Spatial distribution and control status of hypertension in urban field practice area of a tertiary medical care institution of South India: A cross-sectional analytical study

Abstract

Background: Hypertension is a global public health issue. Geographic information systems (GIS) are increasingly being used by health-care systems as an emerging tool to address the public health burden of hypertension. Objective: The objective of the study is to describe the geographic distribution of adults with known hypertension residing in the urban field practice area of a tertiary care institution and to assess the factors associated with its control status. Materials and Methods: We conducted a cross-sectional analytical study in an urban health center (UHC) with adults with hypertension (n = 343) seeking care from the NCD clinic of UHC and private clinics were included. Geo-coding was done (n = 343) using digital GPS device by house-to-house visit and average of the three blood pressure recordings using digital sphygmomanometer taken for assessing control status (n = 277) of hypertension. A structured questionnaire was used to collect sociodemographic, risk factors distribution, and medication adherence. Geospatial analysis was done using QGIS 3.0, ArcGIS 10.2 and SPSS version 22 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Results: The geographic distribution showed clusters and hotspots in the study area. Of the 277 study participants, 57.4% (51.6–63.5) had blood pressure under control and 41% were male. Patients with age ≥60 years (prevalence ratios [PR]: 1.2, 95% CI: 1–1.6), with no comorbidity (PR: 1.3, 95% CI: 1–1.7), high medicine adherence (PR: 7.6, 95% CI: 3.9–14.6) were independent factors associated with control status. Conclusion: The study identified the clustering and hotspot areas of known patients with hypertension. Around three-fifth of known hypertensives had their blood pressure under control.