Prevalence and Risk Factors of Hypertension in Hargeisa, Somaliland: A Hospital-Based Cross-Sectional Study

Abstract

Hypertension is the leading risk factor for cardiovascular diseases and represents a major public health challenge worldwide. There is a paucity of information regarding the hypertension status of adults in Somaliland. We aimed to assess the magnitude of, and factors associated with, hypertension among adult patients seeking care at Hargeisa group hospital in Hargeisa city, Somaliland. We conducted a health facility-based cross-sectional study enrolling adult outpatients. We used the World Health Organization (WHO) STEPwise surveillance approach to obtain patient information. A total of 319 participants (54.2% males; mean age 40.4 ± 14.0 years) had complete data records. The prevalence of hypertension was 22.6% (95% confidence interval; 18.2-27.6%). The prevalence of hypertension increased with age and was higher in males (24.9%) than in females (19.9%). Age, cholesterolaemia and obesity were significantly associated with hypertension. Separate analyses for females and males revealed that obesity was significantly associated with hypertension in females but not in males. On the contrary, cholesterolaemia was significantly associated with hypertension in males but not in females. We found a high prevalence of hypertension and multiple risk factors for non-communicable diseases (NCDs) in outpatients seeking care in Hargeisa. Our findings emphasise the need for enhanced focus on the prevention and management of NCDs in Somaliland.

Keywords: Somaliland; cardiovascular diseases; cross-sectional study; hypertension; non-communicable diseases; prevalence; risk factors.

Figure 1

Study population flow diagram, Hargeisa, Somaliland, 2022.

Figure 2

Prevalence of hypertension according to age group and sex in Somaliland, 2022. Hypertension was defined as being told by a doctor or other health professional that the patient has hypertension or being on antihypertensive medications or having a measured systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg.

Figure 3

Blood pressure levels according to ISH classification across age groups, stratified by sex in Somaliland, 2022. Dash lines represent females while solid lines represent males. Red colour indicates grade 1 hypertension (SBP = 140–159 or DBP = 90–99), black colour indicates grade 2 hypertension (SBP ≥ 160 or DBP ≥ 100), violet colour indicates high normal blood pressure (SBP = 130–139 or DBP = 85–89) and blue colour indicates normal (optimal) blood pressure (SBP < 130 or DBP < 85).