Failure to achieve goal blood pressure and its associated factors among hypertensive patients registered in a primary health centre in South India.

Introduction: Uncontrolled blood pressure (BP) among hypertensive patients leads to life-threatening complications, hospitalization, and premature mortality. Knowledge on the burden of uncontrolled BP and its correlates will help in devising strategies to achieve goal BP. We aimed to determine the proportion who have not achieved goal BP and its associated factors among hypertensive patients in a Primary Health Centre (PHC).

Materials And Methods: A facility-based cross-sectional analytical study was conducted among the hypertensive patients attending chronic disease clinic of PHC at Ramanathapuram, Puducherry. BP was measured and goal BP was defined based on Joint National Committee-8 criteria. The interview was conducted using semi-structured questionnaire capturing sociodemographic details, behavioral characteristics, physical activity with the International Physical Activity Questionnaire (IPAQ), medication adherence with Morisky Medication adherence scale-8 (MMAS-8), and stress with perceived stress scale. The data were entered and analyzed using EpiData software. The proportion "not achieved goal BP" was expressed as percentage and association were measured using prevalence ratios (PRs) with 95% confidence interval (CI).

Results: Of total 259 hypertensives studied, 140 (54.1%) were aged above 60 years, and 161 (62.2%) were females. Overall, 63 (24.3%) participants had not achieved goal BP. On univariate analysis, individuals aged 45-59 years (PR-2.1 [95% CI: 1.4-3.4]), being male (PR-1.6 [95% CI: 1.1-2.4]) and employed (PR-2.0 [95% CI: 1.1-3.5]) were associated with not achieving goal BP.

Conclusion: One-fourth of patients treated for hypertension in PHC failed to achieve goal BP. Considering the consequences of uncontrolled BP, cost-effective, context-specific interventions at the primary health-care level are needed.