Official publication of Rawalpindi Medical University
Observational Assessment of Blood Pressure Goal Achievement in Patients on Antihypertensive Therapy in Urban Pakistan: Results of ACTION Registry
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Syed Arshad Sabir, Bashir Hanif, Aziz-Ur-Rehman, Saleem Ullah, Nadeem Hayat Mallick, Fayyaz Hussain Shah. Observational Assessment of Blood Pressure Goal Achievement in Patients on Antihypertensive Therapy in Urban Pakistan: Results of ACTION Registry. JRMC [Internet]. 2016 Sep. 30 [cited 2024 Mar. 28];20(3). Available from: https://journalrmc.com/index.php/JRMC/article/view/165

Abstract

Background: To assess the proportion of Pakistani
patients achieving blood pressure goal while on existing
antihypertensive therapy and reasons for not achieving BP
goal.
Methods: This descriptive study was conducted in 60
centers across 10 cities of Pakistan by simple random
sampling. It was a national, multi-centre, noninterventional,
cross-sectional, epidemiological disease
registry. Patients, who were ≥15 years of age, on
antihypertensive medications for ≥4 weeks and had taken
a dose on the day of visit, were included. Investigators
were randomly selected from a list of physicians within a
given geographical territory (Urban) in major cities of
Pakistan. Approximately 58% of the physicians were
general practitioners and 42% were specialist such as
medical internist and cardiologist. Reasons for not
achieving BP goal was determined by assessing different
variables. Changes made in BP management in patients
not at BP goal and therapeutic regimens prescribed to
patients at BP goal were also documented. Differences in
the profile of patients according to the attainment of BP
goal were analyzed using bi-variate analysis. A p <0.05
was considered significant.
Results: Mean age of patients (n=1130) was 52.6 ± 11.9
years. Of them 49% were females. Mean duration of HTN
was 6.1 (±6.2) years. Of 1130 patients, 23.80% achieved BP
goal. In patients not achieving BP goal, history of
sedentary lifestyle (60.27%), diabetes (42.97%), and
dyslipidemia (40.30%) were identified as risk factors.
Coronary artery disease (21.25%) was the most common comorbid
condition. Lack of patient understanding on
treatment importance (47.03%) was major reason for not
achieving BP goal. Lifestyle modification (37.74%) and
addition of another drug (37.74%) were recommended.
Majority of patients at BP goal received angiotensinconverting
enzyme inhibitors (36.05%).
Conclusion: In Pakistan, only one in four patients
taking antihypertensive medications and presenting to
physicians achieves BP goal as per JNC VII guidelines.
This has significantly improved as compared with
previous survey. Lack of understanding of importance of
BP treatment remains the major impediment in achieving
better BP control

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