Background: Hypertension is a common chronic disease and an important public health problem. The prevention of complications depends on hypertension control. Aim: To assess blood pressure control, complication presence, and their influencing factors. Methods: This cross-sectional study was conducted on patients with hypertension attending a private medical facility, a governmental facility, and a primary health care center in Khartoum, Sudan, between September 2022 and February 2023. Statistical Package for Special Sciences version 25 was used for data analysis; frequency and percentage were used to describe the qualitative variables. A chi-square test was used for co-relation analysis; a P-value ≤ 0.05 was considered statistically significant, and the confidence interval was 95%. Results: The study included 250 participants; 55.6% were males. Their age was 58.77 ± 6.80 years, and they had hypertension for 10.7 ± 8.51 years. The duration of the disease was 10.7 ± 8.51 years. Systolic blood pressure was 127.1 ± 11.3 mm hg, and diastolic blood pressure was 81.6 ± 7.1 mm hg. Of the participants, 76.4% had controlled hypertension, while 27.6% had complications due to hypertension. Controlled blood pressure was associated with females, age group 40 - 60 years, normal waist circumference, and high adherence level (P ≤ 0.05). The presence of complications was associated with males, participants older than 60 years, and a low adherence level (P ≤ 0.05). Conclusions: In Sudan, the level of control is good; nonetheless, not all patients achieve it. Availability and access to treatment facilities and medications should be improved. Proper patient counseling should be offered, as well as continuous care.
World Health Organization (2008) World Health Statistics 2008. https://www.who.int/publications/i/item/9789241563598
Araújo, Y.B., dos Santos Teixeira, J., de Oliveira, E.C., Sobral, G.S., Meneguz-Moreno, R.A., Amaral, R.G., Santos, S.L. and Andrade, L.N. (2022) Factors Associated with Adherence to Pharmacological Treatment in Hypertensive Patients Enrolled in the HIPERDIA Program. Revista Ciências em Saúde, 12, 35-42. https://doi.org/10.21876/rcshci.v12i2.1270
Oliveria, S.A., Chen, R.S., McCarthy, B.D., Davis, C.C. and Hill, M.N. (2005) Hypertension Knowledge, Awareness, and Attitudes in a Hypertensive Population. Journal of General Internal Medicine, 20, 219-225. https://doi.org/10.1111/j.1525-1497.2005.30353.x
Elmer, P.J., Obarzanek, E., Vollmer, W.M., Simons-Morton, D., Stevens, V.J., Young, D.R., Lin, P.H., Champagne, C., Harsha, D.W., Svetkey, L.P. and Ard, J. (2006) Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Fitness, and Blood Pressure Control: 18-Month Results of a Randomized Trial. Annals of Internal Medicine, 144, 485-495. https://doi.org/10.7326/0003-4819-144-7-200604040-00007
Frisoli, T.M., Schmieder, R.E., Grodzicki, T. and Messerli, F.H. (2011) Beyond Salt: Lifestyle Modifications and Blood Pressure. European Heart Journal, 32, 3081-3087. https://doi.org/10.1093/eurheartj/ehr379
Jackson, T.H., Bentley, J.P., McCaffrey, III D.J., Pace, P., Holmes, E. and West-Strum, D. (2014) Store and Prescription Characteristics Associated with Primary Medication Nonadherence. Journal of Managed Care Pharmacy, 20, 824-832. https://doi.org/10.18553/jmcp.2014.20.8.824
Yamane, T. (1967) Statistics: An Introductory Analysis. 2nd Edition, Harper and Row, New York. https://www.scirp.org/(S(i43dyn45teexjx455qlt3d2q))/reference/ReferencesPapers.aspx?ReferenceID=1440506
Morisky, D.E., Ang, A., Krousel-Wood, M. and Ward, H.J. (2008) Predictive Validity of a Medication Adherence Measure in an Outpatient Setting. The Journal of Clinical Hypertension, 10, 348-354. https://doi.org/10.1111/j.1751-7176.2008.07572.x
Abel, N., Contino, K., Jain, N., Grewal, N., Grand, E., Hagans, I., Hunter, K. and Roy, S. (2015) Eighth Joint National Committee (JNC-8) Guidelines and the Outpatient Management of Hypertension in the African-American Population. North American Journal of Medical Sciences, 7, 438.
