Determinants of blood pressure control among hypertensive patients attending outpatient clinic at Thika Level 5 hospital, Kiambu county, Kenya.

Abstract

Hypertension, a major risk factor for cardiovascular disease, remains poorly controlled despite its prevalence among patients visiting primary healthcare clinics. An estimated 53.5% of hypertensive individuals, roughly 35.8 million people, have uncontrolled blood pressure. This study aimed to identify factors affecting blood pressure control

among hypertensive patients at Thika Level 5 Hospital in Kenya. Using a cross- sectional design with both quantitative and qualitative methods, the study assessed

sociodemographic factors, dietary habits, patient behavior, healthcare systems, and the prevalence of uncontrolled hypertension. Researchers employed a structured questionnaire, key informant interviews, and focus group discussions. A sample size of 500 was determined using Cochran's formula, with an additional 30% for non-response. Systematic random sampling was used to select participants from those enrolled in blood pressure management at the hospital. Data collection involved reviewing patient files, administering questionnaires, and conducting interviews with medical staff. Quantitative data was analyzed using SPSS software, while qualitative data was analyzed thematically and then triangulated with the quantitative data. The response rate was a high 98.6% (493 participants). The study revealed a concerningly high prevalence of uncontrolled hypertension, at 73.6%. Notably, the proportion of respondents with poor knowledge about hypertension control was higher among those with uncontrolled blood pressure. Additionally, a significant finding was that a majority (39.8%) lived more than 15 kilometers from the hospital, and over half (57.3%) reported medication unavailability. Through logistic regression analysis, the study identified knowledge about hypertension, choice of transportation, and distance to the health facility as significant predictors of uncontrolled blood pressure. Patients with lower knowledge, limited transportation options, and residing farther from the hospital were more likely to have uncontrolled blood pressure. These findings highlight the importance of patient education by healthcare workers. The study suggests that healthcare providers should routinely address medication adherence, lifestyle modifications, and other factors related to blood pressure control. Furthermore, efforts to improve healthcare infrastructure and accessibility, including ensuring medication availability and providing transportation services, are crucial. Collaboration between healthcare providers, policymakers, and community organizations is essential to develop and implement effective interventions that address the multifaceted challenges associated with hypertension control.