Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.
References
[1]
WHO (2023) Global Report on Hypertension: The Race against a Silent Killer.
[2]
Yayehd, K., Damorou, F., Akakpo, R., Tchérou, T., N’Da, N.W., Pessinaba, S., et al. (2013) Prévalence de l’hypertension artérielle et description de ses facteurs de risque à Lomé (Togo): Résultats d’un dépistage réalisé dans la population générale en mai 2011. Annales de Cardiologie et d’Angéiologie, 62, 43-50. https://doi.org/10.1016/j.ancard.2012.09.006
[3]
World Health Organization (2008) The Global Burden of Disease: 2004 Update. World Health Organization, 146.
[4]
Lim, S.S., Vos, T., Flaxman, A.D., Danaei, G., Shibuya, K., Adair-Rohani, H., et al. (2012) A Comparative Risk Assessment of Burden of Disease and Injury Attributable to 67 Risk Factors and Risk Factor Clusters in 21 Regions, 1990-2010: A Systematic Analysis for the Global Burden of Disease Study 2010. The Lancet, 380, 2224-2260. https://doi.org/10.1016/s0140-6736(12)61766-8
[5]
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., et al. (2018) 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. European Heart Journal, 39, 3021-3104. https://doi.org/10.1093/eurheartj/ehy339
[6]
Unger, T., Borghi, C., Charchar, F., Khan, N.A., Poulter, N.R., Prabhakaran, D., et al. (2020) 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75, 1334-1357. https://doi.org/10.1161/hypertensionaha.120.15026
[7]
Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K. and He, J. (2005) Global Burden of Hypertension: Analysis of Worldwide Data. The Lancet, 365, 217-223. https://doi.org/10.1016/s0140-6736(05)17741-1
[8]
Girerd, X., Hanon, O., Anagnostospoulos, K., Ciupek, C., Mourad, J.J., Consoli, S. (2001) Evaluation de l’observance du traitement antihypertenseur par un questionnaire: Mise au point et utilisation dans un service spécialisé. La Presse Médicale, 30, 1044-1048.
[9]
Bahloul, A., Ellouze, T., Hammami, R., Charfeddine, S., Triki, S., Abid, L., et al. (2021) Impact des facteurs socioéconomiques sur l’équilibre de la pression artérielle: Étude observationnelle à propos de 2887 hypertendus. Annales de Cardiologie et d’Angéiologie, 70, 259-265. https://doi.org/10.1016/j.ancard.2021.05.009
[10]
Yaméogo, N.V., Kagambèga, L.J., Millogo, R.C.G., Kologo, K.J., Yaméogo, A.A., Mandi, G.D., et al. (2013) Facteurs associés à un mauvais contrôle de la pression artérielle chez les hypertendus noirs africains: Étude transversale de 456 hypertendus burkinabé. Annales de Cardiologie et d’Angéiologie, 62, 38-42. https://doi.org/10.1016/j.ancard.2012.05.001
[11]
Perret-Guillaume, C., Miget, P., Aubry, C., Gueguen, R., Steyer, E. and Bénétos, A. (2006) Contrôle de la pression artérielle par le traitement antihypertenseur chez le sujet âgé de 60 ans et plus. La Revue de Médecine Interne, 27, 285-290. https://doi.org/10.1016/j.revmed.2006.01.004
[12]
Hamida, F., Atif, M.-L., Temmar, M., Chibane, A., Bezzaoucha, A. and Bouafia, M.-T. (2013) Prévalence de l’hypertension artérielle dans l’oasis d’El-Menia, Algérie, et profil métabolique de la population. Annales de Cardiologie et d’Angéiologie, 62, 172-178. https://doi.org/10.1016/j.ancard.2013.04.008
[13]
Wright, J.T., Rahman, M., Scarpa, A., Fatholahi, M., Griffin, V., Jean-Baptiste, R., et al. (2003) Determinants of Salt Sensitivity in Black and White Normotensive and Hypertensive Women. Hypertension, 42, 1087-1092. https://doi.org/10.1161/01.hyp.0000101687.89160.19
[14]
Worthington, M.G., Wendt, M.C. and Opie, L.H. (1993) Sodium Transport in Hypertension: Assessment of Membranes-Associated Defects in South African. Black and Whites Hypertensives. Journal of Human Hypertension, 7, 291-297.