Uncontrolled Hypertension and Associated Factors among Adult Hypertensive Patients at Selected Public Hospitals in Addis Ababa, Ethiopia, 2025: A Multi Centered Institution-Based, Cross-Sectional Study

Abstract

Abstract Background: Uncontrolled hypertension is a significant global public health issue, where it remains a leading cause of cardiovascular diseases, stroke, and premature death. Various factors have been linked to uncontrolled hypertension. Objective: The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals in Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 600 hypertensive patients at selected hospitals from January 1 to January 31, 2025. A systematic random sampling technique was used to select the study participants. Data was collected through face-to-face interviews and reviewing patients’ charts. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with uncontrolled hypertension Result: The prevalence of uncontrolled hypertension among hypertensive patients at public hospitals in Addis Ababa was 58.3% (95% CI = 54.34%, 61.6%). After adjusted analysis, the presence of comorbidity (AOR = 2.38, 95% CI: 1.34, 4.96), being overweight (AOR = 2.52, 95% CI: 1.96, 6.24), non-adherence to anti-hypertensive medication (AOR = 6.31, 95% CI: 3.76, 9.44) and taking three or more anti-hypertensive medications (AOR = 2.21, 95% CI: 1.21, 7.63) were factors associated with uncontrolled hypertension. Conclusion: This study reveals a high prevalence of uncontrolled hypertension, influenced by factors like medication adherence, comorbidities, overweight status, and taking three or more antihypertensive medications. Healthcare providers should prioritize improving medication adherence, managing comorbidities, and offering personalized interventions, especially for those on multiple medications. Enhanced patient education and better healthcare access are also recommended. Keyword: Uncontrolled hypertension, antihypertensive medication adherence, comorbidities, overweight, Ethiopia, cardiovascular risk factors