Abstract
Background. In Indonesia, hypertension treatment relies on primary health care services, and there are no current data on blood pressure control and hypertension treatment in Indonesia’s primary health care system.Methods. We conducted a cross-sectional study including all patients with hypertension (n = 273) who visited the Tegal Alur II Community Health Center in 2017. For all patients with hypertension, medical records containing the most recent blood pressure results and antihypertensive treatments were examined by the authors. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines.Results. The mean systolic and diastolic blood pressures were 143.7 mmHg (SD 18.5) and 87 mmHg (SD 11.4), respectively. Calcium channel blockers were the most frequently used antihypertensive agents (58.6%). Of all patients with hypertension, 27.1% achieved controlled blood pressure. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Multivariate analysis showed that calcium channel blockers were the strongest predictor of blood pressure control, with an adjusted odds ratio of 1.9 (95% confidence interval CI [1.1–3.5], p = 0.022).Conclusion. Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017. The majority of patients with hypertension received single-drug therapy with calcium channel blockers, the most frequently used antihypertensive agents. There was a significant association between antihypertensive agents and blood pressure control.Funding. This study received no financial support from any specific funding agencies.
Highlights
The high prevalence of hypertension is still a global health burden
There was a significant association between antihypertensive agents and blood pressure control (p = 0.009)
After adjusting for age, sex, and comorbidities, calcium channel blockers (CCBs) were the strongest predictor of blood pressure control at the Tegal Alur II Community Health Center
Summary
The high prevalence of hypertension is still a global health burden. In 2013, according to Indonesia’s Ministry of Health, the prevalence of hypertension in Indonesia was 26.5%1. A previous study by Hussain showed that only 9% of adults with hypertension achieved controlled blood pressure in Indonesia[3]. A previous hospital-based study showed that twice-daily administration of antihypertensive drugs was associated with blood pressure control[5]. Little is known about the association between antihypertensive agents and blood pressure control in primary health care. It is hypothesized that antihypertensive agents have a significant association with blood pressure control in Indonesia’s primary health care system. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017.
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