J-027 PREVALENCE OF POOR BLOOD PRESSURE CONTROL AND RESISTANT HYPERTENSION IN GENERAL MEDICAL CLINICS IN SOUTHERN SRI LANKA

Abstract

Background Data on blood pressure control and resistant hypertension are sparse in the Sri Lankan population. Methods The prevalence and characteristics of poorly controlled blood pressure and resistant hypertension was determined in four well-established general medical clinics in the Teaching Hospital, Galle, Sri Lanka. Clinic records were checked for risk factors, complications, medications and compliance and blood pressure measured. Poor blood pressure control was defined when the average of three blood pressure recordings was > 140/90 mmHg. Resistant hypertension was defined when blood pressure recorded was >140/90 mmHg while on 3 antihypertensive medications, including a diuretic. Results The study was carried out in 184 (26.3%) males and 507 (73.3%) female patients with hypertension attending the clinic regularly. Overall 34.2 % of patients had blood pressure recording above 140/90 mmHg with no significant difference between males (n 68–37%) and females (n 168–33.1%). Resistant hypertension was seen in 22 males (12%) and 56 females (11.0%). Those with blood pressure >140/90mmHg were significantly older (65.2 years) compared with those with blood pressure of <140/90 mmHg (61.5 years). Mean age was non-significantly higher (64.1 years) in those with resistant hypertension compared to those without (62.6 years) resistant hypertension. Diabetes mellitus (n 248–35.7%) were non-significantly lower in those with poor blood pressure control and with resistant hypertension. Ischaemic heart disease (n 191–27.6%) was non-significantly related to both poor blood pressure control category and resistant hypertension group. Monotherapy was used in 30.5%, two drugs in 43% and three drugs and more were used in 25.8%. There was non-significant greater use of three or more drugs among patients with poor blood pressure control. ACEIs, diuretics, calcium channel blockers were the drugs used more often either as monotherapy or in combination. Conclusion Blood pressure control is inadequate in this clinic population and resistant hypertension poses a significant challenge.