Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study

Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study Abiyie Demelash Gashe, Fentahun Agegnehu Worku, Kedir Ali Mahamud, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5643741/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The timeframe from antihypertensive medication initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. In Ethiopia, while studies have explored BP control rates, data on the time required to achieve control are limited. This study aimed to estimate time to BP control and identify predictors in Afar region of Ethiopia. Method A facility-based retrospective cohort study was conducted among adult hypertensive patients aged 18 years and older in five public hospitals between September 7, 2019 and January 8, 2023. Data were collected using a structured questionnaire, entered into EpiData version 3.1, and analyzed using Stata version 14.2. Kaplan-Meier survival analysis was used to estimate time to BP control. Cox regression analysis was applied to identify predictors of time to BP control. The adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were computed at p < 0.05 Result A total of 443 hypertensive individuals were retrospectively followed, of which, 410 (92.6%) met the inclusion criteria. The median duration of follow-up was 10 month. The median age of the participants was 56 year. The median time to achieve BP control was 13 months (95% CI: 11⎼15). Factors associated with quicker BP control included combination therapy (AHR = 1.849, 95% CI: 1.276–2.679) and the absence of comorbidities (AHR = 1.86, 95% CI: 1.276–2.679). In contrast, factors leading to delayed BP control included age ≥ 60 years (AHR = 0.378, 95% CI: 0.236–0.605), severe hypertension (AHR = 0.626, 95% CI: 0.467–0.839), creatinine ≥ 1.5 mg/dL (AHR = 0.371, 95% CI: 0.173–0.799), and fasting blood sugar (FBS) ≥ 126 mg/dL; AHR = 0.335, 95% CI: 0.152–0.738). Conclusion The median time to BP control in this study exceeds recommendations from clinical trials and prior estimates. Combination therapy and the absence of comorbidities significantly reduce time to BP control, while advanced age, higher baseline BP, and elevated creatinine and FBS levels are linked to delayed BP control. Our findings highlight the necessity for enhanced counseling, management of comorbidities, regular end-organ evaluation, and use of combination therapies to expedite timely BP control. Hypertension BP control Time to BP control Prompt BP control Delayed BP control predictors of time to BP control Ethiopia Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Background Hypertension is the leading cardiovascular disease (CVDs) risk factor (1). Approximately 80-95% of hypertension has no an identifiable cause, while 5-20% follows the underlying renal, vascular, or endocrine disorders (2). It has rooted certain modifiable and modifiable risk factors. The modifiable risk factors for hypertension include overweight, high salt consumption, harmful alcohol use, physically inactivity and smoking while non-modifiable risk factors are those related to aging, ethnicity and family history (3) Globally, 1.28 billion adults have hypertension, with low-and middle-income countries sharing two-thirds of the disease burden (4). With this current trend, the number is projected to reach 1.56 billion by 2025, and the prevalence is expected to rise to 29% (5, 6). Evidence indicated that nearly 46% of people with hypertension globally are unaware of condition while less than half of adults are diagnosed and treated (7) The burden of hypertension varies across the World Health Organization (WHO) regions and income groups. The WHO region of Africa has the highest prevalence of hypertension (27%) while the WHO Region of the America has the lowest prevalence of hypertension (18%) in 2021 (8). According to May Measurement Month report 2019, hypertension was reported to be 29.3% in the South Asian region, 30.6% in East Asia and 27.9% in sub-Saharan Africa (9). The success of treating hypertension and achieving BP control has been a global challenge despite well-established approaches in the diagnosis and treatment (10). Evidence showed that prevalence of hypertension treatment and BP control were 70.1% vs 42.9% in America, 63.5% vs 30.7% in Europe, 49.9% vs 31.8% in South and Central Asia, 55.9% vs 32.7% in Asia Pacific, 53.8% vs 31.9% in Middle East and North Africa, and 32.1% vs 15.4% in Sub-Saharan Africa, respectively (11). In Ethiopia, the WHO estimated hypertension prevalence to be over 20%, with an alarmingly increase over time (12). Similarly, Data from a meta-analysis and systematic review estimated the prevalence of hypertension to be 9.3-30.3% in population-based studies, 7-37% in institution-based studies, and 13.2-18.8% in hospital-based studies (13). Hospital based studies in Ethiopia reported BP control rates ranging from 26.4% to 52.5% (14-17). Barriers to hypertension control exist at the patient, healthcare provider and health system levels. Patient-related barriers include unable to afford essential medicines and diagnostics, non-adherence to medicines, and poor lifestyle management (18). Healthcare provider-related barriers to hypertension control encompass protocol non-compliance, inadequate patient counseling, and insufficient task sharing. At the health system level, challenges include a lack of policies and guidelines, limited access to healthcare, and insufficient health insurance coverage (19⎼21). Although hypertension control has been identified as a major cost-effective strategy in reducing CVD (cardiovascular disease) risks, achieving prompt BP control was found far important (22). Delayed BP control increases all-cause mortality, while prompt BP control is associated with better CVD prognostic values (23, 24) . Moreover, prompt BP control helps patients to avoid the uncertainty associated with drug therapy and enhances trust in healthcare providers. Therefore, the timeframe from drug initiation to BP control is rarely used but a valuable endpoint measure of hypertension control (25, 26). While the exact timeframe for achieving BP control after initiating antihypertensive treatment is not clearly defined, clinical trials suggest that reaching this goal within 1-3 months is associated with improved CVD outcomes (22, 27). Despite its importance, few studies worldwide estimated time to BP control. Median time to BP control was 49 days in a study conducted in Barcelona, Spain (23), 7.2 months in Malaysia (28), 3.3 months in the USA (29), and notably, 48 months in Felege-Hiwot Specialized Hospital, Bahir Dar, Ethiopia (30). In Ethiopia, existing studies on BP control have primarily focused on the prevalence of BP control without considering the time taken to achieve it. Consequently, data on time to BP control are very limited. Understanding this timeframe is crucial for fostering hypertension management, reducing subsequent CVD risks and designing patient-centered interventions. Therefore, the current study aimed to estimate time to BP control and identify its predictors in the Afar region of Ethiopia. Methods and Materials Study settings A facility-based retrospective cohort study was conducted from September 7, 2019, to January 8, 2023, at five public hospitals in the Afar region. Afar region is one of fourteen regional states in Ethiopia, located at 580 km from Addis-Ababa, capital city of Ethiopia. Based on 2007 census data from the Central Statistical Agency, the regional population for 2022/2023 was projected at 2.8 million. The estimated 90% of regional population are pastoralists while the rest 10% are agro-pastoralists. Of a total of 10 public hospitals found in the region, this study was conducted at five hospitals such as Dubti General Hospital, Asayta Primary Hospital, Mohamed Akale Memorial Hospital, Dalifage Primary Hospital, and Kelwan Primary Hospital. These hospitals had separate chronic follow-up units, provide outpatient and inpatient service for hypertension. They also offer health education programs that emphasize lifestyle modifications and medication adherence for patients with established chronic disease including hypertension. Study populations The source populations were all patients who were receiving antihypertensive treatment in five public hospitals in Afar region. The inclusion criteria were: 1) Patients aged 18 years and older, 2) confirmed diagnosis of hypertension as per Ethiopian national clinical guidelines, 3) Patients who have been on antihypertensive therapy for at least three months prior to the data collection activities, 4) Patients with at least three documented visits/BP measurements. Consequently, patients with incomplete baseline data, such as the date of diagnosis and antihypertensive drug initiation were excluded from the study Sample size determination Sample size was determined using a cox regression model for survival studies in Stata software version 14.2, considering gender, comorbidity, and combination therapy as variables associated with time to BP control (28, 29). All covariates were included to calculate the adequate sample size. Based on female adjusted hazard ratio (AHR) = 1.51, an observed probability of BP control of 78.5% from study by Cheong AT et al (28), a 95% confidence interval (CI), significance (α) = 0.05, power = 80%, and assuming a 20% withdrawal rate, the initial sample size was calculated as 287 with estimated number of events (E) of 185. Considering a design effect of 1.5, the final sample size was determined to be 443, with (E) of 278. Sampling procedure The study participants were selected as follows: First, five hospitals (Dubti General Hospital, Asayta Primary Hospital, Mohamed Akale Memorial Hospital, Dalifage Primary Hospital, and Kelwan Primary Hospital) were randomly selected from a total of ten public hospitals in the region using a simple random sampling. Second, a comprehensive sample frame was established, including all patients who had initiated antihypertensive therapy from September 7, 2019, to January 8, 2023 using a hospital registry. Third, the sample size was proportionally allocated to each facility based on hypertensive patient volume. The allocation was calculated using the formula: N i = Total number of hypertensive patients in the facility i n = Total sample size determined N = Total number of hypertensive patients in all health facilities. The required sample from each facility was obtained via computer-generated randomization, ensuring a representative and unbiased selection of participants (Figure 1) Study variables Outcome variable The primary outcome of this study was time to BP control, measured in completed months from the initiation of antihypertensive agent until the patient's BP is classified as controlled according to national clinical guidelines. Predictor variables Demographic factors: Age, sex, residency (urban/rural) Behavioral factors: Smoking status, alcohol use Baseline BP: Mild hypertension, severe hypertension Comorbidities: Diabetes mellitus, chronic respiratory diseases including bronchial asthma, HIV status, and liver diseases Hypertensive complications: Heart diseases, renal diseases, ocular diseases, stroke Drug therapy-related factors: type of therapy (mono vs combination therapy), treatment intensification, drug switching, antihypertensive drug class, prescription pattern, appointment scheduling, statin therapy, and other concomitant therapies Laboratory parameters: Fasting blood sugar (FBS) levels, creatinine levels Data collection procedure A structured questionnaire was developed based on the relevant information from hypertension cohort register and literatures (23, 28-31), following the WHO's STEPwise approach for chronic disease risk factor surveillance (32). The questionnaire comprised of demographic, behavioral, clinical, drug therapy-related data and laboratory parameters. Demographic, clinical, laboratory, and drug therapy related data were extracted from patient charts and follow-up forms, while behavioral factors were collected from the hypertension cohort registers. A total of ten data collectors, experienced Bachelor of Science degree nurses working in chronic follow-up units, and two supervisors with Master of Public Health degrees oversaw the data collection process. Operational definitions and measurements On the basis of the national clinical guidelines, individuals with a systolic blood pressure (SBP) ≥ 140mmHg and/or diastolic blood pressure (DBP) ≥ 90mmHg were considered as hypertensive. Based on the baseline BP, hypertension was further categorized