International Journal of Hypertension

Research Article

Clinical, Socioeconomic, and Psychosocial Factors Associated with Blood Pressure Control and Adherence: Results from a Multidisciplinary Cardiovascular National Program Providing Universal Coverage in a Developing Country

Table 2

Multivariable adjusted odds ratio for uncontrolled BP (≥140/90 mm/Hg) in hypertensive patients followed in the Cardiovascular Health Program.
 BP <140/90 mmHg 
n= 626 
n (%)		BP ≥140/90 mmHg 
n= 366 
n (%)		Model 1 
Unadjusted 
Odds Ratio 
(CI 95%)		Model 2 
Adjusted 
Odds Ratio 
(CI 95%)
Demographic and socioeconomic characteristic    
  Age (years)56 (49 - 61)58 (50 - 63) 1.03 (1.01 – 1.04)‡1.01 (0.99 – 1.03)
  Male sex 199 (31.8)146 (39.9)‡1.56 (1.30 – 1.86)‡1.73 (1.35 – 2.22)‡
  Low education (<8 years of education)191 (30.5)138 (37.7)†1.58 (1.31 – 1.90)‡1.21 (0.94 – 1.56)
  Low family income (<US$80 per person/month)189 (30.2)124 (34.0)1.19 (0.99 – 1.44)1.44 (1.13 – 1.84)‡
Psychosocial variables    
  Inadequate patient –physician relation179 (31.1)100 (33.4)1.20 (0.99 – 1.47)1.07 (0.84 – 1.37)
  High emotional stress-depression score153 (24.4)105 (28.7)1.29 (1.06 – 1.57)†1.32 (1.03 – 1.70)†
  Low social support221 (33.7)127 (34.7)1.15 (0.96 – 1.38)1.08 (0.85 – 1.37)
  Low knowledge about hypertension333 (53.2)209 (57.1)1.15 (0.97 – 1.38)1.17 (0.93 – 1.47)
Antihypertensive treatment variables    
  No adherence360 (57.5)251 (68.6)†1.67 (1.39 – 2.00)‡1.83 (1.44 – 2.32)‡
  Multiple antihypertensive RX255 (40.7)280 (56.8)‡1.73 (1.45 – 2.07)‡1.53 (1.21 – 1.94)‡
  Time of care in CVHP (years)6.6 (4.0 – 9.9) 7.6 (3.9 – 11.5) 1.03 (1.01 – 1.05)‡1.00 (0.97 – 1.02)
  Systolic blood pressure baseline in CVHP140 (134.5 – 152) 150 (140 – 164.2) 1.03 (1.03 – 1.04)‡1.03 (1.02 – 1.04)‡
  Diastolic blood pressure baseline in CVHP90 (90– 100) 96 (90 -100) 1.02 (1.01 – 1.03)‡1.00 (0.99 – 1.01)
Anthropometrics and clinical variables    
  Diabetes mellitus248 (39.6)127 (34.7)0.88 (0.74 - 1.06)0.87 (0.69 – 1.09)
  Elevated total cholesterol (≥ 200 mg/dL)289 (50.3)150 (51.5)1.01 (0.83 – 1.22)1.07 (0.86 – 1.34)
  BMI (Kg/m2)30.8 (27.8 – 34.2) 32.1 (28.5 – 36.1) 1.05 (1.03 – 1.06)‡1.04 (1.02 – 1.07)‡
Lifestyle habits    
  Smoking (current smoker)170 (27.2)82 (22.4)0.74 (0.60 – 0.90)‡1.00 (0.78 – 1.30)
  Alcohol related abnormal behavior69 (11.0)67 (18.3)‡1.69 (1.32 – 2.15)‡1.23 (0.89 – 1.71)
  Sedentary505 (80.7)318 (86.9)‡1.60 (1.25 – 2.05)‡1.61 (1.15 – 2.25)‡
Median values (percentile 25–75); †p <0.05, ‡p <0.01. OR adjusted for all the variables that were significant at the p<0.05 level in unadjusted model: age (years), systolic and diastolic blood pressure baseline in CVHP (mmHg), and time of follow-up in CVHP (years) and BMI (Kg/m2) as continuous variables. Sex (male), low education (< 8 years of educations), high emotional stress-depression (score ≥7), no adherence (score≥ 1), multiple antihypertensive RX (≥ 2 drug antihypertensive), alcohol related abnormal (score ≥2), smoking (current), and sedentary (<30 minx3/week of leisure physical activity) as dichotomous variables.