Hypertension guideline implementation and blood pressure control in primary care facilities, Matlosana sub-district, North West province

Abstract

Background: High systolic blood pressure remains a leading modifiable risk factor for cardiovascular diseases worldwide and in South Africa. Information about the extent of guideline implementation and blood pressure control is lacking in Matlosana Sub-district, North West province, South Africa. The study aimed to assess implementation of the South African hypertension practice guideline and blood pressure control in adults attending primary care facilities in Matlosana. Methods: A cross-sectional study was conducted, using 523 randomly sampled medical records. Data collected included demographic information, recorded blood pressure readings, anthropometry, screening for target organ damage, hypertension complications, comorbidities, lifestyle advice, and drug therapy. Results: According to the reviewed records the mean age of the participants was 56.77 years with a standard deviation of 12.4 years and 376 (71.9%) records belonged to females. Blood pressure control was documented in 229 (43.8%) of the medical records, with better control recorded in a group with comorbid HIV than groups with other comorbidities. Conclusions: The study found poor documentation of the South African hypertension practice guideline recommendations among patients with hypertension. According to the patient records blood pressure control was suboptimal, the most common documented comorbid illness was HIV, and screening for target organ damage was generally poorly documented. Recommendations: Programs that audit and improve the quality of hypertension guideline implementation and blood pressure control in primary care, require ongoing support and research