Beth
authors.initials: B
authors.lastname: Mbuthia
authors.affiliation: Nyeri Provincial General Hospital, Nyeri, Kenya.
authors.forename: Nelly
authors.initials: N
authors.lastname: Muiruri
authors.affiliation: School of Health Sciences, Dedan Kimathi University of Technology, Nyeri, Kenya.
authors.forename: Joyce Jebet
authors.initials: JJ
authors.lastname: Cheptum
authors.affiliation: School of Health Sciences, Kenyatta University, Nairobi, Kenya.
authors.forename: Thomas
authors.initials: T
authors.lastname: Maingi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D063728:Secondary Care Centers
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers
keywords: Hypertension; Kenya; antihypertensive; blood pressure; diabetes