Blood Pressure Control and its Barriers among Adult Rural Dwellers Living with Hypertension in Ido-Osi Communities of Ekiti State, Southwest Nigeria

Abstract

Adequate control of blood pressure (BP) remains a significant way to reduce the morbidity and mortality associated with hypertension. Barriers such as distance to facilities, affordability of healthcare services, and cultural beliefs have been shown to negatively impact rural populations' management of hypertension. Despite various health interventions in Nigeria, rural communities continue to experience an increasing rate of BP control. The study determined the prevalence of blood pressure control and its barriers among adult rural dwellers living with hypertension in Ido-Osi Communities of Ekiti State, Southwest Nigeria. A multistage sampling technique was employed to recruit 180 patients with hypertension in two rural communities of Ekiti State, Southwest Nigeria. Socio-demographic data and barriers to blood pressure control were collected using a structured questionnaire adapted from the WHO STEP-WISE approach to non-communicable disease surveillance. Blood pressure and body mass index were measured and recorded. Data were analysed using STATA version 16. Multivariate logistic regression analysis using the odds ratio at 95% confidence interval was used to identify factors contributing to blood pressure control.  The mean age of respondents was 55.2 ± 9.5 years, with ages ranging from 36 to 74 years. The prevalence of blood pressure control was 40%. The associations between socio-demographic characteristics and blood pressure control in this study revealed that lower age (p<0.001), higher occupation (p<0.001), higher educational status (p<0.001) and higher income level (p<0.001) were statistically significantly associated with blood pressure control. Affordability of antihypertensive medication (p<0.001), the choice of healthcare providers (p=0.012) and awareness of normal blood pressure levels (p<0.001) were significantly associated with blood pressure control. Hypertensive patients who were of younger age group (AOR = 12.143, 95%CI: 2.178-28.636), could afford antihypertensive medications (AOR =8.573, 95% CI: 1.404-25.948) physically active (AOR =2.016, 95%CI: 1.007-3.699), consumed fruits/vegetables (AOR=2.646, 95% CI: 1.099-4.232), normal BMI (AOR=6.903, 95% CI: 2.013-17.614) and aware of normal blood pressure (AOR=4.556, 95%CI:1.035-8.665) were the determinants of blood pressure control. In contrast, the barriers to blood pressure control included hypertensive patients who were unemployed, (AOR=0.315, 95%CI: 0.001-0.843), no formal education (AOR=0.042, 95% CI: 0.034-0.763), low income (AOR=0.010, 95% CI: 0.001-0.239), and adding salt to the meal (AOR=0.084, 95%CI: 0.004-0.614).  The findings would assist the stakeholders in recommending culturally-appropriate targeted interventions to improve the rate of blood pressure control in rural southwest Nigeria.