Determinants of Hypertensive Crisis among Patients at Adult Emergency Department of Selected Public Hospitals in Jigjiga City, Somali Region, Eastern Ethiopia, 2022: A Case-Control Study

Abstract

Background: Hypertension is a critical health issue that has the potential to cause considerable morbidity and mortality across the world. It has an estimated global population of 1.13 billion people. Hypertensive crises affect 1-2% of the population. In low-income nations like Ethiopia, hypertensive crisis is becoming a major health concern. However, limited studies have been conducted in Ethiopia. Objective: To assess determinants of hypertensive crisis among patients at the adult emergency department of selected public hospitals in Jigjiga city, Somali region, eastern Ethiopia. Methods: A hospital-based unmatched case-control study was conducted among 88 cases and 177 controls at the adult emergency department of selected public hospitals in Jigjiga city, from May 20 to July 5, 2022. Patients presented with hypertensive crisis were considered cases, and hypertensive patients, but without hypertensive crisis, were considered controls. Data were collected by trained nurses using a structured questionnaire and entered into Epi Data version 3.1 and exported into SPSS version 27 for analysis. Descriptive statistics were done and presented using text, frequency tables, charts, and graphs. Binary logistic regression was used, and variables with a p-value less than 0.05 were eligible for the final model. A multivariable logistic regression was also performed. Finally, a statistically significant level was declared at a p-value of less than 0.05. Result: The proportion of participants presented with a family history of hypertension was higher among cases than controls (62.5% and 47.5%) respectively and the likelihood ratio of hypertensive crisis was 3.3 times (AOR=3.359: 95% CI 1.298, 8.694) higher among participants with a family history of HTN compared to those without a family history of HTN. Conclusion: This study demonstrated a statistically strong association of DM, family history of HTN, regular follow-up and participants’ knowledge of HTN with HTN crisis. The government, health facilities, and health care workers should educate the public that regular follow-up can prevent hypertensive crisis, and give training to build communities’ knowledge on hypertension and give attention to DM Patients with hypertension.