• Daniel Mengistu Bekele Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • Gary, RA Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America.
  • Goshu, DY Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
  • Yalew, AW
  • Higgins, MK



Hypertension, blood pressure control, body mass index, comorbidity, clinical profile


Background: Hypertensives’ target blood pressure control remains suboptimal in many countries worldwide. Hence, determining patients’ factors affecting target blood pressure control is critical.

Objective: The objective of the study was to examine hypertensives’ target blood pressure control and its associations with their sociodemographic and clinical characteristics.

Methods: The study employed a cross-sectional design. For the face-to-face data collection with standardized questionnaires, 384 hypertensives attending a tertiary-level hospital were selected using a systematic random sampling technique. Descriptive statistics were used to determine the target blood pressure control status and bivariate chi-square test and binary logistic regression were used to identify factors significantly associated with the target blood pressure control.

Results: The study consisted of nearly equal proportions of male (51.2%) and female (48.8%) participants with a mean age (±SD) of 53.61 ±12.34 years. Only 45.1% had achieved target blood pressure control. Absence of comorbidity (AOR = 1.911, 95% CI: 1.256, 2.908, p = .002), good medication adherence (AOR = 2.535, 95% CI: 1.078, 5.960, p = .033), and normal body mass index (AOR = 1.675, 95% CI: 1.094, 2.564, p = .018) were factors significantly associated with the achievement of the target BP control.

Conclusion: Intervention targeting hypertensives’ body weight control, early comorbidity screening and management, and strict adherence to antihypertension medication may improve patients’ blood pressure control status and should be among the priority of the hypertension care clinic specialists’ team.


Download data is not yet available.


Zhou B, Carrillo-Larco RM, Danaei G, Riley LM, Paciorek CJ, Stevens GA, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet 2021;398: 957–980.

Mills KT, Stefanescu A, and He J. The global epidemiology of hypertension. Nature Reviews Nephrology 2020;16: 223–237.

Dzudie A, Njume E, Mfekeu LK, Djomou A, Ba H, Ndom MS, et al. May Measurement Month 2019: an analysis of blood pressure screening results from Cameroon. European Heart Journal Supplements 2021;23: B33–B36.

Cappuccio FP, and Miller MA. Cardiovascular disease and hypertension in sub-Saharan Africa: burden, risk and interventions. Internal and Emergency Medicine 2016;11: 299–305.

Hailemariam T. Prevalence of Cardiovascular Emergencies in Specialized Hospital, Addis Ababa Ethiopia. Emergency Medicine: Open Access 2014;04: 8–12.

Kibret KT, and Mesfin YM. Prevalence of hypertension in Ethiopia : a systematic meta-analysis 2015.

Tesfaye F. Epidemiology of Cardiovascular Disease Risk Factors in Ethiopia : The rural-urban gradient. Epidemiology & Public Health Sciences, Department of Public Health and Clinical Medicine Umeå University, Sweden. 2008.

Vasan RS, Beiser A, Seshadri S, Larson MG, and Kannel, W. B. et al. Residual Lifetime Risk for Developing Hypertension in Middle-agedWomen andMen The Framingham Heart Study. American Medical Association 2002;287: 1003–1010.

Yau JA, Karaye KM, and Okeahialam BN. Profile of Cardiovascular Risk Factors in Nigerians with Stroke 2016: 125–137.

Alkali N, Bwala S, Akano A, Osi-Ogbu O, Peter Alabi P, and Ayeni O. Stroke risk factors, subtypes, & 30-day case fatality in Abuja, Nigeria. 2013: 54(2): 129–135. 10.4103/0300-1652.110051.

WHO. A global brief on Hypertension: Silent killer, global public health crisis World Health Day 2013. World Health Organization 2013: 1–40.

Misganaw A, HaileMariam D, and Araya T. The double mortality burden among adults in Addis Ababa, Ethiopia, 2006-2009. CDC-Preventing Chronic Disease 2012;9: 1–10.

WHO. WHO methods and data sources for country ‐ level causes of death 2000-2012:Department of Health Statistics and Information Systems WHO, Geneva. 2014.

Ethiopian Public Health Institute: Ethiopian STEPS Report on Risk Factors for Non-communicable Diseases. 2016: 1–13.

Tolla MT, Norheim OF, Memirie ST, Abdisa SG, Ababulgu A, Jerene D, et al. Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis. Cost Effectiveness and Resource Allocation : C/E 2016;14: 10.