Dworatzek, P.D., Arcudi, K., Gougeon, R., Husein, N., Sievenpiper, J.L., Williams, S.L. and Canadian Diabetes Association Clinical Practice Guidelines Expert Committee (2013) Nutrition Therapy. Canadian Journal of Diabetes, 37, S45-S55. https://doi.org/10.1016/j.jcjd.2013.01.019
Zhou, B., Perel, P., Mensah, G.A. and Ezzati, M. (2021) Global Epidemiology, Health Burden and Effective Interventions for Elevated Blood Pressure and Hypertension. Nature Reviews Cardiology, 18, 785-802. https://doi.org/10.1038/s41569-021-00559-8
Zhang, M., Wu, J., Zhang, X., Hu, C.H., Zhao, Z.P., Li, C., Huang, Z.J., Zhou, M.G. and Wang, L.M. (2021) Prevalence and Control of Hypertension in Adults in China, 2018. Chinese Journal of Epidemiology, 42, 1780-1789.
Santosa, A., Zhang, Y., Weinehall, L., Zhao, G., Wang, N., Zhao, Q., Wang, W. and Ng, N. (2020) Gender Differences and Determinants of Prevalence, Awareness, Treatment and Control of Hypertension among Adults in China and Sweden. BMC Public Health, 20, Article No. 1763. https://doi.org/10.1186/s12889-020-09862-4
Shariq, O.A. and McKenzie, T.J. (2020) Obesity-Related Hypertension: A Review of Pathophysiology, Management, and the Role of Metabolic Surgery. Gland Surgery, 9, 80-93. https://doi.org/10.21037/gs.2019.12.03
Kayima, J., Wanyenze, R.K., Katamba, A., Leontsini, E. and Nuwaha, F. (2013) Hypertension Awareness, Treatment and Control in Africa: A Systematic Review. BMC Cardiovascular Disorders, 13, Article No. 54. https://doi.org/10.1186/1471-2261-13-54
Gillis, E.E. and Sullivan, J.C. (2016) Sex Differences in Hypertension: Recent Advances. Hypertension, 68, 1322-1327. https://doi.org/10.1161/HYPERTENSIONAHA.116.06602
Joyner, M.J., Wallin, B.G. and Charkoudian, N. (2016) Sex Differences and Blood Pressure Regulation in Humans. Experimental Physiology, 101, 349-355. https://doi.org/10.1113/EP085146
Regitz-Zagrosek, V. and Kararigas, G. (2017) Mechanistic Pathways of Sex Differences in Cardiovascular Disease. Physiological Reviews, 97, 1-37. https://doi.org/10.1152/physrev.00021.2015
Van der Laan, D.M., Elders, P.J., Boons, C.C., Beckeringh, J.J., Nijpels, G. and Hugtenburg, J.G. (2017) Factors Associated with Antihypertensive Medication Non-Adherence: A Systematic Review. Journal of Human Hypertension, 31, 687-694. https://doi.org/10.1038/jhh.2017.48
Du, S., Zhou, Y., Fu, C., Wang, Y., Du, X. and Xie, R. (2018) Health Literacy and Health Outcomes in Hypertension: An Integrative Review. International Journal of Nursing Sciences, 5, 301-309. https://doi.org/10.1016/j.ijnss.2018.06.001
Yousaf, O., Grunfeld, E.A. and Hunter, M.S. (2015) A Systematic Review of the Factors Associated with Delays in Medical and Psychological Help-Seeking among Men. Health Psychology Review, 9, 264-276. https://doi.org/10.1080/17437199.2013.840954
Obirikorang, Y., Obirikorang, C., Acheampong, E., Odame Anto, E., Gyamfi, D., Philip Segbefia, S., Opoku Boateng, M., Pascal Dapilla, D., Brenya, P.K., Amankwaa, B. and Adu, E.A. (2018) Predictors of Noncompliance to Antihypertensive Therapy among Hypertensive Patients Ghana: Application of Health Belief Model. International Journal of Hypertension, 2018, Article ID: 4701097. https://doi.org/10.1155/2018/4701097
Sarfo, F.S., Mobula, L.M., Burnham, G., Ansong, D., Plange-Rhule, J., Sarfo-Kantanka, O. and Ofori-Adjei, D. (2018) Factors Associated with Uncontrolled Blood Pressure among Ghanaians: Evidence from a Multicenter Hospital-Based Study. PLOS ONE, 13, e0193494. https://doi.org/10.1371/journal.pone.0193494
Attaei, M.W., Khatib, R., McKee, M., Lear, S., Dagenais, G., Igumbor, E.U., AlHabib, K.F., Kaur, M., Kruger, L., Teo, K. and Lanas, F. (2017) Availability and Affordability of Blood Pressure-Lowering Medicines and the Effect on Blood Pressure Control in High-Income, Middle-Income, and Low-Income Countries: An Analysis of the PURE Study Data. The Lancet Public Health, 2, e411-e419.
