Unmet needs of hypertension care in Nigeria: results of the community action against non-communicable diseases (COMAAND) project preintervention survey

Blood Press Monit. 2022 Feb 1;27(1):27-32. doi: 10.1097/MBP.0000000000000561.

Abstract

Objective: Assessing the state of hypertension care remains the first step towards planning a robust health system needed to tackle the rising burden of hypertension. Prior to the commencement of the Community Action Against Non-Communicable Disease project, we assessed hypertension care using the hypertension care cascade (HCC). This will serve as a baseline to evaluate project performance upon completion.

Methods: Hypertensive subjects were grouped into a mutually exclusive care cascade of 5 categories including unscreened and undiagnosed; screened but undiagnosed; diagnosed but untreated; treated but uncontrolled and treated with controlled hypertension.

Results: Of the 372 participants, mean age 48.9 years, 161 (43.3%) were hypertensive, of whom only 12.0% had controlled blood pressure (BP). Among the 88.0% with uncontrolled BP,19.0% were unscreened and undiagnosed, 48.5% were screened but undiagnosed, 13.0% were diagnosed but untreated and 7.5% were treated but BP uncontrolled. The HCC demonstrates that 19% of the hypertensive patients were lost at the screening stage, 60% of those who were screened never diagnosed, 40% of those who were diagnosed did not receive treatment and 60% of those who were on treatment did not reach target BP.

Conclusion: Unmet need of hypertension care is substantially high, thus underpinning the need for intervention with a multifaceted approach.

MeSH terms

  • Blood Pressure
  • Community Participation
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Hypertension* / therapy
  • Middle Aged
  • Nigeria
  • Noncommunicable Diseases* / epidemiology
  • Noncommunicable Diseases* / therapy