Gebrihet TA, Mesgna KH, Gebregiorgis YS, Kahsay AB, Weldehaweria NB, and Weldu MG. Awareness, treatment, and control of hypertension is low among adults in Aksum town, northern Ethiopia: A sequential quantitative-qualitative study. PLoS ONE 2017;12: 1–16.

Berhe DF, Taxis K, Haaijer-Ruskamp FM, Mulugeta A, Mengistu YT, and Mol PGM. Hypertension treatment practices and its determinants among ambulatory patients: retrospective cohort study in Ethiopia. BMJ Open 2017;7: e015743.

Olafiranye O, Zizi F, Brimah P, Jean-louis G, Makaryus AN, Mcfarlane S, et al. Management of Hypertension among Patients with Coronary Heart Disease. International Journal of Hypertension 2011;dio:10.406.

O’Connor PJ, Vazquez-Benitez G, Schmittdiel JA, Parker ED, Trower NK, Desai JR, et al. Benefits of early hypertension control on cardiovascular outcomes in patients with diabetes. Diabetes Care 2013;36: 322–327.

Adebolu, F. A. & Naidoo M. Blood pressure control amongst patients living with hypertension presenting to an urban district hospital outpatient clinic in Kwazulu-Natal 2014: 6–11.

Kayima J, Wanyenze RK, Katamba A, Leontsini E, and Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovascular Disorders 2013;13: 54.

Abebe SM, Berhane Y, Worku A, and Getachew A. Prevalence and associated factors of hypertension: A crossectional community based study in Northwest Ethiopia. PLoS ONE 2015;10: 1–11.

Asgedom SW, Gudina EK, and Desse TA. Assessment of blood pressure control among hypertensive patients in Southwest Ethiopia. PLoS ONE 2016;11: 1–12.

Aberhe W, Mariye T, Bahrey D, Zereabruk K, Hailay A, Mebrahtom G, et al. Prevalence and factors associated with uncontrolled hypertension among adult hypertensive patients on follow-up at Northern Ethiopia, 2019: Cross-sectional study. Pan African Medical Journal 2020;36: 1–14.

Hulley SB, Cummings SR, Browner WS, Grady DG, and Newman TB. Designing Clinical Research. Fouth edition; Lippincott Williams & Wikins, Philadelphia. 2013.

CDC. Body mass index: Considerations for practitioners. Cdc 2011: 4.

Gelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, et al. Validity of the Patient Health Questionnaire-9 for Depression Screening and Diagnosis in East Africa. Psychiatry Res. 15;210(2):dio:10.1016/j.psychres.2013.07.015 2013;210.

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 Practice guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Pressure 2018;27: 314–340.

Teshome DF, Demssie AF, and Zeleke BM. Determinants of blood pressure control amongst hypertensive patients in Northwest Ethiopia 2018: 1–11.

Goverwa TP, Masuka N, Tshimanga M, Gombe NT, Takundwa L, Bangure D, et al. Uncontrolled hypertension among hypertensive patients on treatment in Lupane District , 2014: 1–8.

Mancia G, Fagard R, Narkiewicz K, Redán J, Zanchetti A, Böhm M, et al. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). Journal of Hypertension 2013;31: 1925–1938.

Hisamatsu T. Control rates of systolic and diastolic blood pressure among hypertensive adults in Korea. Korean Circulation Journal 2019;49: 1049–1051.

Chobanian A V, Bakris GL, and Black HR. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report 2009.

Guerrero-García C, and Rubio-Guerra AF. Combination therapy in the treatment of hypertension. Drugs in Context 2018;7: 1–9.

Asgedom SW, Atey TM, and Desse TA. Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia. BMC Research Notes 2018;11: 1–8.

Verma AA, Khuu W, Tadrous M, Gomes T, and Mamdani MM. Fixed-dose combination antihypertensive medications, adherence, and clinical outcomes: A population-based retrospective cohort study. PLoS Medicine 2018;15.

Fekadu G, Adamu A, Gebre M, Gamachu B, Bekele F, Abadiga M, et al. Magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at nekemte referral hospital, western ethiopia. Integrated Blood Pressure Control 2020;13: 49–61.

Abegaz TM, Abdela OA, Bhagavathula AS, and Teni FS. Magnitude and determinants of uncontrolled blood pressure among hypertensive patients in Ethiopia: Hospital-based observational study. Pharmacy Practice 2018;16: 1–7.

