Original Research Hypertension guideline implementation and blood pressure control in Matlosana, South Africa

Keolebile I. Ditlhabolo, Carien Lion-Cachet, Ebrahim Variava

About the author(s) Keolebile I. Ditlhabolo, Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Department of Family Medicine, Primary Health Care Matlosana Sub-district, Dr Kenneth Kaunda District, North West Department of Health, Klerksdorp, South Africa
Carien Lion-Cachet, Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Department of Family Medicine, Primary Health Care Matlosana Sub-district, Dr Kenneth Kaunda District, North West Department of Health, Klerksdorp, South Africa
Ebrahim Variava, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Department of Internal Medicine, Tshepong Hospital, Dr Kenneth Kaunda District, North West Department of Health, Klerksdorp, South Africa

Abstract

Background: High systolic blood pressure remains a leading modifiable risk factor for cardiovascular diseases worldwide and in South Africa (SA). Information about the extent of guideline implementation and blood pressure (BP) control is lacking in Matlosana Sub-district, North West province, SA. The study aimed to assess the implementation of the South African Hypertension Practice Guideline (SAHPG) and BP control in adults attending primary care facilities in Matlosana.

Methods: Cross-sectional study was conducted, using 523 randomly sampled medical records. Data collected included demographic information, recorded BP readings, anthropometry, screening for target organ damage (TOD), 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 human immunodeficiency virus (HIV) than in groups with other comorbidities.

Conclusion: The study found poor documentation of the SAHPG recommendations among patients with hypertension. According to the patient records BP control was suboptimal, the most common documented comorbid illness was HIV, and screening for TOD was generally poorly documented.

Contribution: Programmes that audit and improve the quality of hypertension guideline implementation and BP control in primary care require ongoing support and research.

Keywords

hypertension; management; guidelines; blood pressure control; control targets; implementation; primary care; comorbidities; target organ damage

Sustainable Development Goal

Goal 3: Good health and well-being

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