Kiểm soát huyết áp và yếu tố liên quan trên người bệnh ngoại trú tại tuyến y tế cơ sở

Abstract

This multicenter, cross-sectional study evaluated target blood pressure (BP) achievement rates among 1,419 hypertensive outpatients across Vinh Yen, Hoang Mai, and Tam Diep in 2025, aligned with the VNHA 2024 – 2025 guidelines. The cohort's mean age was 68,8 ± 9,2 years old, and the overall BP control rate was 48.3%, exhibiting a significant disparity between patients without comorbidities (75.7%) and those with comorbidities (19.7%). Monotherapy was the predominant treatment strategy (71.4%), whereas the utilization of single-pill combinations (SPCs) remained low. Multivariate logistic regression analysis identified male gender (aOR = 0.71; 95% CI: 0.54 – 0.91), stage 2 – 3 hypertension at diagnosis (aOR = 0.54 – 0.59; 95% CI: 0.39 – 0.89), and the presence of comorbidities (aOR = 0.04 – 0.08; 95% CI: 0.01 – 0.10) as independent risk factors for failing to achieve target BP (p < 0.05). Comorbidity served as both an associated factor and a key criterion for target differentiation. Conversely, robust medication adherence (measured via MMAS-8) significantly enhanced the likelihood of target attainment (aOR = 1.43; 95% CI: 1.02 – 2.00; p = 0.04). These findings underscore the critical necessity of promoting early combination therapies and optimizing treatment adherence within primary healthcare settings, with a particular therapeutic focus on patients with comorbidities.