Awareness, Treatment, and Control of Hypertension in Primary Health Care and Secondary Referral Medical Outpatient Clinic Settings at Enugu, Southeast Nigeria.

Chioli Chijioke,Chukwuemeka Eze,Nnamdi Nwosu,Kenneth Nwadike,Esther Ekwe,Christopher Amah,Udunma Chijioke,Charles Agunyenwa,Raphael Anakwue,Teddy Okolo

doi:10.1155/2016/5628453

Chioli Chijioke, Chukwuemeka Eze + Show 8 more

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https://doi.org/10.1155/2016/5628453

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Abstract

Essential hypertension is the most common noncommunicable disease (NCD), affecting more than half the adult population in many countries and being the major NCD contributor to the double burden of disease in developing countries. We undertook a survey of the hypertension awareness, treatment, and control in primary and secondary referral health care clinics in Enugu, Nigeria, and compared these data with those obtained in local community surveys. The prevalence of hypertension in the primary care clinic (9.2%) was lower than in a previously reported community survey (42.2%), while, in the referral clinic, 70.3% of patients attending were hypertensive. Hypertension awareness rates were 91.9%, 29.4%, and 93.2% in these respective health care settings. Treatment and control rates (89.9% and 72.9%) were better in the secondary care clinic than in the primary care centre (87.7% and 46.0%). (Chi-square analysis confirmed statistically significant differences between these rates (p < 0.05).) These data may form a useful index of health care system effectiveness in Nigeria. Possible reasons for the differences observed and effective strategies to address the waxing pandemic of hypertension are discussed.

Highlights

Hypertension is at the forefront of a waxing pandemic of noncommunicable diseases, which has been ascribed to the human lifestyle changes in recent decades that accompany increasing urbanization and industrialization (“Westernization”) worldwide [1]
This study aims to ascertain the proportions of hypertensive patients presenting to the primary health care (GOPD) and secondary referral outpatient clinics at UNTH who (a) are not aware that they have high blood pressure, (b) are aware of their hypertension but are not taking the prescribed treatment, (c) are taking their prescribed treatment but their blood pressure is not controlled
Out of 730 patients seen in the Medical Outpatients Clinic (MOP, secondary care referral clinic) 513 (70.3%) were hypertensive

Summary

Introduction

Hypertension is at the forefront of a waxing pandemic of noncommunicable diseases, which has been ascribed to the human lifestyle changes in recent decades that accompany increasing urbanization and industrialization (“Westernization”) worldwide [1]. Systemic hypertension has been estimated to claim 92 million disability-adjusted life years per annum, 80% of this global burden being borne by developing countries [2]. From being a comparatively rare condition in many parts of the world until about 50 years ago, systemic arterial hypertension has become the leading cause of global morbidity and mortality [3]. The proportion of the world population with high blood pressure has increased up towards and even beyond half the adult population in some African countries, within a few decades [4,5,6]. The prevalence of hypertension varies from as low as 5% in rural India to as high as 70% in Poland [7]. Much of the preeminence of hypertension in the global burden of disease stems from a lack of awareness, treatment, and control of the disease. Dong et al [8] reported figures from rural China

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