Objective: Hypertension is a major global issue and in an increasing trend. A disproportional balance between blood pressure controls among treated hypertensive patients is a challenge in public health as uncontrolled hypertension is the main contributor to cardiovascular, cerebrovascular and kidney diseases. Aims of the study are to determine the prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending hypertension clinic at primary health clinics in Tuaran district. Justification of this study is uncontrolled hypertension causing high morbidity and mortality including premature death. Material and Methods: Study included 460 participants; is a cross-sectional study among hypertensive patient registered at three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires and analyzed using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that male gender (OR 2.1, 95% CI: 1.442, 3.061), high BMI status (OR 1.975, 95% CI: 1.305, 2.990), presence of diabetes mellitus (OR 3.436, 95% CI: 2.104, 5.613) and lower medication adherence (OR 1.834, 95% CI: 1.256, 2.678) were significantly associated with uncontrolled hypertension with p <0.05. Conclusion: The prevalence of uncontrolled hypertension in this study population was high with nearly half of the study population had uncontrolled hypertension. Combination of associated factors such as obesity, diabetes mellitus and lower hypertensive medication compliance had a higher impact on uncontrolled hypertension among the study group. This study further needed to address an attitudinal change, extra guidance, coaching and empowerment in the treatment of hypertension.
Keywords: Hypertension; blood pressure; prevalence; smoking, diabetes mellitus; obesity; body mass index
Amaç: Hipertansiyon önemli bir global sorundur ve artma eğilimindedir. Kontrolsüz hipertansiyon kardiyovasküler, serebrovasküler ve böbrek hastalıklarına katkıda bulunan başlıca faktör olduğu için tedavi alan hipertansif hastalarda kan basıncı kontrolleri arasındaki orantısız denge halk sağlığı için zorlayıcı bir durumdur. Bu çalışmanın amaçları Tuaran bölgesindeki birinci basamak kliniklerindeki hipertansiyon kliniğine başvuran hipertansif hastalarda kontrolsüz hipertansiyonun prevalansının ve ilişkili faktörlerin belirlenmesidir. Bu çalışmanın gerekçesi kontrolsüz hipertasiyonun erken ölüm dahil yüksek morbidite ve mortaliteye neden olmasıdır. Gereç ve Yöntemler: Çalışmaya 460 katılımcı alınmıştır; Tuaran bölgesi, Sabah'da üç birinci basamak kliniğine kayıtlı hipertansif hastalarla yapılan kesitsel bir çalışmadır. Veriler yapılandırılmış modifiye anketlerle toplanmıştır ve SPSS 24.0 ile değerlendirilmiştir. Bulgular: Kontrolsüz hipertansiyonun prevalansı %45.9 idi. Erkek cinsiyetin (OO 2.1, 95% GA: 1.442, 3.061), yüksek BKİ (beden kitle indeksi)'nin (OO 1.975, %95 GA: 1.305, 2.990), diyabetes mellitus varlığının (OO 3.436, %95 GA: 2.104, 5.613) ve düşük ilaç uyumunun (OR 1.834, %95 CI:1.256, 2.678) kontrolsüz hipertansiyonla anlamlı ilişkisi olduğu bulunmuştur (p<0.05). Sonuç: Bu çalışma populasyonunda kontrolsüz hipertansiyon prevalansı yüksek bulunmuş olup çalışma populasyonunun yaklaşık yarısının kan basıncı kontrolde değildir. Obezite, diyabetes mellitus ve hipertansif tedaviye düşük uyum gibi ilişkili faktörlerin kombinasyonunun çalışma grubunda kontrolsüz hipertansiyona daha fazla etkisi olduğu bulunmuştur. Bu çalışmada ayrıca hipertansiyon tedavisinde bir tutum değişikliği, ekstra rehberlik, koçluk ve güçlendirme konuları ele alınmıştır.
Anahtar Kelimeler: Hipertansiyon; kan basıncı; prevalans; sigara içme; diabetes mellitus; obezite; beden kitle indeksi
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