The epidemiology of hypertension in Uganda: Findings from the national non-communicable diseases risk factor survey

David Guwatudde, Gerald Mutungi, Ronald Wesonga, Richard Kajjura, Hafisa Kasule, James Muwonge, Vincent Ssenono, Silver K. Bahendeka

Research output: Contribution to journalArticle

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Abstract

Background. Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda's nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods. The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization's STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results. Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25-1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29-1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02-1.03] per yearly increase in age. Conclusions. The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertensionrelated cardiovascular NCDs.

Original languageEnglish
Article numbere0138991
JournalPLoS One
Volume10
Issue number9
DOIs
Publication statusPublished - Sep 25 2015

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noninfectious diseases
Epidemiology
Uganda
hypertension
epidemiology
Blood pressure
risk factors
Hypertension
Poisons
Public health
Medical problems
body mass index
Body Mass Index
urban areas
Health
Surveys and Questionnaires
rural areas
Prehypertension
Benchmarking
Africa South of the Sahara

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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The epidemiology of hypertension in Uganda : Findings from the national non-communicable diseases risk factor survey. / Guwatudde, David; Mutungi, Gerald; Wesonga, Ronald; Kajjura, Richard; Kasule, Hafisa; Muwonge, James; Ssenono, Vincent; Bahendeka, Silver K.

In: PLoS One, Vol. 10, No. 9, e0138991, 25.09.2015.

Research output: Contribution to journalArticle

Guwatudde, D, Mutungi, G, Wesonga, R, Kajjura, R, Kasule, H, Muwonge, J, Ssenono, V & Bahendeka, SK 2015, 'The epidemiology of hypertension in Uganda: Findings from the national non-communicable diseases risk factor survey', PLoS One, vol. 10, no. 9, e0138991. https://doi.org/10.1371/journal.pone.0138991
Guwatudde, David ; Mutungi, Gerald ; Wesonga, Ronald ; Kajjura, Richard ; Kasule, Hafisa ; Muwonge, James ; Ssenono, Vincent ; Bahendeka, Silver K. / The epidemiology of hypertension in Uganda : Findings from the national non-communicable diseases risk factor survey. In: PLoS One. 2015 ; Vol. 10, No. 9.
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abstract = "Background. Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda's nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods. The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization's STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results. Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4{\%}. Prevalence was highest in the central region at 28.5{\%}, followed by the eastern region at 26.4{\%}, western region at 26.3{\%}, and northern region at 23.3{\%}. Prevalence in urban areas was 28.9{\%}, and 25.8{\%} in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7{\%} of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9{\%}. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95{\%} CI = 1.25-1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95{\%} CI = 1.29-1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95{\%} CI = 1.02-1.03] per yearly increase in age. Conclusions. The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7{\%} of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertensionrelated cardiovascular NCDs.",
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AU - Guwatudde, David

AU - Mutungi, Gerald

AU - Wesonga, Ronald

AU - Kajjura, Richard

AU - Kasule, Hafisa

AU - Muwonge, James

AU - Ssenono, Vincent

AU - Bahendeka, Silver K.

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N2 - Background. Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda's nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods. The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization's STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results. Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25-1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29-1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02-1.03] per yearly increase in age. Conclusions. The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertensionrelated cardiovascular NCDs.

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