into mild hypertension (SBP 140-159 mmHg and/or DBP 90-99 mmHg) and severe hypertension (SBP ≥ 160 mmHg and/or DBP ≥ 100 mmHg). BP control was defined as attainment of SBP < 140 mmHg and DBP < 90 mmHg in general population, and SBP < 130 mmHg and DBP < 80 mmHg in patients with established diabetes mellitus, chronic kidney disease and cardiovascular diseases (33). The antihypertensive agents were grouped into the following groups: calcium channel blockers (CCBs) including amlodipine, nifedipine; thiazide diuretics which included hydrochlorothiazide and furosemide; angiotensin converting enzyme blockers (ACE) such as enalapril, captopril, and lisinopril; beta blockers such as propranolol, metoprolol and atenolol; and angiotensin receptor blockers (ARBs) like losartan, valsartan, and telmisartan (2). Use of single antihypertensive agent was considered as monotherapy while use two or more of antihypertensive agents of different class was defined as combination therapy (34). Hypertensive patients who were taking regular medications for comorbid illness were considered as to have concomitant therapies (35). Comorbidities were defined as one or more co-occurring clinical conditions in patients with hypertension primarily not attributed by hypertension itself (36). Furthermore, clinical outcomes that can result from a persistently elevated BP and mainly attributed by raised BP (37). Time to BP control was defined as the time duration from the initiation of antihypertensive drug to achieving controlled BP. Median time to BP control, represented a median survival time at which 50% of participants achieved BP control. Patients who did not achieved BP control, lost to follow-up, or whom the study ended before BP get controlled were taken as censored. Treatment intensification was considered when the dose of antihypertensive drug(s) was increased or new antihypertensive drug(s) is added (38). Drug switching was defined as changing antihypertensive drug to another, regardless of its class (39). Data quality control A data collection tool was carefully designed to capture all relevant variables from hypertension cohort registries and individual patient charts, addressing potential data incompleteness. The tool was pretested on 5% of the sample to ensure its clarity, completeness, and consistency. Data collectors were trained for three days on data collection procedures, study objectives, and data confidentiality measures. To enhance data validity, information from patient charts was cross-validated with data from the cohort registers Missing data handling Considering the challenges in complete documentation of patient records and the feasibility of complete case analysis, we opted to handle missing data through imputation method. While no definitive guidelines exist for determining the cutoff point for excluding missing variables with missing data, a threshold of 10% was adopted based on the data validity concerns and literature recommendations (40⎼42). Variables with missing data exceeding this threshold were removed from the analysis. Finally, missing values were replaced using modal imputation for categorical data and median imputation method for continuous data. Data analysis Data were checked for consistency and completeness, then coded and entered into EpiData Software version 3.1 and analyzed using Stata software version 14.2. Descriptive statistics, including median, range, and interquartile range, were used to summarize continuous data, while proportions/percentages, mode, tables, and figures were used to describe categorical data. Kaplan-Meier survival estimation was used to estimate median survival time, and the life table method was employed to estimate the cumulative survival time. Life table analysis was applied to examine BP treatment outcome at the three, six, 12, 24 and 36 months. The log-rank test was used to compare survival curves of two or more event experiencing groups. The proportional hazards (PH) assumption was assessed graphically (log-log plot of survival, Kaplan-Meir and predicted survival plot) and using the Schoenfeld residuals test. Cox-Snell residuals plots were used to evaluate overall model fitness. Both bivariate and multivariate Cox regression models were fitted to identify predictors of time to BP control. Variables with a p-value < 0.25 in the bivariate Cox regression analysis were considered for inclusion in the multivariate Cox regression analysis. Additionally, the study considered a clinical relevance of the variable during the candidate selection. AHRs, 95% CIs, and p < 0.05 were used to assess the strength and direction of associations. Ethical considerations The study was approved by the Institutional Review Board of St. Paul’s Hospital Millennium Medical College (SPHMMC), approval reference number PM23/567. Support letters were obtained from SPHMMC and the Afar Public Health Institute. Data confidentiality was actively protected through de-identification, data linkage removal and securing the file storage. As this study was based on the secondary data, the Institutional Review Board of SPHMMC waived the requirement for patient consent process according to the above confidentiality clauses. Finally, patients whom the study identified as censored observations were linked to healthcare providers for enhanced counseling and care. Results Socio-demographic and the study characteristics The study included a total of 443 hypertensive patients treated between September 7, 2019, and January 8, 2023, of whom 410 (92.6%) met the inclusion criteria. Among the 410 participants, 213 (52%) were females. The median age was 56 years (IQR: 47–64), and the median duration of follow-up was 10 months, range 3–38 months. Two hundred thirty-two (56.6%) of participants had achieved BP control. The incidence rate (IR) of BP control was 433 per 1000 person-months observations (Table 1 ). Table 1 Socio-demographic, and clinical characteristics of hypertensive patents in Afar region, Northeast Ethiopia Covariates Classification N = 410 Number Percent Sex Males 197 48% Females 213 52% Age 18–39 years 39 9.5% 40–60 years 222 54.1% ≥ 60 years 149 36.3% Residency Urban 111 27.1% Rural 299 72.9% Baseline BP Mild hypertension 245 59.8% Severe hypertension 165 40.2% Comorbidity Yes 155 37.8% No 255 62.2% Types of comorbidities Diabetes mellitus 74 18% Asthma and other chronic respiratory diseases 37 9% HIV 26 6.3% Liver diseases 10 2.5% Others 8 2% Hypertensive complications Yes 150 36.6% No 260 63.4% Types of hypertensive complications Heart diseases 73 17.8% Stroke 38 9.3% Renal diseases 28 6.8% Ocular diseases 11 2.7% Smoking Yes 78 19.0% No 332 81.0% Alcohol use Yes 59 14.4% No 351 85.6% Creatinine < 1.5 mg/dL 379 92.4% ≥ 1.5 mg/dL 31 7.6% FBS < 100 mg/dL 138 33.7% 100–125 mg/dL 234 57.1% ≥ 126 mg/dL 38 9.3% Table 2 Drug therapy related characteristics of hypertensive patents in Afar region, Northeast Ethiopia Indicators Classification N = 410 Number Percent Drug therapy Monotherapy 201 49% Combination therapy 209 51% Monotherapy (class) CCBs 99 24.1% Diuretics 66 16.1% ACE inhibitors 36 8.8% Combination therapy (class) CCBs + diuretics 56 13.7% CCBs + ACE inhibitors 53 12.9% ACE inhibitors + diuretics 44 10.7% CCBs + ARBs 19 4.6% Diuretics + ARBs 6 1.6% Others dual combinations 10 2.4% Triple combinations 21 5.1% Treatment intensification Yes 204 49.8% No 206 50.2% Drug switch Yes 105 25.6% No 305 74.4% Prescription pattern Once per day 125 30.5% Twice and above per day 285 69.5% Appointment schedule Monthly 227 55.4% Every two month 113 27.6% Three months 70 17.0% Concomitant therapy Yes 155 37.8% No 255 62.2% Statin therapy Yes 99 24.1% No 311 75.9% For hypertensive patients whom missing data set less than 10% such as concomitant therapy, statin therapy, smoking, alcohol use, creatinine and FBS, each unobserved value was substituted with a single value using modal and median imputation method (Additional file 1) Baseline clinical and laboratory characteristics Based on baseline BP readings, 245 (59.8%) of patients were classified as having mild form of hypertension. A total of 155 (37.8%) patients had the underlying comorbid clinical conditions. Diabetes mellitus was the most commonly reported comorbidity, affecting 74 (18%) of patients, followed by asthma and other chronic respiratory diseases 37 (9%) and HIV AIDS 26 (6.3%). More than one-third (36.6%) of patients experienced hypertensive complications. Heart diseases 73 (17.8%), stroke 38 (9.3%) and renal diseases 28 (6.3%) were prevalent complications. The median serum creatinine level was 0.99 mg/dL, while the median FBS was 107.5 mg/dL (Table-1). Drug therapy and related factors Two hundred one (49%) of patients were treated with single antihypertensive agents. The most commonly prescribed monotherapies were CCBs 99 (24.1%) followed by diuretics 66 (16.1%) and ACE inhibiters 36 (8.8%). Of patients were treated with combination therapy, commonly prescribed antihypertensive drug combinations were CCBs and diuretics 56 (13.7%); CCBs and ACE inhibitors 53 (12.9%); and ACE inhibitors and diuretics 44 (10.7%). Antihypertensive agents were intensified for nearly half (49.8%) of patients and switched for quarter (25.6%) of patients. Furthermore, nearly one in four (24.1%) of patients were treated with statins while 155 (37.8%) were receiving the concomitant therapies for comorbidity(s) (Table-2). Life table analysis The cumulative survival, explained by the cumulative probability of participants staying without experiencing an event i.e. BP control at the end of follow-up period was 30.5% (95% CI: 0.2419–0.3701). This explains that 30.5% of hypertensive patients did not achieve BP control at the end follow-up period (Table 3 ). Table 3 The cumulative probability of uncontrolled BP among hypertensive patients in Afar region, Northeast Ethiopia Intervals Beg. Total BP controlled Censored Survival 95% CI 0–4 410 1 0 0.9976 0.9828⎼0.9997 4–8 409 116 24 0.7061 0.6587⎼0.7482 8–12 269 61 32 0.5358 0.4841⎼0.5847 12–16 176 32 21 0.4322 0.3799⎼0.4834 16–20 123 10 20 0.3940 0.3415⎼0.4460 20 − 24 93 5 20 0.3702 0.3172⎼0.4233 24–28 68 5 34 0.3340 0.2779⎼0.3909 28–32 29 2 12 0.3049 0.2419⎼0.3701 32–36 15 0 8 0.3049 0.2419⎼0.3701 36–40 7 0 7 0.3050 0.2419⎼0.3701 Conversely, by modeling Ethiopia’s hypertension treatment outcome evaluation standard which offers BP outcome assessment at the three, six, 12, 24 and 36 months, the cumulative probability of BP control at three, six, 12, 24 and 36 months was 0.24%, 22.15%, 48.31%, 64.1% and 69.5%, respectively (data not shown, see additional file 2)) Kaplan-Meier survival estimation The median time to attain BP control was 13 months (Ŝ (t = 13) = 0.5, 95% CI: 11–15). At the end of follow-up, BP control rate was 433 per 1000 person-months observations. This rate indicated that 433 patients were controlling their BP, as if 1000 hypertensive patients have been followed for a month. Patients with higher baseline BP took the longest median time to control their BP (31 months) while younger population within 18–39 years of age had the shortest median time to achieve BP control (7 months) (Table 4 ). Table 4 Median time achieve BP control among hypertensive patients in Afar region, Northeast Ethiopia Classification Median time BP control 95% CI Log-rank test X 2 P-value Gender Males *** N/A 21.66 < 0.001 Females 11 9 ⎼12 Age 18–39 years 7 6⎼10 55.56 < 0.001 40–60 years 11 10⎼13 ≥ 60 years *** N/A Residency Urban 13 10⎼14 1.7 0.19 Rural 14 11⎼22 Baseline BP Mild hypertension 11 10⎼13 19.58 < 0.001 Severe hypertension 31 ≠≠≠ Presence of comorbidities Yes *** N/A 31.34 < 0.001 No 10 9⎼12 Hypertensive complication Yes 11 10⎼13 11.36 0.008 No *** N/A Drug therapy Monotherapy *** N/A 34.15 < 0.001 Combination therapy 10 9⎼12 Treatment intensification Yes 13 11⎼16 0.09 0.7615 No 13 10⎼16 Drug switching Yes 11 10⎼13 6.23 0.0126 No 13 11⎼15 Prescription pattern Once per day *** N/A 4.16 0.0413 ≥ 2 times per day 12 10⎼14 Appointment schedule Monthly 9 9⎼13 13.13 0.0014 Every two months 14 ≠≠≠ Three month and above 11 11⎼27 Concomitant therapy Yes 13 11⎼16 0.34 0.5602 No 13 10⎼16 Statin therapy Yes 13 10⎼20 0.11 0.7390 No 13 11⎼15 Smoking Yes 11 7⎼16 1.07 0.3003 No 13 11⎼16 Alcohol use Yes 11 7⎼20 1.17 0.2803 No 13 11⎼15 Creatinine level < 1.5 mg/dL 12 10⎼14 12.81 0.0003 ≥ 1.5 mg/dL *** N/A FBS < 100 mg/dL 11 9⎼14 16.66 0.0002 100–125 mg/dL 13 10⎼15 ≥ 126 mg/dL 27 ≠≠≠ Keys : *** 50% of observations not achieved BP control , N/A 95% CI not defined , ≠≠≠ either lower or upper bound of 95% CI not defined Kaplan–Meier survival curves The Kaplan–Meier survival curves were