Hypertension remains poorly controlled in Palestine. Improvement of its management will re-quirean understanding of the patient characteristics and treatment factors associated with uncon-trolled hypertension. A cross-sectional analysis
using data from prevalence of hypertension study
in West Bank (N=2077) using two-stage stratifie
d sampling method. We studied antihypertensive
medication use, comorbidity, and blood pressure measurements for 573 hypertensive patients in 3
different primary care settings across Palestine.
We concomitantly conduc
ted comprehensive pa-
tient interviews covering demogra
phic and clinical factors. Mean age of the patients was 57.5 ± SD
9.7 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were
149±12 mm Hg and 91.2±9 mm Hg (respectively). Only 33.2% (190/573) of patients had mean
blood pressure < 140/90 mm Hg during the study pe
riod. Those who are "uncontrolled" had high
systolic blood pressure rather than diastolic pr
essure (59 vs 41%; P<0.01)
. 60% of uncontrolled
hypertension found to be non-adherent to their dr
ug regimen, 28% experience adverse effects and
56% were found to be on monotherapy. There was no
statistically significant in difference in sex
distribution, marital status and educational leve
l between controlled and
uncontrolled hypertension.
Multivariate analysis revealed several independent
predictors of poor hypertension control; being
on monotherapy regimen [OR=2.14, 95% CI 1.51-
2.59], being obese BMI >25 [OR=1.80, 95% CI
1.44-2.46], being non adherence to antihypertensiv
e drugs [OR=2.67, 95% CI 2.34-3.11] and older
age > 65 [OR=2.12, 95% CI1.78-2.86]. Hypertension remains poorly controlled in clinical Practice
in West Bank. Physicians should aggressively treat
elevated systolic BP. A number of factors con-
tribute to poor control of hypertension including
Non-adherence to drug regimens, frustration with
treatment and obesity. Further identification of patients at risk of poor control can lead to targeted
interventions to improve management.