Hypertension control and co-morbidities in primary health care centers in Riyadh

BACKGROUND: The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary healthcare (PHC) centers in Riyadh. METHODS: A cross-sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records were selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. RESULTS: Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females; the mean age was 57.2±11.1 years and 8.3% were smokers. The majority, 204 (85.7%), had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP and 129 (51.6%) had controlled diastolic BP. The most common co-morbidity was diabetes mellitus, found in 98 (38.4%), followed by dyslipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrence of hypertensive co-morbidities did not vary from other demographic characteristics. CONCLUSION: This study demonstrated poor blood pressure control in the mini-clinics in PHC centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels.