Background

Sub-Saharan Africa is experiencing a rising burden of hypertension. Antihypertensive medications and diet are the cornerstone of effective hypertension control.

Aims

To assess adherence to medication and salt restriction in 12 sub-Saharan countries, and to study the relationship between adherence and blood pressure control in patients with hypertension.

Methods

We conducted a cross-sectional survey in urban clinics in twelve sub-Saharan countries. Data were collected on demographics, treatment and adequacy of blood pressure control in patients with hypertension attending the clinics. Adherence was assessed by questionnaires completed by the patients. Hypertension grades were defined according to European Society of Cardiology guidelines. Association between adherence and blood pressure control was investigated using multilevel logistic regression analysis, adjusting for age, sex and country.

Results

Among the 2198 patients, 77.4% had uncontrolled blood pressure, 34.0% were poorly adherent to salt restriction, 64.4% were poorly adherent to medication and 24.6% were poorly adherent to both. Poor adherence to salt restriction (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.03–1.72), medication (OR 1.56, 95% CI 1.25–1.93) or both (OR 1.91 1.39–2.66) was related to uncontrolled blood pressure. Moreover, poor adherence to both medication and salt restriction was related to a 1.52-fold (95% CI 1.04–2.22), 1.8-fold (95% CI 1.22–2.65) and 3.08-fold (95% CI 2.02–4.69) increased likelihood of hypertension grade 1, 2 and 3, respectively.

Conclusions

High levels of poor adherence to salt restriction and medication were noted in this urban sub-Saharan study; both were significantly associated with uncontrolled blood pressure, representing major opportunities for intervention to improve hypertension control in sub-Saharan Africa.

中文翻译：

---

对药物的依从性差和盐分限制不佳，无法控制高血压患者的血压：来自撒哈拉以南12个国家的横断面研究。

背景

撒哈拉以南非洲正在承受越来越重的高血压负担。降压药物和饮食是有效控制高血压的基础。

目的

评估撒哈拉以南地区12个国家对药物和盐限制的依从性，并研究高血压患者依从性与血压控制之间的关系。

方法

我们在撒哈拉以南十二个国家的城市诊所进行了横断面调查。收集有关就诊高血压患者的人口统计学，治疗和血压控制是否适当的数据。通过患者填写的问卷评估依从性。高血压等级是根据欧洲心脏病学会指南定义的。使用多级逻辑回归分析研究依从性与血压控制之间的关联，并根据年龄，性别和国家/地区进行调整。

结果

在2198例患者中，有77.4％的血压不受控制，34.0％的患者对盐分的依从性较差，64.4％的患者对药物的依从性较差，24.6％的患者对药物的依从性较差。对盐限制的依从性差（优势比[OR] 1.33，95％置信区间[CI] 1.03–1.72），药物治疗（OR 1.56、95％CI 1.25–1.93）或两者（OR 1.91 1.39–2.66）均与无法控制相关血压。此外，对药物和盐限制的依从性差与增加1.52倍（95％CI 1.02–2.22），1.8倍（95％CI 1.22–2.65）和3.08倍（95％CI 2.02–4.69）相关分别为1级，2级和3级高血压的可能性。

结论

在撒哈拉以南地区的这项城市研究中，人们对盐分限制和药物的依从性很差。两者均与血压失控显着相关，这代表了在撒哈拉以南非洲地区改善高血压控制的主要干预机会。