used for comparing the event-experiencing times of two or more groups for each covariate included in the model. Accordingly, the overall Kaplan–Meier survival curve illustrates that the probability of event-free observations decreases over time. At Ŝ (t = 13), 50% of observations survived did not experience an event⎼ BP control. The probability of uncontrolled BP control at the end of follow-up was 30.5% (Fig. 2 ). Females experienced quicker BP control than males (Fig. 3 ). Patients with higher baseline BP experienced delayed BP control (median time to BP control of 11 months) than those with mild hypertension whose median time to BP control was 31 months (Fig. 4 ). Furthermore, patients with creatinine < 1.5 mg/dL achieved sooner BP control when compared to those with creatinine ≥ 1.5 mg/dL (Fig. 5 ). Log rank test- comparison of Kaplan-Meir survival curves To avoid the subjectivity nature of relying on graphical comparison Kaplan–Meier survival curves, we employed the log-rank test, the statistical comparison of event-experiencing times of two or more groups. Based on log-rank test, there were no a statistically significant differences in event-experiencing times of groups based on residency, treatment intensification, pill burden, concomitant therapy, statin therapy, cigarette smoking, and alcohol use (Table 4 ). Predictors of time to BP control After controlling for the potential effects of confounding, patients older than 60 years had a 62.2% lower hazard of BP control compared to 18–39 years of age (AHR = 0.378, 95% CI: 0.236⎼0.605). The hazard of BP control in patients with stage severe hypertension was 37.4% lower than those with mild hypertension (AHR = 0.626, 95% CI: 0.467–0.839). Patients having no the underlying comorbidities had a 1.86 times higher hazard of BP control compared to patients with comorbidities (AHR: 1.86, 95% CI 1.276–2.679). Hypertensive patients treated with combination therapy had 1.7 times the increased hazards of BP control compared to those on monotherapy (AHR = 1.664, 95% CI: 1.213⎼2.283) (Table 5 ). Table 5 Predictors of time to BP control among hypertensive patients in Afar region, Northeast Ethiopia Classification Bivariate Cox regression Multivariate Cox regression CHR P-value AHR (95% CI) P-value Gender Males 1 1 Females 1.836 < 0.001 1.316 ( 0.984⎼1.761) 0.064 Age 18–39 years 1 1 40–60 years 0.580 0.004 0.680 (0.459⎼1.006) 0.054 ≥ 60 years 0.231 < 0.001 0.378 (0.236 ⎼ 0.61) < 0.001 Residency Urban 1 1 Rural 0.847 0.204 0.797 (0.60⎼1.048) 0.104 Baseline BP Mild HTN 1 1 Sever HTN 0.548 < 0.001 0.626 (0.467⎼0.839) 0.002 Presence of comorbidities Yes 1 1 No 2.218 < 0.001 1.849 (1.276 ⎼2.679) 0.001 Hypertensive complications Yes 1 1 No 1.587 0.001 0.942 (0.659⎼1.345) 0.742 Drug therapy Monotherapy 1 1 Combination therapy 2.145 < 0.001 1.664 (1.213⎼2.283) 0.002 Treatment intensification Yes 1 1 No 0.962 0.77* 1.149 (0.868⎼1.520) 0.331 Drug switching Yes 1 No 0.710 0.017 0.871 (0.647 ⎼1.173) 0.363 Prescription pattern Once/day 1 1 + twice/day 1.351 0.050 1.090 (0.785⎼ 1.515) 0.606 Appointment schedule Monthly 1 1 Every two month 0.567 0.001 0.735 (0.521⎼1.036) 0.078 Every three month 0.786 0.175 0.777 (0.542⎼1.112) 0.168 Statin therapy Yes 1 1 No 1.050 0.75* 1.15 (0.837⎼1.593) 0.381 Creatinine (in mg/dL) < 1.5 ≥ 1.5 0.287 0.001 0.371 (0.17⎼ 0.799) 0.011 FBS (in mg/dL) < 100 1 1 100–125 0.920 0.546 0.989 (0.752⎼1.303) 0.941 ≥ 126 0.239 0.001 0.335 (0.152⎼0.738) 0.007 *clinically relevant Proportional Hazard (PH) Assumption Log-log plot of survival The log-log plot of survival curves were checked for each covariate included in the model to assess on whether survival curves assumed the parallel pattern and satisfied the PH assumption. Accordingly, the log-log plot for gender did not cross each other, assuming the PH assumption (Fig. 6 ). Likewise, the log-log plot of survival for residency showed that plots were parallel and did not cross each other fulfilling the PH assumption (Fig. 7 ). Kaplan-Meier and predicted survival plot The Kaplan-Meier and predicted survival plots were checked to assess on whether the plots are closely aligned each other and the PH assumption was satisfied or not. For instance, the Kaplan-Meier and predicted survival plots were closely aligned to each other for drug therapy (mono vs combination) satisfying the assumption that PH holds (Fig. 8 ). Similarly, the Kaplan-Meier and predicted survival plots assumed this pattern indicates that that PH assumption is valid and the model adequately captures a variable drug switching (Fig. 9 ). Schoenfeld residual plot The Schoenfeld residual plots were checked to assess on whether plots for a covariate showed a straight line and PH assumption was met for each covariate included in the model. Accordingly, Schoenfeld residual plots for treatment intensification (Fig. 10 ) and drug switching exhibited a straight line with a symmetric pattern around zero, indicating that the PH assumption is satisfied for these covariates (Fig. 11 ). Schoenfeld field statistical test Statistically, none of the covariates included in the model were statistically significant at the 5% level, assuming that the covariates are not time-dependent and the PH assumption was satisfied, global test, p-value = 0.3791 (Data not shown, see additional file 3) Assessing the overall model fitness The Cox-Snell residual plot was used to assess the overall fitness of the survival model. The plot showed that hazard function closely follows 45-degree aligning with the expected exponential distribution. This indicated that the overall model is fit and adequately captures the underlying survival patterns in the hypertension data set, providing evidence for the reliability and validity of survival analysis (Fig. 8 ). Discussion This study aimed to estimate the time required to achieve BP control and identify its predictors among hypertensive patients treated at five public hospitals in the Afar region of Ethiopia. The median time required to achieve BP control was 13 months. Combination therapy and absence of comorbidities were associated with prompt BP control while advanced age, higher baseline BP, elevated creatinine and FBS levels delayed BP control. The median time to achieve BP control was found to be 13 months, which significantly exceeds the 1–3 months recommendations from the clinical trials ( 22 , 27 ). This finding may highlight the systemic barriers within Ethiopian healthcare, such as limited access to medications, inadequate follow-up and potential patient adherence issues. However, it is shorter than that time to BP control reported in a study conducted at Felege-Hiwot Specialized Hospital, Bahir Dar, Ethiopia (48 months) ( 30 ). This discrepancy might be attributed to differences in follow-up duration and patient characteristics. The study in Felege-Hiwot Specialized Hospital employed a longer follow-up period compared to the present study (60 vs 40 months), allowing an extended time for assessment of BP control instead of declaring censored observations. Additionally, hypertensive patients in Felege-Hiwot Specialized Hospital exhibited higher baseline creatinine (0.99 mg/dL vs. 1.1 mg/dL) and FBS (107.5 mg/dL vs. 114.5 mg/dL) levels than in this study ( 30 ), both of which are known to negatively impact BP control (42⎼45). Conversely, the median time to BP control in the present study was longer than that reported in studies from Barcelona, Spain (49 days) ( 23 ), Malaysia (7.2 months) ( 28 ), and the USA (3.25 months) ( 29 ). These disparities may be attributed to differences in follow-up duration, socio-demographic and behavioral characteristics of the study population. The present study indicates that older patients (≥ 60 years of age) had a 62.2% lower hazard of achieving BP control compared to younger patients (18–39 years). This is supported with existing studies conducted at Felege-Hiwot Specialized Hospital ( 30 ) and France ( 46 ) which suggests that aging is often associated with delayed BP control. This may be explained by the fact that elderly patients have the increased risk of the underlying comorbidities and physiological changes that complicate BP management ( 47 ). Factors such as reduced medication adherence, poly pharmacy, and lifestyle changes unique to older patients may contribute to these delays in achieving BP control ( 48 , 49 ) Patients with severe hypertension demonstrated a 37.5% lower hazard of BP control compared to those with mild hypertension. This finding is consistent with studies in Australia ( 49 ) and USA ( 29 ) which indicated that higher hypertension stages correlate with the delayed BP control complicating hypertension management. This correlation could be explained by the suboptimal therapy and the fact that patients with severe hypertension may present with more severe forms of the disease, including target organ damage often making it difficult to achieve timely BP control ( 50 , 51 ). Moreover, the finding emphasizes the need for proactive management strategies for patients presenting with more advanced stages of hypertension to expedite timely BP control. Patients without underlying comorbidities had a 1.9 times higher hazard of achieving BP control compared to those with comorbidities. This finding aligns with a study conducted in the USA, which reported a 35.2% lower likelihood of achieving BP treatment goals among patients with comorbid clinical conditions ( 29 ). This could be explained by the fact that comorbidities often share overlapping pathophysiology and share common risk factors, synergistically increasing the risk of end-organ damage, and competing demands on self-management behaviors collectively could delay time to BP control ( 52 – 54 ). Hypertensive patients treated with combination anti-hypertensive therapy were 1.7 times more likely to achieve a shorter time to BP control compared to those on monotherapy. Similarly, a Malaysian study reported a 3.5 times higher hazard of BP control among patients receiving combination therapy ( 28 ). Certain guidelines such as American College of Cardiology ( 55 ), the Joint National Committee-8 ( 56 ), and the International Society of Hypertension ( 25 ), as well as clinical trials ( 27 ) support the use of combination therapy, especially in patients with severe form of hypertension and those with underlying comorbid conditions to expedite prompt BP control. This could be explained by the fact that antihypertensive agents of different class can target different causal and pathophysiological mechanisms of hypertension, synergistically lowering BP levels and counteracting the side effect induced one by another. The hazard of BP control was 66.5% lower in patients with FBS > 126 mg/dL compared to those with FBS < 100 mg/dL. This could be explained by the fact that elevated blood sugar levels can damage blood vessels and kidneys, increasing vascular resistance and decreasing sodium and water reabsorption, leading to elevated BP levels ( 57 ). However, in contrast to this finding, a study conducted in Felege-Hiwot Specialized Hospital reported the increased hazard of BP control for every unit increase in FBS level ( 30 ). Hypertensive patients with creatinine level ≥ 1.5 mg/dL had a 62.9% lower hazard of BP control compared to those with creatinine < 1.5 mg/dL. This could be explained by the fact that impaired kidney function, characterized by decreased water and salt excretion and reduced production of BP-regulating hormones, can contribute to delayed time to BP control. However, the finding is in contrast with a study conducted at Felege Specialized Hiwot Hospital, Bahr Dar which reported a 13.2% increased hazard of BP control for hypertensive patients having serum creatinine levels ≥ 1.5 mg/dL ( 30 ). Limitations of the study Although, this study explored various potential factors affecting time to BP control, it has the following limitations. First, the use of secondary data restricted the exploration of various socio-demographic and economic factors that could influence BP control. Second, the use of simple imputation methods for handling missing data raises some concerns regarding the validity of the findings, as imputed values may not accurately reflect the true data distributions. Additionally, the interpretation of the study findings is limited to a few literatures due to the scarcity of comparable time-to-event (BP control) studies. Areas for future research As the reliance on secondary data restricts in-depth understanding of various socio-demographic and economic factors potentially affecting time to BP control including income level, education, employment