EVALUATING STRATEGIES FOR HYPERTENSION CONTROL IN FAMILY MEDICINE CLINICS

*Hadeel Yousif Khaleel, Abeer Mahmood Yousif and Mariam Yousif Daniel

ABSTRACT

Background: Hypertension is a growing public health challenge in low- and middle-income countries (LMICs), contributing significantly to cardiovascular morbidity and mortality. Despite existing guidelines, its management remains suboptimal in primary healthcare settings. This study evaluates the knowledge and practices of primary healthcare providers in hypertension management based on the International Forum for Prevention and Control of Hypertension in Africa (IFHA) guidelines. Methods: This study involving 165 nurses from 36 primary healthcare centers. Participants were selected using a multi-stage random sampling approach. Data were collected through structured face-to-face interviews assessing knowledge of cardiovascular risk factors, diagnostic cut-offs, therapeutic goals, and adherence to IFHA recommendations. Statistical analyses were performed using SPSS version 21.0, with comparisons made between structured healthcare network facilities and non-affiliated facilities. Results: The findings revealed significant gaps in hypertension management. While 82.4% of nurses reported receiving in-job training, only 9.6% had training specific to cardiovascular diseases. Knowledge of cardiovascular risk factors was limited, with stress being the most frequently mentioned factor (58.2%), while major risk factors such as smoking, unhealthy diet, and physical inactivity were less recognized. Only 22.4% correctly identified the diagnostic threshold for hypertension (≥140/90 mmHg), and awareness of obesity indices was minimal. Regarding treatment, Alpha Methyldopa, Furosemide, and Thiazide diuretics were the most commonly prescribed medications, despite IFHA recommendations favoring Hydrochlorothiazide as a first-line treatment. Additionally, 81.2% of nurses recognized at least one indication for referral, yet high-risk patients were often managed at primary healthcare centers instead of being referred to specialized care. Conclusion: This study highlights critical deficiencies in healthcare providers' knowledge and practices regarding hypertension management in primary care. Inadequate training and the absence of standardized guidelines contribute to suboptimal care. To improve hypertension control, targeted training programs, evidence-based guidelines, and strengthened referral systems are essential. Implementing these strategies can enhance the effectiveness of hypertension management and reduce associated complications in primary healthcare settings.

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