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. 2015 Dec 5:15:1211.
doi: 10.1186/s12889-015-2546-z.

The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study

David Guwatudde  1 , Joan Nankya-Mutyoba  2 , Robert Kalyesubula  3 , Carien Laurence  4 , Clement Adebamowo  5   6 , IkeOluwapo Ajayi  7   8 , Francis Bajunirwe  9 , Marina Njelekela  10 , Faraja S Chiwanga  11 , Todd Reid  12 , Jimmy Volmink  13   14 , Hans-Olov Adami  15   16 , Michelle D Holmes  17   18 , Shona Dalal  19
Affiliations

The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study

David Guwatudde et al. BMC Public Health. .

Abstract

Background: Hypertension, the leading single cause of morbidity and mortality worldwide, is a growing public health problem in sub-Saharan Africa (SSA). Few studies have estimated and compared the burden of hypertension across different SSA populations. We conducted a cross-sectional analysis of blood pressure data collected through a cohort study in four SSA countries, to estimate the prevalence of pre-hypertension, the prevalence of hypertension, and to identify the factors associated with hypertension.

Methods: Participants were from five different population groups defined by occupation and degree of urbanization, including rural and peri-urban residents in Uganda, school teachers in South Africa and Tanzania, and nurses in Nigeria. We used a standardized questionnaire to collect data on demographic and behavioral characteristics, injuries, and history of diagnoses of chronic diseases and mental health. We also made physical measurements (weight, height and blood pressure), as well as biochemical measurements; which followed standardized protocols across the country sites. Modified Poison regression modelling was used to estimate prevalence ratios (PR) as measures of association between potential risk factors and hypertension.

Results: The overall age-standardized prevalence of hypertension among the 1216 participants was 25.9%. Prevalence was highest among nurses with an age-standardized prevalence (ASP) of 25.8%, followed by school teachers (ASP = 23.2%), peri-urban residents (ASP = 20.5%) and lowest among rural residents (ASP = 8.7%). Only 50.0% of participants with hypertension were aware of their raised blood pressure. The overall age-standardized prevalence of pre-hypertension was 21.0%. Factors found to be associated with hypertension were: population group, older age, higher body mass index, higher fasting plasma glucose level, lower level of education, and tobacco use.

Conclusions: The prevalence of hypertension and pre-hypertension are high, and differ by population group defined by occupation and degree of urbanization. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

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Figures

Fig. 1
Fig. 1
Percentage of participants with hypertension who are aware of their high blood pressure
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References

    1. Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet. 2015;386:801–12. doi: 10.1016/S0140-6736(14)61468-9. - DOI - PubMed
    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60. doi: 10.1016/S0140-6736(12)61766-8. - DOI - PMC - PubMed
    1. Hendriks ME, Wit FWNM, Roos MTL, Brewster LM, Akande TM, de Beer IH, et al. Hypertension in sub-Saharan Africa: cross-sectional surveys in four rural and urban communities. PLoS One. 2012;7:e32638. doi: 10.1371/journal.pone.0032638. - DOI - PMC - PubMed
    1. Ataklte F, Erqou S, Kaptoge S, Taye B, Echouffo-Tcheugui JB, Kengne AP. Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension. 2015;65:291–8. doi: 10.1161/HYPERTENSIONAHA.114.04394. - DOI - PubMed
    1. Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013;15:134–6. doi: 10.1007/s11906-013-0340-9. - DOI - PMC - PubMed

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