status, and access to healthcare, there is need for future prospective studies focused on collecting primary data directly from patients. Given limitations of simple imputation method, future studies should target to more advanced missing data handling techniques such as multiple imputations to enhance the reliability and validity of the findings. Additionally, there is need for future researches targeted to the assessment of medication adherence and healthy lifestyle issues specifically to older adults and patients with underlying comorbidities. Conclusion This study found that the median time to achieve BP control was 13 months, which is longer than recommendations from clinical trials and most of the prior time to BP control estimates. Patients receiving combination therapy and those without comorbidities were more likely to experience faster time to BP control. These findings underscore the importance of combination therapy and effective management of comorbidities in achieving prompt BP control. Conversely, older age, advanced stages of hypertension, impaired kidney function, and elevated blood sugar levels were associated with delayed time to BP control. These findings highlight the importance of targeted interventions that can facilitate timely BP control among older populations and those with the underlying comorbidities. This could include patient education programs, enhanced adherence counseling, regular end-organ evaluation, and optimal glycemic control in patients with diabetes mellitus. Abbreviations ACE: Angiotensin Converting Enzyme; AHRs: Adjusted Hazard Ratios; ARBs: Angiotensin receptor blockers; BP: Blood pressure; CCBs: calcium channel blockers; CHRs: Crude Hazard Ratios; CI: Confidence intervals; CVD: cardiovascular diseases; DBP: Diastolic blood pressure; IR: Incidence rate; SBP: systolic blood pressure; WHO: World health Organization Declarations Ethical considerations and consent to participate The study was approved by the Institutional Review Board of St. Paul’s Hospital Millennium Medical College (SPHMMC), approval reference number PM23/567. Support letters were obtained from SPHMMC and the Afar Public Health Institute. Data confidentiality was actively protected through de-identification, data linkage removal and securing the file storage. As this study was based on the secondary data, the Institutional Review Board of SPHMMC waived the requirement for patient consent process according to the above confidentiality clauses. Finally, patients whom the study identified as censored observations were linked to healthcare providers for enhanced counseling and care. Consent for publication/ permission to reproduce material from other sources Not applicable Availability of data and materials The data sets and/or analyzed during the current study are available from the corresponding author upon the reasonable request. Competing interests The authors declare that they have no financial and non-financial competing interests to this article Funding All authors did not received the specific funding to this article Disclaimer All the claims expressed in this article and its contents are solely the responsibility of the authors and do not necessarily represent the official views of affiliated institutions. Acknowledgments The authors would like to express sincere gratitude to the following individuals and institutions: SPHMMC, School of Public Health, Department of Epidemiology for providing all the essential supports to conduct this study; Afar Public Health Institute for granting permission to conduct the research; and data collectors and supervisors for their diligent efforts in overseeing the data collection process. Author contributions Abiyie Demelash conceived the research idea, designed methodology, conducted the study, analyzed the data, and drafted the manuscript. FA made substantial contributions to the study design and drafting the article. KA contributed to data analysis and interpretation, and critically revised the manuscript for intellectual content. DZ designed research methodology, conducted data analysis and interpretation, and drafted manuscript. TE designed methodology, conducted data analysis and interpretation, and drafted article. 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Supplementary Files Additionalfile1Missingvariablereport.docx Additionalfile2Lifetableforcumulativefailureat361224and36months.docx Additionalfile3Schoenfeldfieldstatisticaltestglobaltest.docx Additionalfile4Questionaire.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5643741","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":391385634,"identity":"ca63a9fc-ce59-4d1c-aae0-f2f73833ca25","order_by":0,"name":"Abiyie Demelash 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residency\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-5643741/v1/2c01d2d6754a659a2df44d91.png"},{"id":72287370,"identity":"3052eda9-0088-4ec1-a540-140f72b7a3be","added_by":"auto","created_at":"2024-12-24 17:09:22","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":38148,"visible":true,"origin":"","legend":"\u003cp\u003eThe Kaplan-Meier and predicted survival plot by antihypertensive therapy\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-5643741/v1/bd83e6db7314ca2c728aa40a.png"},{"id":72287420,"identity":"d485e00f-945f-4f85-ba9d-1cfe3a2aa293","added_by":"auto","created_at":"2024-12-24 17:09:25","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":37601,"visible":true,"origin":"","legend":"\u003cp\u003eThe Kaplan-Meier and predicted survival plot by drug 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17:09:26","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":23589,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile4Questionaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-5643741/v1/0bda9b155b2cd10d2872fae2.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study","fulltext":[{"header":"Background","content":"\u003cp\u003eHypertension is the leading cardiovascular disease (CVDs) risk factor (1). \u0026nbsp;Approximately 80-95% of hypertension has no an identifiable cause, while 5-20% follows the underlying renal, vascular, or endocrine disorders (2). It has rooted certain modifiable and modifiable risk factors. The modifiable risk factors for hypertension include overweight, high salt consumption, harmful alcohol use, physically inactivity and smoking while non-modifiable risk factors are those related to aging, ethnicity and family history (3)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Globally, 1.28 billion adults have hypertension, with low-and middle-income countries sharing two-thirds of the disease burden (4). With this current trend, the number is projected to reach 1.56 billion by 2025, and the prevalence is expected to rise to 29% (5, 6). \u0026nbsp;Evidence indicated that nearly 46% of people with hypertension globally are unaware of condition while less than half of adults are diagnosed and treated (7)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The burden of hypertension varies across the World Health Organization (WHO) regions and income groups. The WHO region of Africa has the highest prevalence of hypertension (27%) while the WHO Region of the America has the lowest prevalence of hypertension (18%) in 2021 (8). According to\u0026nbsp;May Measurement Month report 2019, hypertension was reported to be 29.3% in the South Asian region, 30.6% in East Asia and 27.9% in\u0026nbsp;sub-Saharan Africa (9).\u003c/p\u003e\n\u003cp\u003eThe success of treating hypertension and achieving BP control has been a global challenge despite well-established approaches in the diagnosis and treatment (10). Evidence showed that prevalence of hypertension treatment and BP control were 70.1% vs 42.9% in America, 63.5% vs 30.7% in Europe, 49.9% vs 31.8% in South and Central Asia, 55.9% vs 32.7% in Asia Pacific, 53.8% vs 31.9% in Middle East and North Africa, and 32.1% vs 15.4% in Sub-Saharan Africa, respectively (11).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In Ethiopia, the WHO estimated hypertension prevalence to be over 20%, with an alarmingly increase over time (12). Similarly, Data from a meta-analysis and systematic review estimated the prevalence of hypertension to be 9.3-30.3% in population-based studies, 7-37% in institution-based studies, and 13.2-18.8% in hospital-based studies (13). Hospital based studies in Ethiopia reported BP control rates ranging from 26.4% to 52.5% (14-17).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Barriers to hypertension control exist at the patient, healthcare provider and health system levels. Patient-related barriers include unable to afford essential medicines and diagnostics, non-adherence to medicines, and poor lifestyle management (18). Healthcare provider-related barriers to hypertension control encompass protocol non-compliance, inadequate patient counseling, and insufficient task sharing. At the health system level, challenges include a lack of policies and guidelines, limited access to healthcare, and insufficient health insurance coverage (19⎼21). \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Although hypertension control has been identified as a major cost-effective strategy in reducing CVD (cardiovascular disease) risks, achieving prompt BP control was found far important (22). Delayed BP control increases all-cause mortality, while prompt BP control is associated with better CVD prognostic values (23, 24)\u003cem\u003e.\u003c/em\u003e Moreover, prompt BP control helps patients to avoid the uncertainty associated with drug therapy and enhances trust in healthcare providers. Therefore, the timeframe from drug initiation to BP control is rarely used but a valuable endpoint measure of hypertension control (25, 26). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;While the exact timeframe for achieving BP control after initiating antihypertensive treatment is not clearly defined, clinical trials suggest that reaching this goal within 1-3 months is associated with improved CVD outcomes (22, 27). Despite its importance, few studies worldwide estimated time to BP control.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Median time to BP control was 49 days in a study conducted in Barcelona, Spain (23), 7.2 months in Malaysia (28), 3.3 months in the USA (29), and notably, 48 months in Felege-Hiwot Specialized Hospital, Bahir Dar, Ethiopia (30). In Ethiopia, existing studies on BP control have primarily focused on the prevalence of BP control without considering the time taken to achieve it. Consequently, data on time to BP control are very limited. Understanding this timeframe is crucial for fostering hypertension management, reducing subsequent CVD risks and designing patient-centered interventions. Therefore, the current study aimed to estimate time to BP control and identify its predictors in the Afar region of Ethiopia. \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Methods and Materials ","content":"\u003ch2\u003eStudy settings\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;A facility-based retrospective cohort study was conducted from September 7, 2019, to January 8, 2023, at five public hospitals in the Afar region. Afar region is one of fourteen regional states in Ethiopia, located at 580 km from Addis-Ababa, capital city of Ethiopia. Based on 2007 census data from the Central Statistical Agency, the regional population for 2022/2023 was projected at 2.8 million. The estimated 90% of regional population are pastoralists while the rest 10% are agro-pastoralists. Of a total of 10 public hospitals found in the region, this study was conducted at five hospitals such as Dubti General Hospital, Asayta Primary Hospital, Mohamed Akale Memorial Hospital, Dalifage Primary Hospital, and Kelwan Primary Hospital. These hospitals had separate chronic follow-up units, provide outpatient and inpatient service for hypertension. They also offer health education programs that emphasize lifestyle modifications and medication adherence for patients with established chronic disease including hypertension.