A description of community-based participatory research of hypertension awareness, prevention and treatment in a district of Matabeleland South Province, Zimbabwe

Background: Hypertension is an important worldwide public health challenge because of its high prevalence and concomitant risks of cardiovascular and kidney diseases. The risk factors for hypertension are well known, and screening, diagnosis and treatment of hypertension have been well researched. However, this knowledge has not been translated into community practice as there remains a huge knowledge gap between the academics, health workers and the communities. There is need for community participation in developing and implementation of health interventions among marginalised communities.Aim: The aim of this project was to improve the community's knowledge about hypertension by positively influencing beliefs and behaviours, leading to improved community hypertension outcomes.Setting: The study was undertaken in Ward 14, a rural area situated south-west of Gwanda District, Matebeleland South Province in Zimbabwe.Methods: We conducted a health services research utilising qualitative methods by using a community-based participatory approach using a cooperative inquiry group.Results: There was improvement in knowledge about awareness and primary prevention of hypertension. Community hypertension care was established through competence training of village health workers (VHWs) and more persons living with hypertension were enrolled into care. Pill pickup rate and treatment compliance improved and the community's confidence in VHWs was restored. Community hypertension screening, treatment registers and health facility referrals were established.Conclusion: The community was empowered; the VHW was established as a key link between the community and the formal health delivery. This was a sustainable form of improving community hypertension health outcomes

Correlates of undiagnosed hypertension among health care workers in a secondary health care facility in north central Nigeria

Background: Hypertension is a major risk factor for cardiovascular disease, yet many health care workers rarely check their blood pressure. The detection of hypertension among health care workers is key to prevention of hypertension, its attendant complications in the community and a strategy for health care workers retention. Objective: To determine the prevalence and correlates of undiagnosed hypertension among health care workers in a secondary health care facility. Methods: Using a structured questionnaire, sociodemographic variables and risk factors for hypertension were obtained. Measurements of blood pressure, weight, height and waist circumference were carried out and body mass index calculated. Results: The prevalence of hypertension was 41.9%. The prevalence of undiagnosed hypertension was 35.1%. Multivariate analysis showed that age greater than 42 years (OR=0.24; 95%CI: 0.10-0.72) is a significant correlate of undiagnosed hypertension. Those who self-reported that they had been diagnosed to have hypertension were 15.5% of the study population. Among those who had self-reported hypertension, 79.1% were found to have hypertension by the researchers while among those who had no history of hypertension, 35.1% were hypertensive. When a history of hypertension is used as a screening test for the diagnosis of hypertension, it gave a sensitivity of 29.2%, a specificity of 94.4%, a positive predictive value of 79.1%, a negative predictive value of 64.9% and an accuracy of 67.1%. Conclusion: One in three persons had undiagnosed hypertension and those who were over 42 years are at risk for undiagnosed hypertension. This calls for urgent workplace strategies to create more awareness as a prevention and control strategy for the facility and the general population

Prévalence, connaissance et degré de contrôle de l'hypertension artérielle à Kisangani, RD Congo

Introduction: Déterminer la prévalence, la connaissance et le degré de contrôle de l'hypertension et analyser et comparer ces indicateurs en fonction des facteurs socio démographiques, héréditaires et environnement aux dans la population adulte de la ville de Kisangani, chef-lieu de la province Orientale en RD Congo. Méthodes: Nous avons mené une enquête transversale dans la population de Kisangani de juin 2010 à février 2011. L'étude a porté sur 1934 sujets âgés de ≥18 ans à l'exclusion des femmes enceintes. Les sujets ont été sélectionnés par échantillonnage aléatoire en grappes à quatre niveaux. Résultats: La prévalence de l'hypertension à Kisangani était de 28,3%. Parmi les sujets hypertendus, 72,2% se connaissaient hypertendus, 42,4% avaient leur hypertension contrôlée, 18,4% avaient l'hypertension au stade 2 et 6,5% avaient l'hypertension au stade 3. La prévalence de l'obésité était de 8%, celle de l'obésité abdominale de 13,5%. Les facteurs significativement associés à l'hypertension étaient l'âge, le sexe, le milieu de résidence, le niveau de scolarité, le niveau de revenu financier,la charge sociale,le statut dans le ménage,la prise des boissons alcoolisées, la sédentarité, l'hérédité d'hypertension, l'hérédité d'obésité, l'obésité et l'obésité abdominale. Conclusion: L'hypertension est très fréquente parmi les populations de Kisangani, aussi bien en milieu urbain qu'en milieu urbano-rural. Le niveau de contrôle de l'hypertension est plutôt satisfaisant; cependant la proportion d'hypertendus qui s'ignorent est préoccupante. Les systèmes des soins de santé de la ville de Kisangani devront s'atteler à améliorer les stratégies de dépistage de nouvelle «épidémie»

Incidental Finding of Hypertension and Diminished Femoral Pulses: Short-Segment Stenosis of the Aorta Just Distal to the Origin of the Left Subclavian Artery

Coarctation of the aorta is a congenital condition generally; and may vary from mild to severe. Symptomatology depends on early or late presentation. Young patients may present within the first few weeks of life with poor feeding; tachypnea and lethargy. They usually progress to overt congestive heart failure and shock. Older children may present with a murmur or hypertension. Diagnosis is often made after hypertension is detected as an incidental finding during evaluation of other problems; such as trauma or more common illnesses. Coarctation of the aorta can be cured surgically

Prevalence and Clinical Features of Arterial Hypertension in Ruhengeri District Hospital; Musanze; Rwanda

