Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 24:46:67.
doi: 10.11604/pamj.2023.46.67.39778. eCollection 2023.

Pharmacological management of hypertension and outcome among patients on hemodialysis at Muhimbili National Hospital, Tanzania: a cross-sectional study

Devis Mhagama  1 , Manase Kilonzi  2 , Peter Kunambi  3 , Deus Buma  4 , Fredrick Kalokola  5 , Paschal Ruggajo  6 , Ritah Francis Mutagonda  2
Affiliations

Pharmacological management of hypertension and outcome among patients on hemodialysis at Muhimbili National Hospital, Tanzania: a cross-sectional study

Devis Mhagama et al. Pan Afr Med J. .

Abstract

Introduction: hypertension is prevalent among patients attending hemodialysis. However, published information on hypertension management among patients on hemodialysis in African countries is scarce. This study assessed antihypertensive medication prescribing patterns and blood pressure control among patients with hypertension on hemodialysis in Tanzania.

Methods: an analytical cross-sectional study was conducted at Muhimbili National Hospital in Dar es Salaam from April to June 2022. The study population consisted of patients with hypertension undergoing hemodialysis. Data on demographic, clinical characteristics and the antihypertensive medications used by the patients was collected using a structured questionnaire. Analysis was performed using Statistical Package for the Social Sciences software version 26. Uncontrolled pre-dialysis blood pressure determinants were assessed using a modified Poisson regression model. A p-value < 0.05 was considered statistically significant.

Results: out of 314 participants, the majority (68.2%, n= 214) were male, and the median age was 52 (interquartile range: 42, 60) years. Only 16.9% (n= 53) of patients had their pre-dialysis blood pressure controlled. The most frequent antihypertensive medications prescribed were calcium channel blockers (73.2%, n= 230). Patients with less than three dialysis sessions were 20% more likely to have uncontrolled blood pressure than those with three sessions in a week (adjusted prevalence ratio = 1.2).

Conclusion: most patients on hemodialysis with hypertension had poor blood pressure control, according to the study. Patients with hypertension should be strongly encouraged to adhere to at least three hemodialysis treatments to achieve optimal blood pressure control.

Keywords: Hypertension; Tanzania; antihypertensive medications; blood pressure; hemodialysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
A,B) the median values and the association of pre-and post-dialysis BP (n= 314)
See this image and copyright information in PMC

References

    1. Agarwal R. Hypertension in chronic kidney disease and dialysis: pathophysiology and management. Cardiol Clin. 2005 Aug;23(3):237–48. - PubMed
    1. Bucharles SG, Wallbach KK, Moraes TP, Pecoits-Filho R. Hypertension in patients on dialysis: diagnosis, mechanisms, and management. J Bras Nefrol. 2019 Jul-Sep;41(3):400–411. - PMC - PubMed
    1. Agarwal R, Nissenson AR, Batlle D, Coyne DW, Trout JR, Warnock DG. Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States. Am J Med. 2003 Sep;115(4):291–7. - PubMed
    1. Salem MM. Hypertension in the hemodialysis population: a survey of 649 patients. Am J Kidney Dis. 1995 Sep;26(3):461–8. - PubMed
    1. Agarwal R. Supervised atenolol therapy in the management of hemodialysis hypertension. Kidney Int. 1999 Apr;55(4):1528–35. - PubMed

Substances