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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Prevalence of hypertension and its treatment among adults presenting to primary health clinics in rural Zambia: analysis of an observational database

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Lily D. Yan, Benjamin H. Chi, Ntazana Sindano, Samuel Bosomprah, Jeffrey SA Stringer, Roma Chilengi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2258-4) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

LY conceived this study, performed statistical analysis, and drafted the manuscript. BC and RC participated in the design of the study. NS and SB analyzed the data. BC, NS, SB, JS, and RC all critically revised the manuscript drafts. All authors read and approved the final manuscript.

Authors’ Information

Not applicable.

Availability of data and materials

Not applicable.

Abstract

Background

Hypertension constitutes a growing burden of illness in developing countries like Zambia. Adequately screening and treating hypertension could greatly reduce the complications of stroke and coronary disease. Our objective was to determine the prevalence of hypertension and identify current treatment practices among adult patients presenting for routine care to rural health facilities in the Better Health Outcomes through Mentoring and Assessments (BHOMA) project.

Methods

We conducted a retrospective analysis of routinely collected clinical data from 46 rural government clinics in Zambia. Our analysis cohort comprised patients ≥ 25 years with recorded blood pressure measurements, who sought care at primary health centers. Consistent with prior research, in our primary analysis, we only included data from first visits. Hypertension was defined as a systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg, or reported use of antihypertensive medication. A sensitivity analysis was performed using median blood pressure for individuals with multiple visits.

Results and Discussion

From January 2011 to December 2014, 116,130 first visits by adult patients met eligibility criteria. The crude prevalence of hypertension by onsite measurement or reported use of antihypertensive medication was 23.1 % [95 % CI: 22.8-23.3] (23.6 % in females, 22.3 % in males). The age standardized prevalence of hypertension across participating sites was 28.0 % [95 % CI: 27.7-28.3] (29.7 % in females, 25.8 % in males). Sensitivity analysis revealed a similar prevalence using data from all visits. Only 5.6 % of patients had a diagnosis of hypertension documented in their medical record. Among patients with hypertension, only 18.0 % had any antihypertensive drug prescribed, with nifedipine (8.9 %), furosemide (8.3 %), and propranolol (2.4 %) as the most common.

Conclusions

Age standardized prevalence of hypertension in rural primary health clinics in Zambia was high compared to other studies in rural Africa; however, we diagnosed hypertension with only one measurement and this may have biased our findings. Future efforts to improve hypertension control should focus on population preventive care and primary healthcare provider education on individual management.
Zusatzmaterial
Additional file 1: Table S1. Multivariate logistic regression for predictors of hypertension among all patients, n = 106,523. File format: .xlsx (XLSX 11 kb)
12889_2015_2258_MOESM1_ESM.xlsx
Additional file 2: Table S2. Multivariate logistic regression for predictors of hypertension control among patients taking antihypertensive medication, n = 4223. File format: .xlsx (XLSX 10 kb)
12889_2015_2258_MOESM2_ESM.xlsx
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