Primary hypertansion prevalance , blood pressure control ratio with treatment and effecting factors in patients applying to Karadeniz Technical University Farabi Hospital Hypertansion and Nephrology Clinic

Objective: The aim of this study is to evaluate the frequency of primary hypertension, risk factors, blood pressure control rates and factors affecting in patients applied to KTU Farabi Hospital Hypertension and Nephrology Outpatient Clinic. Materials and Methods: Between 01.06.2019-31.05.2021, 7351 patients applied to the Hypertension and Nephrology outpatient clinic of Karadeniz Technical University Faculty of Medicine. Among 7351 patients, 1955 patients who met the inclusion criteria were included in the study. Data on age, gender, height, body weight, body mass index, comorbidities, age at diagnosis, office blood pressure, risk factors for the development of hypertension, presence of end organ damage, and antihypertensive medications were evaluated. The study was a single-center retrospective chart review. Findings: A total of 1955 patients, 908 (46.4%) females and 1047 (53.6%) males, were included in the study. The frequency of primary hypertension in patients admitted to our outpatient clinic was calculated as 26.5%. When the patients were evaluated according to office blood pressure measurement, 41.5% (n=812) had SBP <140 mmHg and DBP <90 mmHg and they were under control. 58.5% (n=1143) had elevated SBP and/or DBP and they were not under control. In patients with 24-hour urinary sodium excretion ≥6 g/day, the rate of uncontrolled BP was higher than in patients with sodium excretion <2 g/day. Among patients with Na excretion <2 g/day (n=19), 68.5% (n=13) had controlled BP, while 31.5% (n=6) had uncontrolled BP. In patients with Na excretion between 2-5.9 g/day (n=170), BP was regulated in 44.1% (n=75) and not regulated in 55.9% (n=95). In patients with Na excretion ≥6 g/day (n=999), 38.8% (n=388) had regulated BP and 61.2% (n=611) had unregulated BP. When divided into two groups as obese and non-obese, the blood pressure control rate of patients with BMI≥30 kg/m2 was found to be lower than that of patients with BMI<30 kg/m2. When the drug groups used by the patients were evaluated; 25.7% (n=503) were receiving monotherapy, 35.1% (n=686) were taking two antihypertensive drugs, 21.7% (n=425) were taking three antihypertensive drugs, 6, 4% (n=124) were taking four antihypertensive drugs, 1.3% (n=25) were taking five v antihypertensive drugs. 5.4% (n=106) did not use antihypertensive drugs. Among the patients with controlled BP, 26.5% (n=215) were receiving monotherapy, 37.3% (n=303) were taking two antihypertensive drugs, 23.0% (n=187) were taking three antihypertensive drugs, 5.8% (n=47) were taking four antihypertensive drugs and 1.0% (n=8) were taking five antihypertensive drugs. 1.6% (n=13) were under control without antihypertensive medication. Results: In our study, the characteristics of patients with primary hypertension were similar to those found in the literature. The rate of blood pressure regulation was found to be lower in patients with obesity, proteinuria and high 24-hour urinary sodium excretion. In order to prevent end-organ damage in patients with primary hypertension, blood pressure regulation should be ensured; for this, risk factors should be eliminated. Keywords: Primary hypertension, end organ damage, obesity, blood pressure, antihypertensive