Victor, R.G., Lynch, K., Li, N., Blyler, C., Muhammad, E., Handler, J., Brettler, J., Rashid, M., Hsu, B., Foxx-Drew, D. and Moy, N. (2018) A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops. New England Journal of Medicine, 378, 1291-1301. https://doi.org/10.1056/NEJMoa1717250
Lu, X., Yang, H., Xia, X., Lu, X., Lin, J., Liu, F. and Gu, D. (2019) Interactive Mobile Health Intervention and Blood Pressure Management in Adults: A Meta-Analysis of Randomized Controlled Trials. Hypertension, 74, 697-704. https://doi.org/10.1161/HYPERTENSIONAHA.119.13273
Schwalm, J.D., McCready, T., Lopez-Jaramillo, P., Yusoff, K., Attaran, A., Lamelas, P., Camacho, P.A., Majid, F., Bangdiwala, S.I., Thabane, L. and Islam, S. (2019) A Community-Based Comprehensive Intervention to Reduce Cardiovascular Risk in Hypertension (HOPE 4): A Cluster-Randomised Controlled Trial. The Lancet, 394, 1231-1242. https://doi.org/10.1016/S0140-6736(19)31949-X
Islam, S.M., Farmer, A.J., Bobrow, K., Maddison, R., Whittaker, R., Dale, L.A., Lechner, A., Lear, S., Eapen, Z., Niessen, L.W. and Santo, K. (2019) Mobile Phone Text-Messaging Interventions Aimed to Prevent Cardiovascular Diseases (Text2PreventCVD): Systematic Review and Individual Patient Data Meta-Analysis. Open Heart, 6, e001017. https://doi.org/10.1136/openhrt-2019-001017
Jafar, T.H., Gandhi, M., De Silva, H.A., Jehan, I., Naheed, A., Finkelstein, E.A., Turner, E.L., Morisky, D., Kasturiratne, A., Khan, A.H. and Clemens, J.D. (2020) A Community-Based Intervention for Managing Hypertension in Rural South Asia. New England Journal of Medicine, 382, 717-726. https://doi.org/10.1056/NEJMoa1911965
Thomopoulos, C., Parati, G. and Zanchetti, A. (2014) Effects of Blood Pressure Lowering on Outcome Incidence in Hypertension. 1. Overview, Meta-Analyses, and Meta-Regression Analyses of Randomized Trials. Journal of Hypertension, 32, 2285-2295. https://doi.org/10.1097/HJH.0000000000000378
Khan, N.A., McAlister, F.A., Rabkin, S.W., Padwal, R., Feldman, R.D., Campbell, N.R., Leiter, L.A., Lewanczuk, R.Z., Schiffrin, E.L., Hill, M.D. and Arnold, M. (2006) The 2006 Canadian Hypertension Education Program Recommendations for the Management of Hypertension: Part II—Therapy. Canadian Journal of Cardiology, 22, 583-593. https://doi.org/10.1016/S0828-282X(06)70280-X
Anand, T.N., Joseph, L.M., Geetha, A.V., Prabhakaran, D. and Jeemon, P. (2019) Task Sharing with Non-Physician Health-Care Workers for Management of Blood Pressure in Low-Income and Middle-Income Countries: A Systematic Review and Meta-Analysis. The Lancet Global Health, 7, e761-e771. https://doi.org/10.1016/S2214-109X(19)30077-4
Ranzani, O.T., Kalra, A., Di Girolamo, C., Curto, A., Valerio, F., Halonen, J.I., Basagaña, X. and Tonne, C. (2022) Urban-Rural Differences in Hypertension Prevalence in Low-Income and Middle-Income Countries, 1990-2020: A Systematic Review and Meta-Analysis. PLOS Medicine, 19, e1004079. https://doi.org/10.1371/journal.pmed.1004079
Still, C.H., Margevicius, S., Harwell, C., Huang, M.C., Martin, L., Dang, P.B. and Wright, J.T. (2020) A Community and Technology-Based Approach for Hypertension Self-Management (COACHMAN) to Improve Blood Pressure Control in African Americans: Results from a Pilot Study. Patient Preference and Adherence, 23, 2301-2313. https://doi.org/10.2147/PPA.S283086