Kadir, Shaharuddin Che
(2007)
The control of hypertension
Among patients attending
Hospital universiti sains malaysia's
Hypertension clinic.
Other thesis, Universiti Sains Malaysia.
Abstract
This study was conducted with the primary objective of assessing the
proportion of patients who achieved their blood pressure targets. The secondary
objectives were to evaluate the factors associated with uncontrolled blood pressure and to
determine the number of antihypertensive agents required to achieve controlled blood
pressure.
Methods A cross-sectional study of hypertens ive patients attending Hospital USM
hypertension clinic was conducted from April until September 2006. Patients' blood
pressure, smoking history, BMI, urinalysis for protein, fasting lipid profile, renal function
test and fasting blood sugar were obtained. The blood pressure was defined as controlled
if < 140/90 mmHg or < 130/80 mmHg in patients with diabetes or chronic kidney
disease, or < 125/75 mmHg in patients with proteinuria > 1g/day.
Results A total of 245 patients compliant to medications were recruited. Thirty
four percent of them achieved controlled blood pressure (n = 83). Patients with chronic
kidney disease were the majority (69.14%) among patients with uncontrolled blood
pressure. Univariate analysis showed several factors were associated with uncontrolled
blood pressure: older age, malay race, history of smoking; higher creatinine, uric acid,total cholesterol, triglyceride and fasting blood sugar; lower eGFR; the use of more than
2 antihypertensive agents and the use of diuretics; and the presence of diabetes mellitus,
chronic kidney disease and proteinuria. However the results of multiple logistic
regression analysis indicated that female gender (p = 0.00 I), malay race (p = 0.031),
smoking (p < 0.001), eGFR (p < 0.001) and diabetes mellitus (p = 0.001) were the
independent factors associated with uncontrolled blood pressure. Univariate analysis
showed that patients who were on treatment with 1 or 2 antihypertensive agents were
more likely to have controlled blood pressure than those on more than 2 drugs (p =
0.001 ), however, this was not statistically significant in multivariate analysis.
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