Hypertension screening, prevalence, treatment, and control at a large private hospital in Kampala, Uganda: A retrospective analysis

PLOS Glob Public Health. 2022 May 10;2(5):e0000386. doi: 10.1371/journal.pgph.0000386. eCollection 2022.

Abstract

Adult hypertension prevalence in Uganda is 27%, but only 8% are aware of their diagnosis, accordingly treatment and control levels are limited. The private sector provides at least half of care nationwide, but little is known about its effectiveness in hypertension control. We analyzed clinical data from 39 235 outpatient visits among 17 777 adult patients from July 2017 to August 2018 at Uganda's largest private hospital. We calculated blood pressure screening rate at every visit, and hypertension prevalence, medication treatment, and control rates among the 5 090 patients with two or more blood pressure checks who received any medications from the hospital's pharmacy. We defined hypertension in this group as 1) an average of two blood pressure measurements at separate consecutive visits, higher than 140 mm Hg systolic or 90 mm Hg diastolic, 2) receipt of any antihypertensive medication, or 3) the use of a hypertension electronic medical record code. We deemed hypertension control as normotensive at the most recent check. 12 821 (72.1%) of patients received at least 1 blood pressure check. Among the 5 090 patients above, 2 121 (41.6%) had hypertension (33.4% age-standardized to a world population standard): 1 915 (37.6%) with elevated blood pressure, and 170 (3.3%) were normotensive but receiving medication. 838 (39.4%) of patients with hypertension received medication at least once. Overall, 18.3% of patients achieved control (27% of treated patients, and 15% of untreated patients). Hypertension is common and incompletely controlled in this Ugandan private-sector population, suggesting several avenues for novel interventions.

Grants and funding

Research training for RNC was supported by the Fogarty International Center of the National Institutes of Health, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); under a single award, number 1R25TW011213. The content in this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. DJH reports receiving a research grant from Teva Pharmaceutical Industries. However, this grant was for work separate from this study and was not in any way involved in the conduct of this research. DJH also reports funding from Resolve, Incorporated (formerly Resolve to Save Lives), also for work separate from this study and in no way related to the conduct of this research. For all disclosed sources of funding above, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.