Poor adherence to medication and salt restriction as a barrier to reaching blood pressure control in patients with hypertension: Cross-sectional study from 12 sub-Saharan countries.

Autor: Macquart de Terline D; Sorbonne Université, AP-HP, Sorbonne Université, Hôpital Saint Antoine, Service de Pharmacie, 75012 Paris, France; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France; Université de Paris, Paris, France. Electronic address: diane.macquart-de-terline@aphp.fr., Kramoh KE; Institute of Cardiology of Abidjan, BPV 206, Abidjan, Côte d'Ivoire., Bara Diop I; Cardiology Department, University Hospital of Fann, Dakar, Senegal., Nhavoto C; Instituto do Coração (ICOR), Maputo, Mozambique., Balde DM; Department of Cardiology, University Hospital of Conakry, Guinea., Ferreira B; Instituto do Coração (ICOR), Maputo, Mozambique., Houenassi MD; National University Hospital of Hubert K. Maga (CNHU-HKM), 01 BP 386, Cotonou, Bénin., Hounsou D; National University Hospital of Hubert K. Maga (CNHU-HKM), 01 BP 386, Cotonou, Bénin., Ikama MS; Cardiology Department, National University Hospital of Brazzaville, Marien Ngouabi University, Brazzaville, Congo., Kane A; Cardiology Department, University Hospital of Aristide Le Dantec, Dakar, Senegal., Kimbally-Kaki SG; Cardiology Department, National University Hospital of Brazzaville, Marien Ngouabi University, Brazzaville, Congo., Kingue S; University of Yaoundé, Ministry of Public Health, Cameroon., Koffi F; Institute of Cardiology of Abidjan, BPV 206, Abidjan, Côte d'Ivoire., Kouam Kouam C; Internal Medicine Department, Regional Hospital, Bafoussam, Cameroon., Limbole E; Department of Internal Medicine of la Gombe (CMCG), Ngaliema Hospital, Kinshasa, Democratic Republic of the Congo., Mfeukeu Kuate L; Central Hospital of Yaoundé, Cameroon., Mipinda JB; University Hospital of Libreville, Libreville, Gabon., N'goran Y; Institute of Cardiology of Abidjan, BPV 206, Abidjan, Côte d'Ivoire., Sesso Z; Cardiology Department, Lomé, Togo., Sidi Aly A; Cardiology Clinics, Nouakchott, Mauritania., Toure IA; Internal Medicine and Cardiology Department, University Hospital of Lamordé, Niamey University, Niamey, Niger., Plouin PF; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France; Université de Paris, Paris, France; Department of Cardiology, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France., Azizi M; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France; Université de Paris, Paris, France; Department of Cardiology, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France., Perier MC; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France., Narayanan K; MaxCure Hospitals, Hyderabad, Telangana, 500081 India., Empana JP; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France., Jouven X; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France; Université de Paris, Paris, France; Department of Cardiology, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France., Antignac M; Sorbonne Université, AP-HP, Sorbonne Université, Hôpital Saint Antoine, Service de Pharmacie, 75012 Paris, France; Université de Paris, INSERM U970, Paris Cardiovascular Research Centre, Integrative Epidemiology of cardiovascular disease, Paris, France.
Jazyk: angličtina
Zdroj: Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2020 Jun - Jul; Vol. 113 (6-7), pp. 433-442. Date of Electronic Publication: 2020 May 17.
DOI: 10.1016/j.acvd.2019.11.009
Abstrakt: Background: Sub-Saharan Africa is experiencing a rising burden of hypertension. Antihypertensive medications and diet are the cornerstone of effective hypertension control.
Aims: To assess adherence to medication and salt restriction in 12 sub-Saharan countries, and to study the relationship between adherence and blood pressure control in patients with hypertension.
Methods: We conducted a cross-sectional survey in urban clinics in twelve sub-Saharan countries. Data were collected on demographics, treatment and adequacy of blood pressure control in patients with hypertension attending the clinics. Adherence was assessed by questionnaires completed by the patients. Hypertension grades were defined according to European Society of Cardiology guidelines. Association between adherence and blood pressure control was investigated using multilevel logistic regression analysis, adjusting for age, sex and country.
Results: Among the 2198 patients, 77.4% had uncontrolled blood pressure, 34.0% were poorly adherent to salt restriction, 64.4% were poorly adherent to medication and 24.6% were poorly adherent to both. Poor adherence to salt restriction (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.03-1.72), medication (OR 1.56, 95% CI 1.25-1.93) or both (OR 1.91 1.39-2.66) was related to uncontrolled blood pressure. Moreover, poor adherence to both medication and salt restriction was related to a 1.52-fold (95% CI 1.04-2.22), 1.8-fold (95% CI 1.22-2.65) and 3.08-fold (95% CI 2.02-4.69) increased likelihood of hypertension grade 1, 2 and 3, respectively.
Conclusions: High levels of poor adherence to salt restriction and medication were noted in this urban sub-Saharan study; both were significantly associated with uncontrolled blood pressure, representing major opportunities for intervention to improve hypertension control in sub-Saharan Africa.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: