Abstract:

INTRODUCTION: Hypertension is increasingly common in sub-Saharan Africa and is among the modifiable risk factor for CVDs that causes morbidity and mortality among hypertensive patients. Data regarding the prevalence of hypertensive urgency, the pattern of established cardiovascular diseases among hypertensive patients seen in sub-Saharan Africa and their outcomes are lacking. This information is needed for improving clinician’s awareness, addressing the risk factors to the community, which will also improve awareness, overall morbidity and mortality among these patients will be reduced. Therefore, there is an essential need to conduct an epidemiological profile on the prevalence, predictors, and outcome of hypertensive urgency in Tanzania. The general objective of this study was to determine the prevalence of hypertensive urgency, the pattern of established cardiovascular diseases, associated factors and the 120-days outcomes for adults with hypertensive urgency attending MOPD at Bugando Medical Centre.

METHODOLOGY: A cross-sectional study with a follow-up component was conducted at medical clinics among hypertensive patients who were interviewed through a designed modified WHO STEPS questionnaire. BP measured, a Retinal photograph was taken, and a resting 12 lead electrocardiograms, serum creatinine, FBG/RBG and urine for dipstick were done. Then they were followed for four months after that through a phone call.

RESULTS: The prevalence of hypertensive urgency was found to be 150/7600 (2.0%); 29 (19.3%) were admitted or died at four months and 21/29 (72.4%) of them had moderated to poor adherence and baseline (OR 76.2, [14.20-409.12], p <0.001. Higher systolic blood pressure per milliliter was strongly associated with admission or death (OR 1.09, [1.05-1.14], p <0.001, as well as having a flush toilet versus pit latrine (OR 40.0, [2.39-668.66], p-value 0.01. There is a high proportional of established cardiovascular disease among these patients. This is a referral hospital-based study it is unlikely to tell us the actual burden of hypertensive urgency; however it will improve clinician’s awareness and improve on prompt diagnosis and management to decrease morbidity and mortality.