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 3
Multivariable adjusted odds ratio for no adherence risk to antihypertensive in hypertensive patients followed in the Cardiovascular Health Program.
Adherence n= 381 n (%)
No Adherence n= 611 n (%)
Model 1 Unadjusted Odds Ratio (CI 95%)
Model 2 Adjusted Odds Ratio (CI 95%)
Demographic and socioeconomic characteristic
Age
56 (50 - 61)
55 (49 – 61)
0.99 (0.98 – 1.00)
0.99 (0.98 – 1.00)
Male sex
115 (30.2)
230 (37.6)†
1.47 (1.22 - 1.76)
1.54 (1.23 – 1.93)
Low education (<8 years of education)
119 (31.2)
210 (34.4)
1.12 (0.93 - 1.35)
1.06 (0.85 – 1.32)
Low family income (<US$80 per person month)
68 (17.8)
160 (26.2)‡
1.66 (1.35 – 2.06)
1.39 (1.11 – 1.72)
Psychosocial variables
Inadequate patient –physician relation
95 (28.1)
184 (34.3)†
1.33 (1.09 – 1.63)
1.04 (0.84 – 1.29)
High emotional stress-depression score
76 (19.9)
182 (29.8)‡
1.84 (1.49 – 2.26)
2.15 (1.68 – 2.76)
Low social support
113 (29.7)
225 (36.8)†
1.44 (1.19 – 1.73)
1.34 (1.08 – 1.66)
Low Knowledge about hypertension
200 (52.5)
342 (56.0)
1.08 (0.91 – 1.28)
0.98 (0.81 – 1.21)
Antihypertensive treatment variables
Uncontrolled BP (≥ 140/90 mmHg)
160 (42.0)
305 (49.9)†
1.67 (1.39 – 2.00)
1.52 (1.22 – 1.90)
Multiple antihypertensive RX
197 (51.7)
266 (43.5)†
0.81 (0.68 – 0.96)
0.92 (0.75 – 1.13)
Time of care in CVHP (years)
6.9 (3.9 – 11.9)
6.7 (3.9 – 10.2)
0.98 (0.96 – 1.00)
0.98 (0.95 – 1.00)
Systolic blood pressure baseline in CVHP
150 (140 - 160)
145 (140 - 160)
1.00 (0.99 – 1.00)
1.00 (0.99 – 1.00)
Diastolic blood pressure baseline in CVHP
94 (90 - 100)
90 (90 - 100)
0.99 (0.98 – 1.00)
1.00 (0.99 – 1.00)
Anthropometrics and clinical variables
Diabetes mellitus
156 (40.9)
219 (35.8)
0.80 (0.67 – 0.95)
0.81 (0.66 – 0.99)
Elevated total cholesterol (≥ 200 mg/dL)
160 (48.3)
273 (52.7)
1.23 (1.02 – 1.48)
1.26 (1.04 – 1.54)
BMI (Kg/m2)
31 (28 - 35)
31 (27 – 35)
1.00 (0.99 – 1.02)
1.00 (0.98 – 1.02)
Lifestyle habits
Smoking (Current smoker)
97 (25.5)
156 (25.5)
0.98 (0.81 – 1.19)
0.98 (0.78 – 1.22)
Alcohol related abnormal behavior
39 (10.2)
97 (15.9)†
1.55 (1.19 – 2.01)
1.18 (0.86 – 1.60)
Sedentary
310 (81.4)
513 (84.0)
1.16 (0.92 – 1.45)
0.98 (0.75 – 1.29)
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: sex (male), low family income <US$80 per person/month), inadequate patient-physician relation (score ≤ 71), high emotional stress-depression (score ≥7), low social support (score <57), uncontrolled BP (≥ 140/90 mmHg), multiple antihypertensive RX (≥ 2 drug antihypertensive), diabetes, elevate total cholesterol (≥ 200 mg/dL), and alcohol related abnormal (score ≥2) as dichotomous variables.
