Determinants of hypertensive crisis among patients at adult emergency department of selected public hospitals in Addis Ababa, 2021: A case-control study
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Date
2021-06
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Addis Abeba University
Abstract
Background: Hypertension is one of the major health problems that can cause significant
morbidity and mortality in the world. It affects about 1.13 billion world population. 1-2% of
this population have hypertensive crisis. Hypertensive crisis is becoming the main health issue
in countries with low-income level. However, limited studies have been conducted in Ethiopia.
The aim of this study is to assess determinants of hypertensive crisis among patients visited
adult emergency department of selected public hospitals in Addis Ababa, 2021
Method: Hospital based unmatched case-control study was conducted among 85 cases and
170 controls at adult emergency department of selected public hospitals in Addis Ababa from
March 15 to May 15 2021. Patients presented with hypertensive crisis were considered as
cases and hypertensives but without hypertensive crisis were considered as controls. Data were
collected by trained nurses using structured questionnaire and entered to Epi Data version 4.6
and exported into SPSS version 26 for analysis. Descriptive statistics was done and presented
using text, frequency tables, charts and graphs. Binary logistic regression was done and
variables with p-value less than 0.25 were eligible for the final model. A multivariable logistic
regression was also performed. Finally, statistical significant level was declared at a p-value of
less than 0.05.
Result: The proportion of participants presented with history of previous HTN was higher
among cases than controls (82.4% and 64.1%) respectively and the likelihood ratio of
hypertensive crisis was 3.6 times (AOR= 3.621: 95% CI 1.634,8.024,P=0.002) higher among
participants with history of previous HTN compared to without history of previous HTN.
There was also 4 times increased risk of hypertensive crisis among participants presented with
diabetes mellitus than participants presented without it (AOR=4.179: 95% CI 2.064, 8.643,
P=0.000). Similarly, participants presented with heart failure had 3 times higher odds (AOR=
3.056: 95% CI 1.516, 6.162, P=0.002) compared to participants without heart failure.
Conclusion: This study demonstrated statistically significant association of unemployment,
diabetes mellitus, stroke, heart failure, history of previous hypertension, family history of
hypertension and regular follow up with hypertensive crisis. The government, health facilities
and health care workers should give attention for hypertensive crisis and the associated
determinants.
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Keywords
Hypertension, Hypertensive crisis, Determinants, Public hospitals, Addis Ababa