High prevalence of uncontrolled hypertension among patients with early chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania

Abstract Background The prevalence of uncontrolled hypertension has been increasing globally including Sub-Saharan Africa (SSA) accelerating the burden of chronic kidney disease (CKD), cardiovascular diseases (CVD) and non-communicable diseases (NCDs). Methods A cross-sectional study was conducted among adult patients with early-stage CKD attending the medical outpatient department (MOPD) clinics of two tertiary hospitals in Dodoma between November 2020 to March 2021. Descriptive and inferential statistics were performed using SPSS software version 26 and multivariable logistic regression analysis was used to identify variables associated with uncontrolled hypertension. Results A total of 352 patients were enrolled; 64 (18.2%) were in CKD stage 2 and 288 (81.8%) in CKD stage 3, median age was 54 (47–59) years, 182 (51.7%) were males, the prevalence of hypertension was 58.5% and the prevalence of uncontrolled hypertension was 58.3%. For patients with uncontrolled hypertension, the median SBP was 146 (142–150) mmHg, the median DBP was 86(82–90) mmHg, the median BMI was 26.1 (24.0-27.5) kg/m2, the median waist circumference was 97(90–104) cm, the median eGFR of 48 (43–55) mil/min/1.73m2. Among patients with uncontrolled hypertension; 88.3% patients had CKD stage 3, 80.0% patients reported non-adherence to antihypertensives, 76.7% patients had overweight/ obesity, 72.5% patients reported current alcohol use, 60.0% patients had dyslipidemia, 43.3% patients reported current smoking, 36.7% patients had significant proteinuria and 26.7% patients had diabetes mellitus. Variables with higher odds for uncontrolled hypertension were; age ≥ 50 years (OR = 5.17, 95% CI 2.37–13.33, P = 0.001), alcohol use (OR = 11.21, 95% CI 3.83–32.84, P = 0.001), Overweight/obesity (OR = 6.28, 95% CI 2.54–15.53, P = 0.001), non-adherence to antihypertensives (OR = 10.19, 95% CI 4.22–24.61, P = 0.001) and CKD stage 3 (OR = 3.52, 95% CI 1.32–9.42, P = 0.012). Conclusion Uncontrolled hypertension is highly prevalent among patients with early-stage CKD in our settings and it’s associated with age, current alcohol use, overweight/obesity and non-adherence to antihypertensives.