\u003c/p\u003e\n\u003ch2\u003eStudy populations \u0026nbsp; \u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe source populations were all patients who were receiving antihypertensive treatment in five public hospitals in Afar region. The inclusion criteria were: 1) Patients aged 18 years and older, 2) confirmed diagnosis of hypertension as per Ethiopian national clinical guidelines, 3) Patients who have been on antihypertensive therapy for at least three months prior to the data collection activities, 4) Patients with at least three documented visits/BP measurements. Consequently, patients with incomplete baseline data, such as the date of diagnosis and antihypertensive drug initiation were excluded from the study\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Sample size determination\u003c/h2\u003e\n\u003cp\u003eSample size was determined using a cox regression model for survival studies in Stata software version 14.2, considering gender, comorbidity, and combination therapy as variables associated with time to BP control (28, 29). All covariates were included to calculate the adequate sample size. Based on female adjusted hazard ratio (AHR) = 1.51, an observed probability of BP control of 78.5% from study by Cheong AT et al (28), a 95% confidence interval (CI), significance (\u0026alpha;) = 0.05, power = 80%, and assuming a 20% withdrawal rate, the initial sample size was calculated as 287 with estimated number of events (E) of 185. Considering a design effect of 1.5, the final sample size was determined to be 443, with (E) of 278.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Sampling procedure\u003c/h2\u003e\n\u003cp\u003eThe study participants were selected as follows: First, five hospitals (Dubti General Hospital, Asayta Primary Hospital, Mohamed Akale Memorial Hospital, Dalifage Primary Hospital, and Kelwan Primary Hospital) were randomly selected from a total of ten public hospitals in the region using a simple random sampling. Second, a comprehensive sample frame was established, including all patients who had initiated antihypertensive therapy from September 7, 2019, to January 8, 2023 using a hospital registry. Third, the sample size was proportionally allocated to each facility based on hypertensive patient volume. The allocation was calculated using the formula:\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; N\u003csub\u003ei\u003c/sub\u003e = Total number of hypertensive patients in the facility i\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; n = Total sample size determined\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;N = Total number of hypertensive patients in all health facilities.\u003c/p\u003e\n\u003cp\u003eThe required sample from each facility was obtained via computer-generated randomization, ensuring a representative and unbiased selection of participants (Figure 1)\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eStudy variables\u003c/h2\u003e\n\u003ch2\u003eOutcome variable\u003c/h2\u003e\n\u003cp\u003eThe primary outcome of this study was time to BP control, measured in completed months from the initiation of antihypertensive agent until the patient\u0026apos;s BP is classified as controlled according to national clinical guidelines.\u003c/p\u003e\n\u003cp\u003ePredictor variables\u003c/p\u003e\n\u003cp\u003eDemographic factors: Age, sex, residency (urban/rural)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBehavioral factors: Smoking status, alcohol use\u003c/p\u003e\n\u003cp\u003eBaseline BP: Mild hypertension, severe hypertension \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eComorbidities: Diabetes mellitus, chronic respiratory diseases including bronchial asthma, HIV status, and liver diseases\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHypertensive complications: Heart diseases, renal diseases, ocular diseases, stroke\u003c/p\u003e\n\u003cp\u003eDrug therapy-related factors: type of therapy (mono vs combination therapy), treatment intensification, drug switching, antihypertensive drug class, prescription pattern, appointment scheduling, statin therapy, and other concomitant therapies\u003c/p\u003e\n\u003cp\u003eLaboratory parameters: Fasting blood sugar (FBS) levels, creatinine levels\u003c/p\u003e\n\u003cp\u003eData collection procedure \u003c/p\u003e\n\u003cp\u003eA structured questionnaire was developed based on the relevant information from hypertension cohort register and literatures (23, 28-31), following the WHO\u0026apos;s STEPwise approach for chronic disease risk factor surveillance (32). The questionnaire comprised of demographic, behavioral, clinical, drug therapy-related data and laboratory parameters. Demographic, clinical, laboratory, and drug therapy related data were extracted from patient charts and follow-up forms, while behavioral factors were collected from the hypertension cohort registers. A total of ten data collectors, experienced Bachelor of Science degree nurses working in chronic follow-up units, and two supervisors with Master of Public Health degrees oversaw the data collection process.\u003c/p\u003e\n\u003ch2\u003eOperational definitions and measurements \u0026nbsp;\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;On the basis of the national clinical guidelines, individuals with a systolic blood pressure (SBP) \u0026ge; 140mmHg and/or diastolic blood pressure (DBP) \u0026ge; 90mmHg were considered as hypertensive. Based on the baseline BP, hypertension was further categorized into mild hypertension (SBP 140-159 mmHg and/or DBP 90-99 mmHg) and severe hypertension (SBP \u0026ge; 160 mmHg and/or DBP \u0026ge; 100 mmHg). BP control was defined as attainment of SBP \u0026lt; 140 mmHg and DBP \u0026lt; 90 mmHg in general population, and SBP \u0026lt; 130 mmHg and DBP \u0026lt; 80 mmHg in patients with established diabetes mellitus, chronic kidney disease and cardiovascular diseases (33).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The antihypertensive agents were grouped into the following groups: calcium channel blockers (CCBs) including amlodipine, nifedipine; thiazide diuretics which included hydrochlorothiazide and furosemide; angiotensin converting enzyme blockers (ACE) such as enalapril, captopril, and lisinopril; beta blockers such as propranolol, metoprolol and atenolol; and angiotensin receptor blockers (ARBs) like losartan, valsartan, and telmisartan (2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Use of single antihypertensive agent was considered as monotherapy while use two or more of antihypertensive agents of different class was defined as combination therapy (34). Hypertensive patients who were taking regular medications for comorbid illness were considered as to have concomitant therapies (35). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Comorbidities were defined as one or more co-occurring clinical conditions in patients with hypertension primarily not attributed by hypertension itself (36). Furthermore, clinical outcomes that can result from a persistently elevated BP and mainly attributed by raised BP (37).\u003c/p\u003e\n\u003cp\u003eTime to BP control was defined as the time duration from the initiation of antihypertensive drug to achieving controlled BP. Median time to BP control, represented a median survival time at which 50% of participants achieved BP control. Patients who did not achieved BP control, lost to follow-up, or whom the study ended before BP get controlled were taken as censored. Treatment intensification was considered when the dose of antihypertensive drug(s) was increased or new antihypertensive drug(s) is added (38). Drug switching was defined as changing antihypertensive drug to another, regardless of its class (39).\u003c/p\u003e\n\u003ch2\u003eData quality control\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;A data collection tool was carefully designed to capture all relevant variables from hypertension cohort registries and individual patient charts, addressing potential data incompleteness. The tool was pretested on 5% of the sample to ensure its clarity, completeness, and consistency. Data collectors were trained for three days on data collection procedures, study objectives, and data confidentiality measures. To enhance data validity, information from patient charts was cross-validated with data from the cohort registers\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Missing data handling\u003c/h2\u003e\n\u003cp\u003eConsidering the challenges in complete documentation of patient records and the feasibility of complete case analysis, we opted to handle missing data through imputation method. While no definitive guidelines exist for determining the cutoff point for excluding missing variables with missing data, a threshold of 10% was adopted based on the data validity concerns and literature recommendations (40⎼42). Variables with missing data exceeding this threshold were removed from the analysis. Finally, missing values were replaced using modal imputation for categorical data and median imputation method for continuous data.\u003c/p\u003e\n\u003ch2\u003eData analysis\u003c/h2\u003e\n\u003cp\u003eData were checked for consistency and completeness, then coded and entered into EpiData Software version 3.1 and analyzed using Stata software version 14.2. Descriptive statistics, including median, range, and interquartile range, were used to summarize continuous data, while proportions/percentages, mode, tables, and figures were used to describe categorical data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Kaplan-Meier survival estimation was used to estimate median survival time, and the life table method was employed to estimate the cumulative survival time. Life table analysis was applied to examine BP treatment outcome at the three, six, 12, 24 and 36 months.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe log-rank test was used to compare survival curves of two or more event experiencing groups. The proportional hazards (PH) assumption was assessed graphically (log-log plot of survival, Kaplan-Meir and predicted survival plot) and using the Schoenfeld residuals test. Cox-Snell residuals plots were used to evaluate overall model fitness.\u003c/p\u003e\n\u003cp\u003eBoth bivariate and multivariate Cox regression models were fitted to identify predictors of time to BP control. Variables with a p-value \u0026lt; 0.25 in the bivariate Cox regression analysis were considered for inclusion in the multivariate Cox regression analysis. Additionally, the study considered a clinical relevance of the variable during the candidate selection. AHRs, 95% CIs, and p \u0026lt; 0.05 were used to assess the strength and direction of associations.\u003c/p\u003e\n\u003ch2\u003eEthical considerations\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;The study was approved by the Institutional Review Board of St. Paul\u0026rsquo;s Hospital Millennium Medical College (SPHMMC), approval reference number PM23/567. Support letters were obtained from SPHMMC and the Afar Public Health Institute. Data confidentiality was actively protected through de-identification, data linkage removal and securing the file storage. As this study was based on the secondary data, the Institutional Review Board of SPHMMC waived the requirement for patient consent process according to the above confidentiality clauses. Finally, patients whom the study identified as censored observations were linked to healthcare providers for enhanced counseling and care.