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Pre-hypertension in Uganda: a cross-sectional study
Fred Nuwaha1, Geofrey Musinguzi
1Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P,O, Box 7072, Kampala, Uganda. nuwahaf@yahoo.co.uk.
Insights
Over one-third of Ugandan adults have pre-hypertension, a condition linked to cardiovascular disease risk. Key risk factors include age, male sex, smoking, alcohol, and obesity, highlighting the need for public health interventions.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Pre-hypertension, defined as systolic blood pressure (BP) of 120 to <140 mmHg or diastolic BP of 80 to <90 mmHg, is linked to increased cardiovascular disease (CVD) risk.
- Understanding pre-hypertension determinants is crucial for prevention and control, especially in low-income countries.
Purpose of the Study:
- To estimate the prevalence of pre-hypertension in an adult Ugandan population.
- To identify risk factors associated with pre-hypertension and hypertension in this population.
Main Methods:
- A cross-sectional community survey analyzed data from 4142 adults (≥18 years) in Uganda.
- Blood pressure was measured, and risk factors including smoking, alcohol use, weight status, physical activity, sex, age, marital status, residence, and diet were assessed.
- Bivariate and multivariable logistic regression models were used to compare groups with normotension, pre-hypertension, and hypertension.
Main Results:
- The age-standardized prevalence was: normal BP 37.6%, pre-hypertension 33.9%, and hypertension 28.5%. Raised blood pressure affected 62% of the population.
- Pre-hypertension was more prevalent in men (41.6%) than women (29.4%).
- Risk factors for pre-hypertension included age ≥40 years, smoking, alcohol consumption, not being married, male sex, and overweight/obesity. Hypertension risk increased with age, inactivity, urban residence, and overweight/obesity.
Conclusions:
- More than one in three adults in the surveyed Ugandan population exhibited pre-hypertension.
- The findings underscore the urgent need for preventive and public health strategies to mitigate the prevalence of raised blood pressure.
Background:
Persons with a systolic blood pressure (BP) of 120 to < 140 or diastolic BP of 80 to < 90 mm hg are classified as having pre-hypertension. Pre-hypertension is associated with cardiovascular disease (CVD) risk factors, incident CVD and CVD mortality. Understanding determinants of pre-hypertension especially in low income countries is a pre-requisite for improved prevention and control.
Methods:
Data were analyzed for 4142 persons aged 18 years and older with BP measured in a community cross sectional survey in Uganda. The prevalence of pre-hypertension was estimated and a number of risk factors e.g. smoking, use of alcohol, overweight, obesity, physical activity, sex, age, marital status, place of residence, and consumption of vegetables and fruits were compared among different groups (normotension, pre-hypertension, and hypertension) using bivariate and multivariable logistic regression.
Results:
The age standardized prevalence of normal blood pressure was 37.6%, pre-hypertension 33.9%, hypertension 28.5% and raised blood pressure 62%. There was no difference between the prevalence of hypertension among women compared to men (28.9% versus 27.9%). However, the prevalence of pre-hypertension was higher among men (41.6%) compared to women (29.4%). Compared to people with normal blood pressure, the risk of pre-hypertension was increased by being 40 years and above, smoking, consumption of alcohol, not being married, being male and being overweight or obese. Compared to pre-hypertension, hypertension was more likely if one was more than 40 years, had infrequent or no physical activity, resided in an urban area, and was obese or overweight.
Conclusions:
More than one in three of adults in this population had pre-hypertension. Preventive and public health interventions that reduce the prevalence of raised blood pressure need to be implemented.
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