Socioeconomic and modifiable predictors of blood pressure control for hypertension in primary care attenders in the Western Cape, South Africa

• Published in: South African medical journal 2016-12, Vol.106 (12), p.1241
• Main Authors: Folb, N, Bachmann, M O, Bateman, E D, Steyn, K, Levitt, N S, Timmerman, V, Lombard, C, Gaziano, T A, Fairall, L R
• Format: Article
• Language: English
• Subjects: Antihypertensive drugs; Blood pressure; Control; Dosage and administration; Health aspects; Hypertension; Regulation; Risk factors
• ISSN: 0256-9574
• DOI: 10.7196/SAMJ.2016.v106i12.12005

Low socioeconomic status is associated with the risk of hypertension. There are few reports of the effect of socioeconomic and potentially modifiable factors on the control of hypertension in South Africa (SA). To investigate associations between patients' socio-economic status and characteristics of primary healthcare facilities, and control and treatment of blood pressure in hypertensive patients. We enrolled hypertensive patients attending 38 public sector primary care clinics in the Western Cape, SA, in 2011, and followed them up 14 months later as part of a randomised controlled trial. Blood pressure was measured and prescriptions for antihypertension medications were recorded at baseline and follow-up. Logistic regression models assessed associations between patients' socioeconomic status, characteristics of primary healthcare facilities, and control and treatment of blood pressure. Blood pressure was uncontrolled in 60% (1 917/3 220) of patients at baseline, which was less likely in patients with a higher level of education (p=0.001) and in English compared with Afrikaans respondents (p=0.033). Treatment was intensified in 48% (892/1 872) of patients with uncontrolled blood pressure at baseline, which was more likely in patients with higher blood pressure at baseline (p