Awareness Status and Associated Risk Factors for Hypertension among Adult Patients Attending Yala Sub-County Hospital, Siaya County, Kenya

Hypertension affects approximately 26% of the adult population worldwide and is a significant risk factor for cardiovascular diseases, stroke and renal failure. In Kenya, hypertension accounts for approximately 64% of stroke cases. However, information regarding its prevalence, awareness status and associated risk factors among patients seeking healthcare from hospitals in Kenya is unknown. Yala sub county hospital is one of the largest sub-county rural hospitals in Siaya County. In the past four years it had experienced increased number of patients diagnosed with high blood pressure (BP). But due to frequent breakages of BP monitoring machines and fewer medical staff at the outpatient department could make the reported data on hypertension not to be relied upon. This might lead to the true prevalence rate of the problem being underestimated. Moreover, lack of awareness regarding the disease status increases incidence of complications and mortality. The aim of the present study was to determine the prevalence, awareness and determinants of hypertension among adult patients attending Yala sub-county hospital, in Gem sub-county, Kenya. This was a hospital based cross-sectional study conducted on 393(144 males and 249 females) randomly sampled patients aged 18 years and above between February and March 2015. Study participants were considered to be hypertensive when they presented with a systolic blood pressure (BP) of 140mmHg and above and/or a diastolic BP of 90mmHg and above. Individuals who reported being on regular anti-hypertensive therapy were also grouped together with the cases. Data on demographics, social economic, exposure history to various potential risk factors for hypertension and awareness was collected using a pre-tested Questionnaire. Logistic regression analysis was used to identify factors associated with hypertension. The prevalence of hypertension in the study participants was at 36.9% (145/393) (male 38.9%, 56/144, females 35.7%, 89/249; p = 0.533). Out of all the hypertensive cases 85(58.6%) were found to be aware of their status and out of the 85 cases 75(88.1%) were on medication but only 21 of them (28.4%) had controlled blood pressure (systolic blood pressure 30 years OR= 12.0 (2.7 - 52.3), body mass index (overweight, OR= 2.98 (1.85 - 4.79) and Obesity, OR= 4.23 (2.15 to 8.30), current tobacco smoking OR= 2.63 (1.32 - 5.23), high waist circumference, OR= 2.39 (1.57 - 3.64). Increasing education level was however associated with decreased likelihood of suffering hypertension. These findings suggest that in the Gem community hypertension is most prevalent among adults aged 30 years and above and the risk factors are the same as those that have been reported in other population (body mass index, obesity, high waist circumference, tobacco smoking and low education levels). Approximately half of the hypertensive cases were aware of their status and the available hypertension medications did not fully control the high pressure in all the cases. Therefore, there is need to have community screening programs, instituting awareness raising programmes through health promotion to target individuals at risk and interventions aiming at reducing the associated factors identified in this study.