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSocio-demographic and the study characteristics\u003c/p\u003e \u003cp\u003eThe study included a total of 443 hypertensive patients treated between September 7, 2019, and January 8, 2023, of whom 410 (92.6%) met the inclusion criteria. Among the 410 participants, 213 (52%) were females. The median age was 56 years (IQR: 47\u0026ndash;64), and the median duration of follow-up was 10 months, range 3\u0026ndash;38 months. Two hundred thirty-two (56.6%) of participants had achieved BP control. The incidence rate (IR) of BP control was 433 per 1000 person-months observations (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic, and clinical characteristics of hypertensive patents in Afar region, Northeast Ethiopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCovariates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;410\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;39 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBaseline BP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMild hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSevere hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eComorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eTypes of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAsthma and other chronic respiratory diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLiver diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHypertensive complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of hypertensive complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRenal diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOcular diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAlcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1.5 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;1.5 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;100 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;125 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;126 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDrug therapy related characteristics of hypertensive patents in Afar region, Northeast Ethiopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIndicators\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;410\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDrug therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCombination therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMonotherapy (class)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCCBs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiuretics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eACE inhibitors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eCombination therapy (class)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCCBs\u0026thinsp;+\u0026thinsp;diuretics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCCBs\u0026thinsp;+\u0026thinsp;ACE inhibitors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eACE inhibitors\u0026thinsp;+\u0026thinsp;diuretics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCCBs\u0026thinsp;+\u0026thinsp;ARBs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiuretics\u0026thinsp;+\u0026thinsp;ARBs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers dual combinations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTriple combinations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatment intensification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDrug switch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrescription pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnce per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwice and above per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAppointment schedule\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvery two month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThree months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eConcomitant therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStatin therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e311\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFor hypertensive patients whom missing data set less than 10% such as concomitant therapy,\u003c/p\u003e \u003cp\u003estatin therapy, smoking, alcohol use, creatinine and FBS, each unobserved value was substituted with a single value using modal and median imputation method (Additional file 1)\u003c/p\u003e \u003cp\u003eBaseline clinical and laboratory characteristics\u003c/p\u003e \u003cp\u003eBased on baseline BP readings, 245 (59.8%) of patients were classified as having mild form of hypertension. A total of 155 (37.8%) patients had the underlying comorbid clinical conditions. Diabetes mellitus was the most commonly reported comorbidity, affecting 74 (18%) of patients, followed by asthma and other chronic respiratory diseases 37 (9%) and HIV AIDS 26 (6.3%). More than one-third (36.6%) of patients experienced hypertensive complications. Heart diseases 73 (17.8%), stroke 38 (9.3%) and renal diseases 28 (6.3%) were prevalent complications. The median serum creatinine level was 0.99 mg/dL, while the median FBS was 107.5 mg/dL (Table-1).\u003c/p\u003e \u003cp\u003eDrug therapy and related factors\u003c/p\u003e \u003cp\u003eTwo hundred one (49%) of patients were treated with single antihypertensive agents. The most commonly prescribed monotherapies were CCBs 99 (24.1%) followed by diuretics 66 (16.1%) and ACE inhibiters 36 (8.8%). Of patients were treated with combination therapy, commonly prescribed antihypertensive drug combinations were CCBs and diuretics 56 (13.7%); CCBs and ACE inhibitors 53 (12.9%); and ACE inhibitors and diuretics 44 (10.7%). Antihypertensive agents were intensified for nearly half (49.8%) of patients and switched for quarter (25.6%) of patients. Furthermore, nearly one in four (24.1%) of patients were treated with statins while 155 (37.8%) were receiving the concomitant therapies for comorbidity(s) (Table-2).\u003c/p\u003e \u003cp\u003eLife table analysis\u003c/p\u003e \u003cp\u003eThe cumulative survival, explained by the cumulative probability of participants staying without experiencing an event i.e. BP control at the end of follow-up period was 30.5% (95% CI: 0.2419\u0026ndash;0.3701). This explains that 30.5% of hypertensive patients did not achieve BP control at the end follow-up period (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe cumulative probability of uncontrolled BP among hypertensive patients in Afar region, Northeast Ethiopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervals\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBeg. Total\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBP controlled\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSurvival\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e410\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.9976\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.9828⎼0.9997\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e409\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.7061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.6587⎼0.7482\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.5358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.4841⎼0.5847\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.4322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.3799⎼0.4834\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3940\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.3415⎼0.4460\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20 \u0026minus;\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.3172⎼0.4233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u0026ndash;28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.2779⎼0.3909\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28\u0026ndash;32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.2419⎼0.3701\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32\u0026ndash;36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.2419⎼0.3701\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e36\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.3050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.2419⎼0.3701\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eConversely, by modeling Ethiopia\u0026rsquo;s hypertension treatment outcome evaluation standard which offers BP outcome assessment at the three, six, 12, 24 and 36 months, the cumulative probability of BP control at three, six, 12, 24 and 36 months was 0.24%, 22.15%, 48.31%, 64.1% and 69.5%, respectively (data not shown, see additional file 2))\u003c/p\u003e \u003cp\u003eKaplan-Meier survival estimation\u003c/p\u003e \u003cp\u003eThe median time to attain BP control was 13 months (Ŝ (t\u0026thinsp;=\u0026thinsp;13)\u0026thinsp;=\u0026thinsp;0.5, 95% CI: 11\u0026ndash;15). At the end of follow-up, BP control rate was 433 per 1000 person-months observations. This rate indicated that 433 patients were controlling their BP, as if 1000 hypertensive patients have been followed for a month. Patients with higher baseline BP took the longest median time to control their BP (31 months) while younger population within 18\u0026ndash;39 years of age had the shortest median time to achieve BP control (7 months) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMedian time achieve BP control among hypertensive patients in Afar region, Northeast Ethiopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMedian time BP control\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eLog-rank test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e21.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 ⎼12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;39 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6⎼10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e55.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline BP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e19.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e\u0026ne;\u0026ne;\u0026ne;\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e31.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9⎼12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertensive complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e11.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrug therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e34.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombination therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9⎼12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment intensification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.7615\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrug switching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e6.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0126\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrescription pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0413\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 2 times per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppointment schedule\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9⎼13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e13.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.0014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery two months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ne;\u0026ne;\u0026ne;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThree month and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConcomitant therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.5602\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatin therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.7390\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7⎼16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.3003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7⎼20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.2803\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11⎼15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 1.5 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e12.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 1.5 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 100 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9⎼14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e16.