TY - JOUR
T1 - The epidemiology of hypertension in Uganda
T2 - Findings from the national non-communicable diseases risk factor survey
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.
N1 - Funding Information:
The authors are grateful to the research participants who volunteered to participate in the NCD risk factor prevalence survey; and for the technical and administrative support provided by Uganda’s Ministry of Health, and that from the Uganda Bureau of Statistics. The authors also acknowledge the technical support provided by Melanie Cowan and Lubna Ishaq Bhatti of the Surveillance and Population-based Prevention Unit, Department of Prevention of Non-communicable Diseases, Non-communicable Diseases and Mental Health Cluster, World Health Organization, Geneva, Switzerland. The conduct of the survey was supported by funding from the Uganda government, the World Health Organization, the World Diabetes Foundation, and the United Nations Development Program.
Publisher Copyright:
© 2015 Guwatudde et al.
PY - 2015/9/25
Y1 - 2015/9/25
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.
AB - 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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U2 - 10.1371/journal.pone.0138991
DO - 10.1371/journal.pone.0138991
M3 - Article
C2 - 26406462
AN - SCOPUS:84947271066
SN - 1932-6203
VL - 10
JO - PLoS One
JF - PLoS One
IS - 9
M1 - e0138991
ER -
