Predictors of time to blood pressure control among hypertensive patients in pastoral communities of the Afar region, Northeastern Ethiopia

The timeframe from drug initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. While numerous studies have explored BP control rates, data on the time to BP control are limited. This study aimed to estimate time to BP control and identify its predictors in the Afar region of Ethiopia. A facility-based retrospective cohort study was conducted among at five public hospitals. Data were collected using a structured questionnaire from cohort registers and patient charts and analyzed using Stata version 14.2. Kaplan–Meier survival analysis was used to estimate the time to BP control. Cox regression analysis was performed to identify predictors of time to BP control. The median age of the participants was 56 years (interquartile range: 47–64 years).The median time to BP control was 13 months (95% CI: 11–15). Factors associated with faster BP control included the use of combination therapy (AHR = 1.85, 95% CI: 1.28–2.68) and the absence of comorbidities (AHR = 1.86, 95% CI: 1.28–2.68). In contrast, factors associated with delayed BP control were age ≥ 60 years (AHR = 0.38, 95% CI: 0.24–0.61), severe hypertension (AHR = 0.63, 95% CI: 0.47–0.84), serum creatinine ≥1.5 mg/dL (AHR = 0.37, 95% CI: 0.17–0.8), and fasting blood sugar (FBS) ≥126 mg/dL (AHR = 0.34, 95% CI: 0.15–0.74). The median time to BP control in the present study exceeded the indications from clinical trials and previous estimates. Combination therapy and the absence of comorbidities were associated with a shorter time to BP control, whereas older age, higher baseline BP levels, and elevated creatinine and FBS levels were associated with delayed BP control. These findings highlight the need for enhanced patient education and counseling, comprehensive management of comorbidities, regular end-organ evaluation, and the use of combination therapies to achieve timely BP control.