Prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending medical outpatient clinic, Thika level 5 hospital, Kenya

Magara Monyenye Gladys, John Gachohi, Alex Muriithi


Background: Uncontrolled hypertension is a key risk factor for stroke and heart and kidney disease. A study was conducted to determine the factors associated with the prevalence of uncontrolled hypertension among hypertensive patients (study participants) attending a medical outpatient clinic, Thika level 5 Hospital (TL5H), Kenya.

Methods: The study adopted a cross-sectional study design and a mixed-methods approach. While the quantitative arm sampled 394 study participants using systematic random sampling, purposive sampling selected 18 health care workers who served as key informant sand 35 study participants took part in focus group discussions in the qualitative arm. Uncontrolled hypertension was defined as systolic and or diastolic blood pressure ≥140 and or ≥90 in one or both previous and current readings during clinic visits. Quantitative data including socio-demographic, socioeconomic, and clinical characteristics of study subjects were collected using interviewer-administered questionnaires. Qualitative data were collected using guides and checklists. Data were analysed descriptively and inferentially using Pearson’s chi-square statistics, Fishers exact tests and regression modelling to determine associations between independent variables and uncontrolled hypertension using STATA 14. Qualitative data were organized thematically using NVIVO.

Results: 48% of the study participants had uncontrolled hypertension at the time of the study.  Univariable analyses returned level of education (p=0.017), source of financing for hypertensive drugs (p=0.011), BMI (p=0.005) as significant factors.

Conclusions: The study recommends community health promotion activities to increase awareness of how to modify these significant factors to reduce hypertension.


Prevalence, Uncontrolled hypertension, Kenya

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Heller O, Somerville C, Suggs LS, Lachat S, Piper J, Pastrana AN, et al. The process of prioritization of non-communicable diseases in the global health policy arena. Health Policy Plan. 2019;34(5):370-83.

Beaney T, Schutte AE, Stergiou GS, Borghi C, Burger D, Charchar F, et al. May Measurement Month 2019: The Global Blood Pressure Screening Campaign of the International Society of Hypertension. Hypertension. 2020;76(2):333-41.

Ogola EN, Barasa F, Barasa AL, Gitura BM, Njunguna B, Beaney T, et al. May Measurement Month 2017: the results of blood pressure screening of 14,845 individuals in Kenya-Sub-Saharan Africa. Eur Heart J Suppl. 2019;21:71-3.

Seedat YK. Why is control of hypertension in sub-Saharan Africa poor? Cardiovasc J Afr. 2015;26(4):193-5.

WHO. A global brief on hypertension Silent killer, global public health crisis, 2013. Available at: Accessed on 23 March 2021.

Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334-57.

Cuschieri S, Vassallo J, Calleja N, Pace N, Mamo J. The Effects of Socioeconomic Determinants on Hypertension in a Cardiometabolic At-Risk European Country. Int J Hypertens. 2017;7107385.

Kubota Y, Heiss G, Mac LRF, Roetker NS, Folsom AR. Association of Educational Attainment With Lifetime Risk of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study. JAMA Intern Med. 2017;177(8):1165-72.

James PA, Oparil S, Carter BL, Cushman WC, Dennison HC, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee. JAMA. 2014;311(5):507-20.

Nansseu JR, Noubiap JJ, Mengnjo MK, Aminde LN, Essouma M, Jingi AM, et al. The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis. BMJ Open. 2016;6(9):11452.

Tesfaye B, Haile D, Lake B, Belachew T, Tesfaye T, Abera H. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study. Res. Reports Clin. Cardiol. 2017;8:21-9.

Ministry of Health. Kenya national strategy for the prevention and control of non-communicable diseases, 2015. Available at: Accessed on 23 March 2021.

Kubo MN, Kayima JK, Were AJ, McLigeyo SO, Ogola EN. Factors Associated with Uncontrolled Hypertension among Renal Transplant Recipients Attending Nephrology Clinics in Nairobi, Kenya. J Transplant. 2015;746563.

Beaney T, Burrell LM, Castillo RR, Charchar FJ, Cro S, Damasceno A, Kruger R, Nilsson PM, et al. May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension. Eur Heart J. 2019;40(25):2006-17.

Sheikh D, Mateti UV, Kabekkodu S, Sanal T. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. Futur J Pharm Sci. 2017;3,60-4.

Burnier M, Egan BM. Adherence in Hypertension. Circ Res. 2019;124(7):1124-40.

Liu SY, Buka SL, Linkletter CD, Kawachi I, Kubzansky L, Loucks EB. The association between blood pressure and years of schooling versus educational credentials: test of the sheepskin effect. Ann Epidemiol. 2011;21(2):128-38.

Chen H, Zhang R, Zheng Q, Yan X, Shouling W, Youren C. Impact of body mass index on long-term blood pressure variability: A cross-sectional study in a cohort of Chinese adults. BMC Public Health. 2018,1193.

Johnson M, Backman D, Kohatsu N, Stewart O, Abbott R, Yu Z, et al. Interventions for Reducing Body Mass Index and Other Weight-related Indicators: A Review of Systematic. Reviews Acknowledgements. 2016;1-30.

Yang MH, Kang SY, Lee JA, Kim YS, Sung EJ, Lee KY, et al. The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients. Korean J Fam Med. 2017;38(4):173-80.

Payne RS, Piernas C, Aveyard P, Sheppard JP, Rayner M, Jebb SA. The Salt Swap intervention to reduce salt intake in people with high blood pressure: protocol for a feasibility randomised controlled trial. Trials. 2019;20(1):584.

Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, et al. Hypertension in older adults: Assessment, management, and challenges. Clin Cardiol. 2020;43(2):99-107.

Dipette DJ, Skeete J, Ridley E, Campbell NRC, Lopez JP, Kishore SP, et al. Fixed-dose combination pharmacologic therapy to improve hypertension control worldwide: Clinical perspective and policy implications. J Clin Hypertens (Greenwich). 2019;21(1):4-15.

Mendenhall E, Kohrt BA, Norris SA, Ndetei D, Prabhakaran D. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet. 2017;389(10072):951-63.