Factors Affecting Uncontrolled Hypertension in an Iranian Population

Introduction: Hypertension is among the major causes of mortality and disability worldwide. Despite the development of various treatment protocols, a significant proportion of hypertensive patients cannot reach the target blood pressure. The present study followed the participants of the Isfahan Healthy Heart Program (IHHP) to evaluate the factors effective on blood pressure control. Methods: In a cross-sectional study, the names of hypertensive individuals in the IHHP were extracted. The subjects were then invited to fill out questionnaires - including demographics, socioeconomic status, knowledge, attitude, and performance toward hypertension, lifestylerelated information (diet, physical activity, smoking, and stress management), and history of diseases. Height, weight, and blood pressure measurements were then performed. Patients with blood pressure ? 140/90 mm Hg were considered to have uncontrolled blood pressure. Data of the two groups with controlled and uncontrolled blood pressure were compared using the independent t and chi-square tests in SPSS15. Results: Although 300 persons were invited, only 139 patients accepted to participate. Since 30 subjects did not fulfill hypertension criteria, a total number of 109 individuals were finally evaluated. Measurements revealed 30 (27.5%) patients to have blood pressure below 140/90 mm Hg. However, 79 (72.5%) subjects were identified to have uncontrolled blood pressure. Subjects with controlled and uncontrolled blood pressure were not significantly different in terms of mean age (61.07 ± 10.30 vs. 61.11 ± 9.82; p value = 0.982). The corresponding scores were 65.30 ± 14.24 and 70.48 ± 9.43 for knowledge (p value = 0.073) and 76.67 ± 23.61 and 82.91 ± 18.14 for attitude (p value = 0.144). The mean values of waist circumference and waist-to-hip ratio were significantly higher in patients with uncontrolled blood pressure. In addition, subjects with uncontrolled blood pressure had significantly better knowledge about the necessity of having physical activity, not smoking, and stress management. However, no other significant differences were observed between the two groups. Conclusion: According to our findings, patient education and follow-up, as well as designing supportive and reminder systems, must aim to control blood pressure through eliminating obesity. Evaluating the knowledge, attitude, and performance of Iranian physicians would further highlight factors affecting blood pressure control in the country.