Abstract 15917: Burden of End Organ Damage Among Patients With Hypertension and Associated Patient- and Facility-Level Factors in Ghana

Abstract

End-organ damage (EOD) are a serious complication of uncontrolled hypertension stroke, kidney disease, retinopathy, cardiovascular disease, and neuropathy are the most prevalent. The studies of EOD and associated factors are scarce in Sub-Saharan Africa. We explored the burden of EOD and the associated patient- and facility-level factors among patients with hypertension in Ghana. Methods: We recruited 14 health facilities and 15 patients with hypertension from each facility. Health facilities with hypertension services and patients on hypertension treatment were eligible for inclusion. The outcome of interest was the self-report of one or more of the most prevalent EOD. The patient-level independent variables were adherence to hypertension treatment, alcohol consumption, employment, and education. At the facility level, we included the facility type, size, ownership, and availability of hypertension guidelines as independent variables. The mixed-effect logistic regression model was used. Results: The study included two hundred and nine (209) patients. 172 (82%) were female, and the mean (±SD) age of participants was 61 (±12.7). 80 (38%) participants reported having suffered at least one EOD, the most prevalent being retinopathy, 38 (18%), followed by cardiovascular complications, 24 (11%). Employment was associated with lower odds (Odds Ratio: 0.42, 95% CI: 0.19, 0.90) of EOD than unemployment and tertiary or higher education was associated with lower odds (Odds Ratio: 0.32, 95% CI: 0.14, 0.74) of EOD than primary or lower educational level. Higher adherence to hypertension treatment was associated with lower odds (Odds Ratio: 0.88, 95% CI: 0.79, 0.97) of EOD. Conclusion: The prevalence of EOD is high. Patient-level interventions to improve hypertension care are needed with a focus on socio-determinants of health. Largescale studies are recommended to explore the facility-level factors that impact the development of EOD in Ghana.