abstract: 'Objective Assess capacity of health-care facilities in a low-resource

  setting to implement the absolute risk approach for assessment of

  cardiovascular risk in hypertensive patients and effective management of

  hypertension

  Design and setting A descriptive cross-sectional study in Egbeda and

  Oluyole local government areas of Oyo State in Nigeria in 56 randomly

  selected primary- (n = 42) and secondary-level (n = 2) health-care and

  private health-care (n = 12) facilities.

  Participants One thousand consecutive, known hypertensives attending the

  selected facilities for follow-up, and health-care providers working in

  the above randomly selected facilities, were interviewed.

  Results About two-thirds of hypertensives utilized primary-care centers

  both for diagnosis and for follow-up. Laboratory and other

  investigations to exclude secondary hypertension or to assess target

  organ damage were not available in the majority of facilities,

  particularly in primary care. A considerable knowledge and awareness gap

  related to hypertension and its complications was found, both among

  patients and health-care providers. Blood pressure control rates were

  poor {[}28\% with systolic blood pressure (SBP) < 140 mmHg and diastolic

  blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not

  evidence based and cost effective. The majority of patients (73\%) in

  this low socio-economic group (mean monthly income US\$73) had to pay

  fully, out of their own pocket, for consultations and medications.

  Conclusions If the absolute risk approach for assessment of risk and

  effective management of hypertension is to be implemented in

  low-resource settings, appropriate policy measures need to be taken to

  improve the competency of health-care providers, to provide basic

  laboratory facilities and to develop affordable financing mechanisms.

  (C) 2004 Lippincott Williams Wilkins.'
affiliation: 'Mendis, S (Corresponding Author), WHO, Bur 4034, 20 Ave Appia, CH-1211
  Geneva, Switzerland.

  WHO, Bur 4034, CH-1211 Geneva, Switzerland.'
author: Mendis, S and Abegunde, D and Oladapo, O and Celletti, F and Nordet, P
author-email: mendiss@who.int
author_list:
- family: Mendis
  given: S
- family: Abegunde
  given: D
- family: Oladapo
  given: O
- family: Celletti
  given: F
- family: Nordet
  given: P
da: '2023-09-28'
doi: 10.1097/00004872-200401000-00013
eissn: 1473-5598
files: []
issn: 0263-6352
journal: JOURNAL OF HYPERTENSION
keywords: hypertension; cardiovascular risk; absolute risk; low-resource settings
keywords-plus: 'GENERAL-PRACTICE; BLOOD-PRESSURE; NATIONAL-SURVEY; HEALTH; POPULATION;

  CARE'
language: English
month: JAN
number: '1'
number-of-cited-references: '23'
orcid-numbers: mendis, shanthi/0000-0002-8959-5738
pages: 59-64
papis_id: 41f7e6ac92213a09ff69a62fecab4d65
ref: Mendis2004barriersmanagement
researcherid-numbers: 'Mendis, Shanthi/GLT-0465-2022

  '
times-cited: '56'
title: Barriers to management of cardiovascular risk in a low-resource setting using
  hypertension as an entry point
type: Article
unique-id: WOS:000222672400012
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '22'
web-of-science-categories: Peripheral Vascular Disease
year: '2004'