Hypertension remains poorly controlled in Palestine. Improvement of its management will require
an understanding of the patient characteristics and treatment factors associated with uncontrolled
hypertension. A cross-sectional analysis using data from prevalence of hypertension study
in West Bank (N=2077) using two-stage stratified sampling method. We studied antihypertensive
medication use, comorbidity, and blood pressure measurements for 573 hypertensive patients in 3
different primary care settings across Palestine. We concomitantly conducted comprehensive patient
interviews covering demographic and clinical factors. Mean age of the patients was 57.5 ± SD
9.7 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were
149±12 mm Hg and 91.2±9 mm Hg (respectively). Only 33.2% (190/573) of patients had mean
blood pressure < 140/90 mm Hg during the study period. Those who are "uncontrolled" had high
systolic blood pressure rather than diastolic pressure (59 vs 41%; P<0.01). 60% of uncontrolled
hypertension found to be non-adherent to their drug regimen, 28% experience adverse effects and
56% were found to be on monotherapy. There was no statistically significant in difference in sex
distribution, marital status and educational level between controlled and uncontrolled hypertension.
Multivariate analysis revealed several independent predictors of poor hypertension control; being
on monotherapy regimen [OR=2.14, 95% CI 1.51-2.59], being obese BMI >25 [OR=1.80, 95% CI
1.44-2.46], being non adherence to antihypertensive drugs [OR=2.67, 95% CI 2.34-3.11] and older
age > 65 [OR=2.12, 95% CI1.78-2.86]. Hypertension remains poorly controlled in clinical Practice
in West Bank. Physicians should aggressively treat elevated systolic BP. A number of factors contribute
to poor control of hypertension including Non-adherence to drug regimens, frustration with
treatment and obesity. Further identification of patients at risk of poor control can lead to targeted
interventions to improve management.