BACKGROUND: Hypertension Is a major risk factor for cardio vascular disease.Govt.of Tamil Nadu implemented state wide hypertension screening and management program since 2011. Only half of the hypertension patients treated in public health facilities in Thanjavur district had their blood pressure under control(systolic bloodpressure <140mmHg, Diastolic blood pressure <90mmHg). We determined the risk factors associated with lack of hypertension control among hypertension patients who registered in public health facilities in Thanjavur District, Tamil Nadu, 2018
METHODS : We conducted a case-control study among the hypertensive patients who registered in two different public health facilities of Thanjavur district in Tamil Nadu. Patients who had latest two BP recordings were controlled (BP less than 140/90) in one year reference period were taken as control and patients who had latest two BP recordings or any one of the latest two BP recordings were uncontrolled (BP equal and above 140/90) were taken as a case. We calculated a sample size of 160 for cases and 160 for controls. We used a structured questionnaire to collect information. Crude and adjusted odds ratio with 95%confidence interval were calculated by logistic regression.
RESULTS : We recruited 160cases and160controls in Primary Health Care centres. Spss version 23 software was used for analysis. Age, gender, education, occupation, marital status, smokeless tobacco, duration of missing tablets, drug prescription status and knowledge of complications were not associated with uncontrol hypertension. Missing tablets more than seven days (OR 2.2;95%CI (1.0 – 4.6)) and being male (OR 13.6; 95%CI 1.7 – 106.8) was associated with uncontrolled hypertension.
CONCLUSION : Lack of adherence to medications despite dispensing of drugs for 30 days in the public health facilities was a riskfactor for uncontrolled hypertension.Medical officers and staff nurses should emphasize patient counselling with more focus on males. Systems should be developed to monitor adherence, such as phone call or SMS based reminders.