Poor hypertension control among patients attending the Kilimanjaro Christian Medical Centre, Tanzania: a cross-sectional study.


  • Sabrina Issa KCMC
  • Madhur Singh
  • Kajiru Kilonzo
  • Beatrice John
  • Sia Msuya
  • James Ngocho


Keywords: Prevalence, Hypertension, Control, Factors, Tanzania.



Poor hypertension control contributes significantly to the growing burden of Disability Adjusted Life Years. Despite the awareness and availability of interventions, only a small number of patients achieve the desired outcome, and the factors associated with poor control remain unclear. Therefore, the current study aimed to determine the prevalence of, and factors associated with poor hypertension control.


We conducted a hospital-based cross-sectional study between June and August 2018. At the medical outpatient clinic, hypertensive patients 18 years and above who gave consent were enrolled. An interview schedule was used to collect the general characteristics, followed by blood pressure recording. Poor hypertension control was defined as two consecutive high blood pressure of one month apart among patients on anti-hypertensive. Logistic regression was performed to determine factors associated with poor control.


 A total of 300 patients were enrolled in this study. More than half (52.0%) of the participants were female and living in rural (57.3%).  The mean (±SD) age of participants was 64.1 (±12.02) years. More than three quarter (86.7%) of the participants had poor control. Factors associated with poor control were; older age (cOR=1.05, 95% CI=1.02-1.08), being unemployed (cOR=3.46, 95% CI=1.30-9.14), and duration on anti-hypertensive (cOR=1.05, 95% CI=1.00-1.11).


Eight in every ten hypertensive patients had poor control. The poor control in this population was associated with unemployment, age and duration on anti-hypertensive.  The results call for more concerted efforts to address hypertension management.


1. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults. Jama [Internet]. 2014;311(5):507. Available from: http://jama.jamanetwork.com/article.aspx?
2. Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. BMJ Open. 2013;3(8):1–10.
3. Ibrahim MM. Hypertension in Developing Countries : A Major Challenge for the Future. Current Hypertension Reports; 2018;
4. Kayima J, Wanyenze RK KA, Al. E. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord. 2013;(13):54.
5. Dewhurst MJ, Dewhurst F, Gray WK, Chaote P, Orega GP, Walker RW. The high prevalence of hypertension in rural-dwelling Tanzanian older adults and the disparity between detection, treatment and control: A rule of sixths? J Hum Hypertens [Internet]. Nature Publishing Group; 2013;27(6):374–80.
6. WHO. Global Health Risks: Mortality and burden of disease attributable to selected major risks. Bull World Health Organ [Internet]. 2009;87:646–646. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf
7. Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115mmHg, 1990-2015. JAMA - J Am Med Assoc. 2017;317(2):165–82.
8. Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence , awareness , treatment and control in national surveys from England , the USA and Canada , and correlation with stroke and ischaemic heart disease mortality : a cross-sectional study. 2013;1–9.
9. Lei X, Yin N, Zhao Y. China Economic Review Socioeconomic status and chronic diseases : The case of hypertension in China. China Econ Rev [Internet]. Elsevier Inc.; 2012;23(1):105–21.
10. Agyemang C, Bruijnzeels MA. Factors associated with hypertension awareness , treatment , and control in Ghana , West Africa. 2006;67–71.
11. Esteghamati A, Abbasi M, Alikhani S, Gouya MM, Delavari A, Shishehbor MH, et al. Prevalence , Awareness , Treatment , and Risk Factors Associated With Hypertension in the Iranian Population : The National Survey of Risk Factors for Noncommunicable Diseases of Iran. 2008;21(6).
12. Jenson A, Omar AL, Omar MA. Global Public Health : An International Journal for Research , Policy and Practice Assessment of hypertension control in a district of Mombasa , Kenya. 2011;(January 2015):37–41.
13. STEPS_Instrument new 2018.
14. Flores M, Roma O. Trends in prevalence , awareness , treatment and control of hypertension in urban communities in Chile ´ n ´ n Za ´ n and Fabrizio Fasce. 2003;1807–11.
15. England TN. IN THE UNITED STATES. 2001;345(7):479–86.
16. Chen R, Morrison C, Connaghan J, Brook RA. Trends and social factors in blood pressure control in Scottish MONICA surveys 1986 – 1995 : the rule of halves revisited. 2003;751–9.
17. Plange-rhule J. Unaffordable drug prices : The major cause of non-compliance with hypertension medication in Ghana Unaffordable drug prices : the major cause of non-compliance with hypertension medication in Ghana . 2004;(October 2014):1–4.
18. Article O. Prevalence, awareness, treatment and control of hypertension among slum dwellers in Nairobi, Kenya. 2013;1–7.
19. Muntner P, Gu D, Wu X, Duan X, Wenqi G, Whelton PK. Factors Associated With Hypertension Awareness , Treatment , and Control in a Representative Sample of the Chinese Population The International Collaborative Study of Cardiovascular. 2015;578–86.
20. Manuscript A. NIH Public Access. 2014;98(1):50–7.






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