Abstract

MANAGEMENT OF HYPERTENSION: A RETROSPECTIVE STUDY IN TERTIARY HEALTH FACILITIES IN SOUTHERN NIGERIA

Biobarakuma Aberenimi Joseph*, Joshua Funsho Eniojukan and Ishmail Ayinla Suleiman

ABSTRACT

Hypertension control is essential for cardiovascular morbidity and mortality. Disease management evaluation is a tool in the quest to achieve desired goals. Non-pharmacologic and pharmacologic management of hypertension was evaluated retrospectively for a cross-section of patients in two tertiary health facilities in Southern Nigeria. The sample size was determined from the Cochrane formula for a population < 10,000 from hypertensive patients who attended the medical outpatient and cardiology clinics from 1st January 2016 to 31st December 2017. Patients’ data were extracted from their medical folder by trained Pharmacists. Analysis was done using SPSS software version 23.0, Graph Pad, and ANOVA. Non-pharmacologic management constituted advice on lifestyle modification. Reduction of the following intakes; salt - 498 (68.9%), oil- 286 (39.6%), alcoholic beverage - 371 (51.3%), and increase in the intake of vegetables andfruits- 400 (55.3%). Patients advised to exercise more were 304 (42.0%) while 173 (23.9%) were advised to avoid consumption of tobacco products. For pharmacologic management, the most frequently prescribed combinations were angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) plus calcium channel blockers (CCB) followed by ACEI or ARB with CCB and Thiazide diuretics, and then CCB/ Thiazides diuretics respectively. Efforts were rewarding with the reduction of hypertensive proportion of 70.1% to 38.3% within three months. The use of JNC 8 and ACC/AHA guidelines was noted. To avoid conflicting approaches, we suggest that Africa should streamline the use of guidelines to a few for effective use of resources.

Keywords: Antihypertensive agents, hypertension, management, calcium channel blockers.