A Qualitative Analysis of the Association of Treatment Outcomes, Psychosocial Factors, and Multimorbidity in Severe Hypertensive Patients Attending Health Institutions in Southeast Nigeria

Abstract

Severe hypertension is associated with a two-fold increase in relative risk of death. Interventions to date fail to achieve sustained improvement in blood pressure, particularly in regional areas of high social disparity. Growing evidence points to multiple psychological, social and morbidity factors as contributors to the onset of and trajectory of hypertension. This study aims to examine the association of psychosocial factors and multimorbidity with response to treatment and treatment outcomes in the management of severe hypertensive patients providing updated knowledge and recommendations to improve their quality of care. We employed a hospital based comparative cross-sectional study using a quantitative and qualitative approach. Semi-structured questionnaires were used to collect information from 733 severe hypertensive patients attending cardiology clinics in two tertiary health institutions in southeastern Nigeria. Data collected was transcribed, coded, and analysed with IBM SPSS version 23 software with appropriate descriptive tools used in presenting findings. We observed a significant association between age of the respondents and their response to treatment. Overweight/obese respondents were 1.5times less likely to respond to treatment. These findings add to existing knowledge provoking thoughtful discussions among relevant public health actors and stakeholders to update management policies for severe hypertension.