Abstract:

Background: Bradycadia0 refers to a heart rate of less than 60 beats per minute. It can be symptomatic or asymptomatic in patients. It is can be linked to physiological changes as well as the pathological progression of an underlying disease (1). Problems in the sinal atrial node and atrioventricular block can cause low heart rates. Hypertension is a well-known risk factor for bradycardia and often co-exists with it. The high prevalence of hypertension in developing countries such as Tanzania makes it an important public health concern. Symptoms of bradycardia include fatigue, heart palpitations, memory problems, confusion, difficult concentrating, dizziness, lightheadedness, fainting/syncope, irritability, agitation, or other personality changes (2). While some of the possible causes of bradycardia are electrolyte imbalance, anorexia nervosa, inflammation or infections, Rheumatic fever and Rheumatic heart disease, lyme disease, Chagas disease, sick sinus syndrome, heart block, drugs, heart surgery, radiation therapy, heart attack, heart failure, CAD and trauma (2)(3).

Objectives: The objective of this study was to determine prevalence of bradycardia among hypertensive patients attending clinic at BMC, Mwanza – Tanzania and to identify the risk factors associated with bradycardia among hypertensive patients attending clinic at BMC, Mwanza – Tanzania.

Methodology: This study was conducted at BMC where a cross – sectional study design was conducted for four (4) months starting from May 2023 to September 2023 and involved all hypertensive patients attending clinic at BMC. Ethical clearance for conducting this study was sought from the joint CUHAS – BMC research and ethics review committee to gain permission to conduct the study. The data was collected using a semi structured questionnaire tool that enquired demographic characteristics together with symptoms of bradycardia with an estimated sample size of 150 participants. The collected data was then filled in software Microsoft Excel 2010, then data cleaning and coding was done. Analysis of the data was done using SPSS version 20.

Complications: Limitations of this study included inadequate fund to aid the research logistics and limited time to conduct the research.


Results: The predominant age of the respondents was 60 – 69years (39.33%). About 68% of them were married, with about 41.33% having attained secondary level education being the predominant group in terms of education level. A low level of knowledge on bradycardia was observed in hypertensive patients who participated in this study whereby only 17.13% were aware of the condition and most of the respondents (82.87%) had no knowledge on the meaning or occurrence of bradycardia. Among the respondents (hypertensive patients), the prevalence of bradycardia was noted to be 18.33%. In determining the relationship between socio-demographic characteristics and bradycardia, there was significant association statistically between age of the respondents and the occurrence of bradycardia with a P-value = 0.067 (table 3). For the other socio-demographic characteristics (level of education, marital status and sex) there was no statistical association with the occurrence of bradycardia. Whereas the odds of bradycardia occurrence was (COR = 9.000% CI: 0.482, 250.865) times more among the teachers group as compared to farmers group. As well it was (COR = 3.333 CI: 0.189, 59.799) times more in the entrepreneur group as compared to the farmers group. It was observed that most of the respondents (63.01%) agreed with alcohol being their major risk for bradycardia, followed by poor exercising habits (62.33% of the respondents). Other factors that had notable agreeing responses were; smoking cigarrete (53.52%) and poor dietary intake of nutritious food (50.91%).

Conclusion: It was observed in this study that a large number of the participants had no knowledge as well as not screened nor treated for bradycardia. Age was observed as an important predictor. Educational level and occupation were observed to be important factors contributing to the occurrence of bradycardia. A large number of people who participated in this study were unaware of the complications and symptoms of bradycardia. Very few participants (17.13%) had knowledge on symptoms and occurrence of bradycardia. On the factors contributing to the occurrence of bradycardia, two factors were the most stated being old age as well as excessive alcohol intake. There was a gap observed with mass media having not been utilized well to disseminate knowledge on hypertension and its association with bradycardia which complicates its course of illness among hypertensive patients.