Hypertension Control and Its Correlates Among Adults Attending a Hypertension Clinic in Tanzania.
Hypertension control rates are low in sub-Saharan Africa. Population-specific determinants of blood pressure (BP) control have not been adequately described. The authors measured BP and conducted interviews to determine factors associated with BP control among adults attending a hypertension clinic in Tanzania. Three hundred adults were enrolled. BP was controlled in 47.7% of patients at the study visit but only 28.3% over three consecutive visits. Demographic and socioeconomic factors were not associated with control. Obesity and higher medication cost were associated with decreased control. Their effect was mediated through adherence. Good knowledge of (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.0-6.1; P=.047), attitudes towards (OR, 2.7; 95% CI, 1.0-7.1; P=.04), and practices concerning (OR, 5.4; 95% CI, 2.3-13.0; P<.001) hypertension were independently associated with increased control, even after adjusting for mediation through adherence. Good adherence had the strongest association with control (OR, 14.6; 95% CI, 5.8-37.0; P<.001). Strategies to reduce hypertension-related morbidity and mortality in sub-Saharan Africa should target these factors. Interventional studies of such strategies are needed.
School of Public Health, Catholic University of Health & Allied Sciences, Mwanza, Tanzania.
John
J
Maginga
Weill Cornell Medical College, Cornell University, New York, NY.
Mariana
M
Guerrero
Weill Cornell Medical College, Cornell University, New York, NY.
Eileen
E
Koh
MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.|Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
Christian
C
Holm Hansen
Department of Internal Medicine, Catholic University of Health & Allied Sciences, Mwanza, Tanzania.
Rehema
R
Shedafa
Department of Internal Medicine, Catholic University of Health & Allied Sciences, Mwanza, Tanzania.
Fredrick
F
Kalokola
Department of Internal Medicine, Catholic University of Health & Allied Sciences, Mwanza, Tanzania.|Center for Global Health, Weill Cornell Medical College, New York, NY.
Luke R
LR
Smart
Department of Internal Medicine, Catholic University of Health & Allied Sciences, Mwanza, Tanzania.|Center for Global Health, Weill Cornell Medical College, New York, NY.
Robert N
RN
Peck
D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013636:Tanzania
D000959:Antihypertensive Agents