Abstract:
Uncontrolled hypertension is a significant public health problem both in 
developed and developing countries. Nearly one billion individuals are living with uncontrolled 
hypertension globally. In Sub-Saharan Africa, 77.4% of adult hypertension patients had 
uncontrolled hypertension. Several studies were conducted in Ethiopia, to the best of our 
literature review, there was no study conducted in the study area. Also, the previous studies did 
not assess the role of anxiety, depression, and social support in uncontrolled hypertension. 
Objective: To assess the magnitude of uncontrolled hypertension and associated factors among 
adult hypertensive patients on follow-up at public Hospitals in Harar region and Dire Dawa 
administration, Eastern Ethiopia, from June 15 to July 15, 2021.
Methods: A Hospital based cross-sectional study was conducted among 415 selected by 
systematic random sampling hypertensive patients. Data were collected through face-to-face 
interviews using a structured questionnaire and reviewing patients’ charts. The data were entered 
into Epi Data version 3.1 and exported into Statistical Package for the Social Science version 
20 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regression 
analysis were performed. All covariates with p-value ≤ 0.25 in bivariable binary logistic 
regression analysis were entered into multivariable analysis to control the confounding. 
Variables with p-value < 0.05 were considered statistically significant.
Result: This study revealed uncontrolled hypertension among hypertensive patients was 199 
(48 %) (95% CI, 43.1–52.8%). Being male (AOR= 2.05, 95% CI: 1.29-3.26), age ≥ 55 years 
(AOR=3.16, 95% CI: 1.96-5.08), non-adherence to anti-hypertensive medication (AOR= 1.83, 
95% CI: 1.14-2.94), non-adherence to low-salt diet (AOR= 2.94, 95% CI: 1.74-4.94), non adherence to physical activity (AOR=3.20, 95% CI: 1.84-5.56), having co-morbidity (AOR= 
3.04, 95% CI: 1.90-4.85) were significantly associated with uncontrolled hypertension.
Conclusion: Half of hypertensive patients had uncontrolled hypertension. Older age, male sex, 
non-adherence to antihypertensive medication, non-adherence to low salt diet, non-adherence 
to physical exercise, and having comorbidity were significantly associated with uncontrolled 
hypertension. The stringent strategy that enhances self-care practice need to be in place