Gebremichael GB, Berhe KK, and Zemichael TM. Uncontrolled hypertension and associated factors among adult hypertensive patients in Ayder comprehensive specialized hospital, Tigray, Ethiopia, 2018. BMC Cardiovascular Disorders 2019;19: 1–10.

Li YT, Wang HHX, Liu KQL, Lee GKY, Chan WM, Griffiths SM, et al. Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings. Medicine (United States) 2016;95: 1–10.

Kang CD, Tsang PPM, Li WTL, Wang HHX, Liu KQL, Griffiths SM, et al. Determinants of medication adherence and blood pressure control among hypertensive patients in Hong Kong: a cross-sectional study. International Journal of Cardiology 2015;182: 250–257.

Visco V, Finelli R, Pascale AV, Mazzeo P, Ragosa N, Trimarco V, et al. Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control. Journal of Human Hypertension 2018;32: 467–476.

Desta M, Yibeltal D, Memiah P, Ayenew T, Mulugeta H, Gedefaw M, et al. Antihypertensive medications adherence and associated uncontrolled blood pressure among hypertensive patients in Ethiopia: Systematic review and meta-analysis. International Journal of Africa Nursing Sciences 2022;16: 100404.

Khayyat SM, Khayyat SMS, Hyat Alhazmi RS, Mohamed MMA, and Hadi MA. Predictors of medication adherence and blood pressure control among Saudi hypertensive patients attending primary care clinics: A cross-sectional study. PLoS ONE 2017;12: 1–12.

Adu-Boakye Y, Gyabaah S, Arthur J, Nyarko O, Boateng F, Nkyi C, et al. Hypertension Clinic Registry : Blood Pressure Control Among Hypertensives In A Specialist-Led Clinic In Ghana 2021;10: 1–8.

Bernabe-Ortiz A, Carrillo-Larco RM, and Miranda JJ. Association between body mass index and blood pressure levels across socio-demographic groups and geographical settings: Analysis of pooled data in Peru. PeerJ 2021;9.

Reisin E, Graves J, Yamal J-M, Barzilay JI, Pressel S, Einhorn PT, et al. Blood Pressure Control and Cardiovascular Outcomes in Normal, Overweight, and Obese Hypertensives Treated with Three Different Anti-Hypertensives in ALLHAT. J Hypertens 2017;32: 1503–1513.

Bhagavathula AS, Shah SM, Suliman A, Oulhaj A, and Aburawi EH. Hypertension control and guideline-recommended target blood pressure goal achievement at an early stage of hypertension in the UAE. Journal of Clinical Medicine 2022;11.

Amare F, Nedi T, and Berhe DF. Blood pressure control practice and determinants among ambulatory hypertensive patients attending primary health care facilities in Addis Ababa. SAGE Open Medicine 2020;8: 205031212094652.

Bekele etabalew E, Tadesse T, Negaw R, and Zewde T. Magnitude and associated factors of hypertension in Addis Ababa public health facilities, Ethiopia. MOJ Public Health 2018;7: 280–286.

Masilela C, Pearce B, Ongole JJ, Adeniyi OV, and Benjeddou M. Cross-sectional study of prevalence and determinants of uncontrolled hypertension among South African adult residents of Mkhondo municipality. BMC Public Health 2020;20: 1–10.

Akpa OM, Made F, Ojo A, Ovbiagele B, Adu D, Motala AA, et al. Regional patterns and association between obesity and hypertension in Africa: Evidence from the H3Africa Chair study. Hypertension 2020: 1167–1178.

Kang YS. Obesity associated hypertension: New insights into mechanism. Electrolyte and Blood Pressure 2013;11: 46–52.

Vance DE. Motivational Interviewing in Health Care: Helping Patients Change Behavior, by Stephen Rollnick, PhD, William R. Miller, PhD, & Christopher C. Butler, MD. Guilford Press, New York, NY, 2007, 210 pages, softcover, $25.00, hardcover $45.00, ISBN: 978-1-5938. Physical & Occupational Therapy In Geriatrics 2010;28: 101–102.

RNAO. Nursing Management of Hypertension. Nursing Best Practice Guideline 2009: 1–134.

Carter BL. Collaborative care model for hypertension. Journal of Clinical Hypertension 2018;20: 96–97.




How to Cite