ABSTRACT
Background. Hypertension remains a global health burden; with a high incidence of long-term morbidity and mortality.Objective. To evaluate blood pressure (BP) control; factors associated with poor BP control; target organ damage (TOD); white-coat hypertension; treatment-resistant hypertension and secondary hypertension in patients referred to a tertiary-level hypertension clinic.Method. This was a prospective case-control study of patients referred for specialist hypertension management. Patient parameters recorded included age; gender; body mass index; uric acid; cholesterol; screening BP; follow-up BP; TOD and medications. We also recorded causes of secondary hypertension. Net BP change and the percentage achieving target BP were calculated in all patients followed up.Results. A total of 175 patients were sampled (72 males and 103 females; mean age 46.5 years). Of the patients 16.6% had a normal screening BP; 62.9% of patients were followed up; and 43.6% of these achieved BP control. After intervention; there was a net drop of 13.2 mmHg (range 7.9 - 18.4) in systolic BP and of 3.8 mmHg (4.4 - 12.0) in diastolic BP. Of all the patients; 12.6% had resistant hypertension; 49.1% had evidence of left ventricular hypertrophy and 18.3% had microalbuminuria; 13.1% of the patients were diagnosed with secondary hypertension. Conclusion. Specialist intervention was useful in identifying patients with white-coat and secondary hypertension; as well as in improving hypertension control in patients with apparent treatment-resistant hypertension. However; a significant percentage of patients did not reach target BP; and further efforts are required to identify the underlying causes for this