Uncontrolled hypertension among black Africans in the city of Brussels: a case-control study.

AIM The aim of this study is to identify determinants that are associated with uncontrolled hypertension among black Africans in the city of Brussels. DESIGN A not-matched case-control study. METHODS Seventy-five black Africans were assigned to a case group with uncontrolled hypertension and a control group with controlled hypertension. Demographic characteristics, lifestyle and compliance were recorded as well as their blood pressure. Compliance in patients was evaluated by means of the Morisky Medication Adherence Scale-4 (MMAS-4). RESULTS The mean age of the case group was 52 years (SD 7.8) and for the control group 49 years (SD 6.2). Almost 60% were women. Uncontrolled hypertension was associated with obesity (p = 0.01) and sedentary lifestyle (p = 0.034). About 50% of women were obese and 70% of these had uncontrolled hypertension. Patients with type 2 diabetes had a 4.5 times higher risk for uncontrolled hypertension and lower compliance to the medication regimen compared to non-diabetics. Patients were often treated with diuretics (29%), renin-angiotensin inhibitors (25%), and calcium-channel inhibitors (23%). According to the MMAS4-score uncontrolled patients had an intermediate compliance and the controlled patients had a high compliance. CONCLUSIONS Black obese women and diabetics had the highest risk for uncontrolled hypertension. Compliance was significantly lower among uncontrolled patients.