Characteristics, treatment, and control of hypertension in public primary healthcare centers in Nigeria: baseline results from the Hypertension Treatment in Nigeria Program.
Characteristics, treatment, and control of hypertension in public primary healthcare centers in Nigeria: baseline results from the Hypertension Treatment in Nigeria Program.
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DOI：
10.1097/hjh.0000000000003089
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发表时间：
2022-05-01
影响因子：
4.9
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中科院分区：
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在非洲，关于改善初级卫生保健(PHC)水平的高血压诊断、治疗和控制率的大规模、多水平实施研究的数据有限。我们描述了尼日利亚高血压治疗计划中公立PHC中心高血压患者的特征、治疗和控制率。数据是在2020年1月至2020年11月期间从60个公共≥中心的18岁成年人中收集的。高血压治疗率在登记时和首次就诊结束时计算。高血压控制率是根据收缩压和舒张压计算的。建立回归模型以评估与高血压治疗和控制状况相关的因素。4927人(66.7%女性，平均年龄48.2[12.9]岁)纳入研究。男性的平均收缩压(SD)高于女性(152.9[20.0]mm Hg比150.8[21.0]mm Hg，p=0.001)。大多数患者(58.3%)在登记时正在接受治疗，在基线访问结束时，89.2%的患者正在接受治疗。基线高血压控制率为13.1%，且控制率在年龄较大(调整后OR[95%CI]：1.01[1.01，1.02])、女性(调整后OR[95%CI]：1.30[1.05，1.62])、使用固定剂量联合治疗(调整后OR[95%CI]：1.83[1.49，2.26])和受教育程度较高的患者中更为常见。这份非洲最大的以设施为基础的高血压研究的基线报告表明，高血压治疗率很高，但控制率很低。
There are limited data on large-scale, multi-level implementation research studies to improve hypertension diagnosis, treatment, and control rates at the primary health care (PHC) level in Africa. We describe the characteristics, treatment, and control rates of patients with hypertension in public PHC centers in the Hypertension Treatment in Nigeria Program. Data were collected from adults ≥18 years at 60 public PHC centers between January 2020 and November 2020. Hypertension treatment rates were calculated at registration and upon completion of the initial visit. Hypertension control rates were calculated based on systolic and diastolic blood pressures <140/90 mmHg. Regression models were created to evaluate factors associated with hypertension treatment and control status. 4,927 individuals (66.7% female, mean [SD] age = 48.2 [12.9] years) were included. Mean (SD) systolic blood pressure was higher in males compared with females (152.9 [20.0] mm Hg versus 150.8 [21.0] mm Hg, p = 0.001). Most (58.3%) patients were on treatment at the time of registration, and by the end of the baseline visit, 89.2% of patients were on treatment. The baseline hypertension control rate was 13.1%, and control was more common among patients who were older (adjusted OR [95% CI]: 1.01 [1.01, 1.02]), female (adjusted OR [95% CI]: 1.30 [1.05, 1.62]), who used fixed dose combination therapy (adjusted OR [95% CI]: 1.83 [1.49, 2.26]), and had higher education levels. This baseline report of the largest facility-based hypertension study in Africa demonstrates high hypertension treatment rates but low control rates.