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.0002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e100\u0026ndash;125 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10⎼15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 126 mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ne;\u0026ne;\u0026ne;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eKeys\u003c/em\u003e: \u003csup\u003e\u003cem\u003e***\u003c/em\u003e\u003c/sup\u003e\u003cem\u003e50% of observations not achieved BP control\u003c/em\u003e, \u003csup\u003e\u003cem\u003eN/A\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e95% CI not defined\u003c/em\u003e, \u003csup\u003e\u003cem\u003e\u0026ne;\u0026ne;\u0026ne;\u003c/em\u003e\u003c/sup\u003e \u003cem\u003eeither lower or upper bound of 95% CI not defined\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eKaplan\u0026ndash;Meier survival curves\u003c/p\u003e \u003cp\u003eThe Kaplan\u0026ndash;Meier survival curves were used for comparing the event-experiencing times of two or more groups for each covariate included in the model. Accordingly, the overall Kaplan\u0026ndash;Meier survival curve illustrates that the probability of event-free observations decreases over time. At Ŝ (t\u0026thinsp;=\u0026thinsp;13), 50% of observations survived did not experience an event⎼ BP control. The probability of uncontrolled BP control at the end of follow-up was 30.5% (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Females experienced quicker BP control than males (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Patients with higher baseline BP experienced delayed BP control (median time to BP control of 11 months) than those with mild hypertension whose median time to BP control was 31 months (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Furthermore, patients with creatinine\u0026thinsp;\u0026lt;\u0026thinsp;1.5 mg/dL achieved sooner BP control when compared to those with creatinine\u0026thinsp;\u0026ge;\u0026thinsp;1.5 mg/dL (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLog rank test- comparison of Kaplan-Meir survival curves\u003c/p\u003e \u003cp\u003eTo avoid the subjectivity nature of relying on graphical comparison Kaplan\u0026ndash;Meier survival curves, we employed the log-rank test, the statistical comparison of event-experiencing times of two or more groups. Based on log-rank test, there were no a statistically significant differences in event-experiencing times of groups based on residency, treatment intensification, pill burden, concomitant therapy, statin therapy, cigarette smoking, and alcohol use (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePredictors of time to BP control\u003c/p\u003e \u003cp\u003eAfter controlling for the potential effects of confounding, patients older than 60 years had a 62.2% lower hazard of BP control compared to 18\u0026ndash;39 years of age (AHR\u0026thinsp;=\u0026thinsp;0.378, 95% CI: 0.236⎼0.605). The hazard of BP control in patients with stage severe hypertension was 37.4% lower than those with mild hypertension (AHR\u0026thinsp;=\u0026thinsp;0.626, 95% CI: 0.467\u0026ndash;0.839). Patients having no the underlying comorbidities had a 1.86 times higher hazard of BP control compared to patients with comorbidities (AHR: 1.86, 95% CI 1.276\u0026ndash;2.679). Hypertensive patients treated with combination therapy had 1.7 times the increased hazards of BP control compared to those on monotherapy (AHR\u0026thinsp;=\u0026thinsp;1.664, 95% CI: 1.213⎼2.283) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePredictors of time to BP control among hypertensive patients in Afar region, Northeast Ethiopia\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eBivariate Cox regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMultivariate Cox regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCHR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAHR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.316 ( 0.984⎼1.761)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;39 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.580\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.680 (0.459⎼1.006)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.378 (0.236 ⎼ 0.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.847\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.797 (0.60⎼1.048)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline BP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild HTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSever HTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.626 (0.467⎼0.839)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.849 (1.276 ⎼2.679)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertensive complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.942 (0.659⎼1.345)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.742\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrug therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombination therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.664 (1.213⎼2.283)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment intensification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.149 (0.868⎼1.520)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.331\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrug switching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.710\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.871 (0.647 ⎼1.173)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.363\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrescription pattern\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce/day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e+ twice/day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.090 (0.785⎼ 1.515)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.606\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppointment schedule\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery two month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.735 (0.521⎼1.036)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery three month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.777 (0.542⎼1.112)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatin therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.75*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.15 (0.837⎼1.593)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.381\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine (in mg/dL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.371 (0.17⎼ 0.799)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS (in mg/dL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e100\u0026ndash;125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.989 (0.752⎼1.303)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.941\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.335 (0.152⎼0.738)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*clinically relevant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eProportional Hazard (PH) Assumption\u003c/p\u003e \u003cp\u003eLog-log plot of survival\u003c/p\u003e \u003cp\u003eThe log-log plot of survival curves were checked for each covariate included in the model to assess on whether survival curves assumed the parallel pattern and satisfied the PH assumption. Accordingly, the log-log plot for gender did not cross each other, assuming the PH assumption (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Likewise, the log-log plot of survival for residency showed that plots were parallel and did not cross each other fulfilling the PH assumption (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eKaplan-Meier and predicted survival plot\u003c/p\u003e \u003cp\u003eThe Kaplan-Meier and predicted survival plots were checked to assess on whether the plots are closely aligned each other and the PH assumption was satisfied or not. For instance, the Kaplan-Meier and predicted survival plots were closely aligned to each other for drug therapy (mono vs combination) satisfying the assumption that PH holds (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e). Similarly, the Kaplan-Meier and predicted survival plots assumed this pattern indicates that that PH assumption is valid and the model adequately captures a variable drug switching (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSchoenfeld residual plot\u003c/p\u003e \u003cp\u003eThe Schoenfeld residual plots were checked to assess on whether plots for a covariate showed a straight line and PH assumption was met for each covariate included in the model. Accordingly, Schoenfeld residual plots for treatment intensification (Fig.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e10\u003c/span\u003e) and drug switching exhibited a straight line with a symmetric pattern around zero, indicating that the PH assumption is satisfied for these covariates (Fig.\u0026nbsp;\u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSchoenfeld field statistical test\u003c/p\u003e \u003cp\u003eStatistically, none of the covariates included in the model were statistically significant at the 5% level, assuming that the covariates are not time-dependent and the PH assumption was satisfied, global test, p-value\u0026thinsp;=\u0026thinsp;0.3791 (Data not shown, see additional file 3)\u003c/p\u003e \u003cp\u003eAssessing the overall model fitness\u003c/p\u003e \u003cp\u003eThe Cox-Snell residual plot was used to assess the overall fitness of the survival model. The plot showed that hazard function closely follows 45-degree aligning with the expected exponential distribution. This indicated that the overall model is fit and adequately captures the underlying survival patterns in the hypertension data set, providing evidence for the reliability and validity of survival analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to estimate the time required to achieve BP control and identify its predictors among hypertensive patients treated at five public hospitals in the Afar region of Ethiopia. The median time required to achieve BP control was 13 months. Combination therapy and absence of comorbidities were associated with prompt BP control while advanced age, higher baseline BP, elevated creatinine and FBS levels delayed BP control.\u003c/p\u003e \u003cp\u003eThe median time to achieve BP control was found to be 13 months, which significantly exceeds the 1\u0026ndash;3 months recommendations from the clinical trials (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). This finding may highlight the systemic barriers within Ethiopian healthcare, such as limited access to medications, inadequate follow-up and potential patient adherence issues. However, it is shorter than that time to BP control reported in a study conducted at Felege-Hiwot Specialized Hospital, Bahir Dar, Ethiopia (48 months) (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This discrepancy might be attributed to differences in follow-up duration and patient characteristics. The study in Felege-Hiwot Specialized Hospital employed a longer follow-up period compared to the present study (60 vs 40 months), allowing an extended time for assessment of BP control instead of declaring censored observations. Additionally, hypertensive patients in Felege-Hiwot Specialized Hospital exhibited higher baseline creatinine (0.99 mg/dL vs. 1.1 mg/dL) and FBS (107.5 mg/dL vs. 114.5 mg/dL) levels than in this study (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), both of which are known to negatively impact BP control (42⎼45). Conversely, the median time to BP control in the present study was longer than that reported in studies from Barcelona, Spain (49 days) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), Malaysia (7.2 months) (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), and the USA (3.25 months) (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). These disparities may be attributed to differences in follow-up duration, socio-demographic and behavioral characteristics of the study population.\u003c/p\u003e \u003cp\u003eThe present study indicates that older patients (\u0026ge;\u0026thinsp;60 years of age) had a 62.2% lower hazard of achieving BP control compared to younger patients (18\u0026ndash;39 years). This is supported with existing studies conducted at Felege-Hiwot Specialized Hospital (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) and France (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e) which suggests that aging is often associated with delayed BP control. This may be explained by the fact that elderly patients have the increased risk of the underlying comorbidities and physiological changes that complicate BP management (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Factors such as reduced medication adherence, poly pharmacy, and lifestyle changes unique to older patients may contribute to these delays in achieving BP control (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e)\u003c/p\u003e \u003cp\u003ePatients with severe hypertension demonstrated a 37.5% lower hazard of BP control compared to those with mild hypertension. This finding is consistent with studies in Australia (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) and USA (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e) which indicated that higher hypertension stages correlate with the delayed BP control complicating hypertension management. This correlation could be explained by the suboptimal therapy and the fact that patients with severe hypertension may present with more severe forms of the disease, including target organ damage often making it difficult to achieve timely BP control (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Moreover, the finding emphasizes the need for proactive management strategies for patients presenting with more advanced stages of hypertension to expedite timely BP control.