The prevalence of arterial hypertension (AH) varies among countries and within sub-classes of a country. It has been estimated that hypertension accounts for 6 deaths worldwide. Though it is said to be a disease of developed countries; its prevalence is not lower in under-developed countries. Hypertension is a major modifiable risk factor for cardiovascular disease that can; if untreated; result in serious morbidity and mortality from cardiac; cerebrovascular; vascular; and renal diseases [1]. Optimal control of diabetes and hypertension is needed to prevent development of heart failure [2]. Rwanda is one of the most densely populated (344 persons/Sq. km; 2006) [3] under-developed countries in Eastern Africa. This study was undertaken to study the prevalence of hypertension and its clinical presentations; comorbidities and prognosis in the department of internal medicine of the Ruhengeri district hospital. It was a retrospective study in which records of hospitalized patients for the period of January to June 2008 were studied. Data of patients were collected and analyzed using SPSS (Statistical Package for the Social Sciences) version 11.5 and Epidata. Total number of patients with hypertension was 57 which were 2.53.Hypertension was more common in women (64.9); than men (35.1). The majority of patients had more than 50 years of age (64.9). The most Common symptom was headache (47.4); followed by dizziness (36.8); palpitations (28.1) and visual disturbances (19.3); epistaxis (5); miscellaneous symptoms like loss of consciousness; tinnitus; e.t.c. (59.6). The majority of patients had severe hypertension (47.4) and patients over 50 years of age had the highest prevalence of severe hypertension (67). Alcohol consumption; diabetes mellitus; congestive heart failure had significant association with hypertension. Among the patients studied; 5.26 died during the period of study. The Study revealed that the hypertension prevalence and severity of its effect were more for the patients above 50 years of age; and women were more affected as compared to men. Headache was the most common symptom among patients with hypertension

Hypertension in Adults: Part 1. Prevalence; Types; Causes and Effects

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Hypertension in Adults: Part 2. Assessment and Management

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A Cross-Sectional Study of Blood Pressure Control in Hypertensive Patients in General Practice (the I-TARGET Study) : Cardiovascular Topics

Introduction: Despite the availability of multiple effective antihypertensive drugs; hypertension control rates remain poor. The reasons for this are complex; but increasingly; physician inertia has been identified as a crucial factor. In this study we attempted to define the level of blood pressure (BP) control and reasons for not achieving control in a survey of selected general practices within South Africa. Methods: This was a multi-centre; cross-sectional disease study involving 15 selected general practices throughout South Africa. Treated hypertensive patients over 18 years old were eligible for inclusion. The study was approved by Pharma Ethics; and after informed consent; consecutive hypertensive patients at the participating general practice centres were included; with each centre enrolling 30 patients. Results: A total of 451 patients; from 15 sites in South Africa; were entered in the study. The mean age of the patients was 60.7 years; 56.3were female and 15.7were current smokers. The BP was reduced by 26.4/17.6 mmHg (p 0.001) in 220 patients with a documented initial BP. Co-morbidities were present in 322 (71.4) patients and overall; 37.9had more than one co-morbidity. Lifestyle modification was not uniformly applied; with only 46.1; 59.6 and 56.8receiving advice about weight loss; exercise and diet; respectively. Less than a third (30.7) of patients were on monotherapy; 42.8were on two drugs (25.9on fixed-drug combination and 16.9on free combination) and 26.5were on more than two agents. Most (86.9) practitioners used either international or local guidelines to determine target BP. Overall; 61.2of patients were at goal (BP 140/90 mmHg). If a stricter target BP (BP ? 130/80 mmHg) is applied to patients with co-morbidities; as recommended by the guidelines; 60.6of patients did not reach goal. Of the 175 patients not at target BP; there was no action plan in 22.9; while 39.4were advised to undertake lifestyle changes only. Conclusions: Control rates were quite good in comparison with other surveys within and outside South Africa. However we were able to define several important deficiencies: there was evidence of physician inertia and also practitioners need to be more cognisant of local and international guidelines to optimise treatment

The management of Hyperttension in Nigerians

A review on the present state of management of hypertension is presented. The methods for case detection and investigation of cases are described. Treatment modes; patient education; society awareness are all factors that are important in the control of hypertension and limiting its complications. The role of primary health care workers in detecting and promoting complianceis being advocated

Proposal for prevention and treatment of hypertension and renal failure in Zimbabwe

Zimbabwe has made great strides in the development of a national health care system to provide care to all of its citizens. It has embarked on an extensive program to provide access to basic health services to the entire population. The Government of Zimbabwe established a Health Manpower Department within the Ministry of Health to facilitate the attainment of its health objectives in the most cost effective and efficient manner. The result is a commitment to an increase in all health services with an accompanied need not only for more manpower; and productivity in all existing disciplines; but also for the development of new essential specialties. Over the last few years there has been increased awareness of the devastating consequences that occur as a result of untreated or undiagonosed hypertension. Major sequelae that occur with hypertension include cerebral vascular accident; hypertensive cardiovascular disease; and renal failure. Appropriately; special emphasis has been placed on detection and treatment of hypertension so as to prevent the morbidity and mortality of this disease. The Health Department Institute (HDI); established in 1984; provides health care training; health risk management; hepertension screening; prevention education; and medical treatment for many in the greater Los Angeles area. HDI; and its affiliated companies; manage both hospital based hemodialysis units and free-standing hemodialysis and peritoneal dialysis units. HDI trains patent care technicians and nurses to provide care at these facilities; and participates in curriculm development and training of medical students and physicians at university based hypertension/renal training programs. [abstract terminated]