A2993 Prevalence of uncontrolled hypertension and patient characteristics in a middle-income sub-Saharan African country

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Objectives: According to a 2014 national non-communicable diseases (NCD) risk factors survey, Botswana has 29.3% prevalence of hypertension among adults aged 15–69 years. There is a need to understand whether healthcare services are responding by controlling this high burden of disease, and if not who is affected. We thus aimed to describe the prevalence of uncontrolled blood pressure (BP), and factors associated with uncontrolled BP, among known hypertensives. Methods: Out of 4,070 adults surveyed, a subset of 1,080 known hypertensives was analyzed. Descriptive and bivariate analyses using STATA v12 were performed to describe patient demographic, behavioral and clinical characteristics and to assess association with uncontrolled BP (defined as mean systolic BP > 140 or mean diastolic BP > 90, of three BP measurements). Results: Median age 44 years(IQR: 33–55), 838(78%) female. 446(41%) on BP medicines. 575(53%) had uncontrolled BP; 104(10%) severe (systolic BP > 180 or diastolic BP > 110). Uncontrolled BP was associated with male gender (p = 0.008), age > 30 years (p < 0.000), low education (p < 0.000), tobacco use (p = 0.001), BMI > 25 (p < 0.000), being on antihypertensive medicines (p < 0.000), receiving lifestyle counseling (p = 0.008). Conclusion: We found high proportion of uncontrolled BP, and an association (unadjusted) with being male, of low socioeconomic status and having modifiable risk factors. Findings from logistic regression modelling will be presented, and may suggest areas of targeted public health and healthcare service interventions to improve control of hypertension. Further studies are needed to understand better how patient and health system factors contribute to uncontrolled hypertension in Botswana.

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