\u003c/p\u003e \u003cp\u003ePatients without underlying comorbidities had a 1.9 times higher hazard of achieving BP control compared to those with comorbidities. This finding aligns with a study conducted in the USA, which reported a 35.2% lower likelihood of achieving BP treatment goals among patients with comorbid clinical conditions (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). This could be explained by the fact that comorbidities often share overlapping pathophysiology and share common risk factors, synergistically increasing the risk of end-organ damage, and competing demands on self-management behaviors collectively could delay time to BP control (\u003cspan additionalcitationids=\"CR53\" citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHypertensive patients treated with combination anti-hypertensive therapy were 1.7 times more likely to achieve a shorter time to BP control compared to those on monotherapy. Similarly, a Malaysian study reported a 3.5 times higher hazard of BP control among patients receiving combination therapy (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Certain guidelines such as American College of Cardiology (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e), the Joint National Committee-8 (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e), and the International Society of Hypertension (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), as well as clinical trials (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) support the use of combination therapy, especially in patients with severe form of hypertension and those with underlying comorbid conditions to expedite prompt BP control. This could be explained by the fact that antihypertensive agents of different class can target different causal and pathophysiological mechanisms of hypertension, synergistically lowering BP levels and counteracting the side effect induced one by another.\u003c/p\u003e \u003cp\u003eThe hazard of BP control was 66.5% lower in patients with FBS\u0026thinsp;\u0026gt;\u0026thinsp;126 mg/dL compared to those with FBS\u0026thinsp;\u0026lt;\u0026thinsp;100 mg/dL. This could be explained by the fact that elevated blood sugar levels can damage blood vessels and kidneys, increasing vascular resistance and decreasing sodium and water reabsorption, leading to elevated BP levels (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e). However, in contrast to this finding, a study conducted in Felege-Hiwot Specialized Hospital reported the increased hazard of BP control for every unit increase in FBS level (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHypertensive patients with creatinine level\u0026thinsp;\u0026ge;\u0026thinsp;1.5 mg/dL had a 62.9% lower hazard of BP control compared to those with creatinine\u0026thinsp;\u0026lt;\u0026thinsp;1.5 mg/dL. This could be explained by the fact that impaired kidney function, characterized by decreased water and salt excretion and reduced production of BP-regulating hormones, can contribute to delayed time to BP control. However, the finding is in contrast with a study conducted at Felege Specialized Hiwot Hospital, Bahr Dar which reported a 13.2% increased hazard of BP control for hypertensive patients having serum creatinine levels\u0026thinsp;\u0026ge;\u0026thinsp;1.5 mg/dL (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLimitations of the study\u003c/p\u003e \u003cp\u003eAlthough, this study explored various potential factors affecting time to BP control, it has the following limitations. First, the use of secondary data restricted the exploration of various socio-demographic and economic factors that could influence BP control. Second, the use of simple imputation methods for handling missing data raises some concerns regarding the validity of the findings, as imputed values may not accurately reflect the true data distributions. Additionally, the interpretation of the study findings is limited to a few literatures due to the scarcity of comparable time-to-event (BP control) studies.\u003c/p\u003e \u003cp\u003eAreas for future research\u003c/p\u003e \u003cp\u003eAs the reliance on secondary data restricts in-depth understanding of various socio-demographic and economic factors potentially affecting time to BP control including income level, education, employment status, and access to healthcare, there is need for future prospective studies focused on collecting primary data directly from patients. Given limitations of simple imputation method, future studies should target to more advanced missing data handling techniques such as multiple imputations to enhance the reliability and validity of the findings. Additionally, there is need for future researches targeted to the assessment of medication adherence and healthy lifestyle issues specifically to older adults and patients with underlying comorbidities.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study found that the median time to achieve BP control was 13 months, which is longer than recommendations from clinical trials and most of the prior time to BP control estimates. Patients receiving combination therapy and those without comorbidities were more likely to experience faster time to BP control. These findings underscore the importance of combination therapy and effective management of comorbidities in achieving prompt BP control. Conversely, older age, advanced stages of hypertension, impaired kidney function, and elevated blood sugar levels were associated with delayed time to BP control. These findings highlight the importance of targeted interventions that can facilitate timely BP control among older populations and those with the underlying comorbidities. This could include patient education programs, enhanced adherence counseling, regular end-organ evaluation, and optimal glycemic control in patients with diabetes mellitus.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eACE: Angiotensin Converting Enzyme; AHRs: Adjusted Hazard Ratios; ARBs: Angiotensin receptor blockers; BP: Blood pressure; CCBs: calcium channel blockers; CHRs: Crude Hazard Ratios; CI: Confidence intervals; CVD: cardiovascular diseases; DBP: Diastolic blood pressure; IR: Incidence rate; SBP: systolic blood pressure; WHO: World health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthical considerations and consent to participate\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study was approved by the Institutional Review Board of St. Paul\u0026rsquo;s Hospital Millennium Medical College (SPHMMC), approval reference number PM23/567. Support letters were obtained from SPHMMC and the Afar Public Health Institute. Data confidentiality was actively protected through de-identification, data linkage removal and securing the file storage. As this study was based on the secondary data, the Institutional Review Board of SPHMMC waived the requirement for patient consent process according to the above confidentiality clauses. Finally, patients whom the study identified as censored observations were linked to healthcare providers for enhanced counseling and care.\u003c/p\u003e\n\u003cp\u003eConsent for publication/ permission to reproduce material from other sources\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe data sets and/or analyzed during the current study are available from the corresponding author upon the reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no financial and non-financial competing interests to this article\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eAll authors did not received the specific funding to this article\u003c/p\u003e\n\u003cp\u003eDisclaimer\u003c/p\u003e\n\u003cp\u003eAll the claims expressed in this article and its contents are solely the responsibility of the authors and do not necessarily represent the official views of affiliated institutions.\u003c/p\u003e\n\u003cp\u003eAcknowledgments\u003c/p\u003e\n\u003cp\u003eThe authors\u0026nbsp;would like to express sincere gratitude to the following individuals and institutions: SPHMMC, School of Public Health, Department of Epidemiology for providing all the essential \u0026nbsp;supports to conduct this study; Afar Public Health Institute for granting permission to conduct the research; and data collectors and supervisors for their diligent efforts in overseeing the data collection process.\u003c/p\u003e\n\u003cp\u003eAuthor contributions\u003c/p\u003e\n\u003cp\u003eAbiyie Demelash conceived the research idea, designed methodology, conducted the study, analyzed the data, and drafted the manuscript. FA made substantial contributions to the study design and drafting the article. KA contributed to data analysis and interpretation, and critically revised the manuscript for intellectual content. DZ designed research methodology, conducted data analysis and interpretation, and drafted manuscript. TE designed methodology, conducted data analysis and interpretation, and drafted article. AY designed methodology, conducted data analysis and interpretation, and drafted manuscript. All authors have read and approved the final manuscript to be published.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. Journal of the American College of Cardiology. 2019 Nov 19;74(20):2529-32\u003c/li\u003e\n\u003cli\u003eLoscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL et al. 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Canadian Journal of Cardiology. 2018 May 1;34(5):575-84.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hypertension, BP control, Time to BP control, Prompt BP control, Delayed BP control, predictors of time to BP control, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-5643741/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5643741/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe timeframe from antihypertensive medication initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. In Ethiopia, while studies have explored BP control rates, data on the time required to achieve control are limited. This study aimed to estimate time to BP control and identify predictors in Afar region of Ethiopia.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethod\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA facility-based retrospective cohort study was conducted among adult hypertensive patients aged 18 years and older in five public hospitals between September 7, 2019 and January 8, 2023. Data were collected using a structured questionnaire, entered into EpiData version 3.1, and analyzed using Stata version 14.2. Kaplan-Meier survival analysis was used to estimate time to BP control. Cox regression analysis was applied to identify predictors of time to BP control. The adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were computed at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003cp\u003e\u003cb\u003eResult\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA total of 443 hypertensive individuals were retrospectively followed, of which, 410 (92.6%) met the inclusion criteria. The median duration of follow-up was 10 month. The median age of the participants was 56 year. The median time to achieve BP control was 13 months (95% CI: 11⎼15). Factors associated with quicker BP control included combination therapy (AHR\u0026thinsp;=\u0026thinsp;1.849, 95% CI: 1.276\u0026ndash;2.679) and the absence of comorbidities (AHR\u0026thinsp;=\u0026thinsp;1.86, 95% CI: 1.276\u0026ndash;2.679). In contrast, factors leading to delayed BP control included age\u0026thinsp;\u0026ge;\u0026thinsp;60 years (AHR\u0026thinsp;=\u0026thinsp;0.378, 95% CI: 0.236\u0026ndash;0.605), severe hypertension (AHR\u0026thinsp;=\u0026thinsp;0.626, 95% CI: 0.467\u0026ndash;0.839), creatinine\u0026thinsp;\u0026ge;\u0026thinsp;1.5 mg/dL (AHR\u0026thinsp;=\u0026thinsp;0.371, 95% CI: 0.173\u0026ndash;0.799), and fasting blood sugar (FBS)\u0026thinsp;\u0026ge;\u0026thinsp;126 mg/dL; AHR\u0026thinsp;=\u0026thinsp;0.335, 95% CI: 0.152\u0026ndash;0.738).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe median time to BP control in this study exceeds recommendations from clinical trials and prior estimates. Combination therapy and the absence of comorbidities significantly reduce time to BP control, while advanced age, higher baseline BP, and elevated creatinine and FBS levels are linked to delayed BP control. Our findings highlight the necessity for enhanced counseling, management of comorbidities, regular end-organ evaluation, and use of combination therapies to expedite timely BP control.\u003c/p\u003e","manuscriptTitle":"Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-24 17:09:16","doi":"10.21203/rs.3.rs-5643741/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4b9c92b-dee1-48ea-b3bf-f1c0d5da363c","owner":[],"postedDate":"December 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-14T09:24:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-24 17:09:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5643741","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5643741","identity":"rs-5643741","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}