Abstract
BackgroundThe prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries. This study aims to describe the epidemiology of high blood pressure among adults in Addis Ababa, so as to inform policy and lay the ground for surveillance interventions.MethodsAddis Ababa is the largest urban centre and national capital of Ethiopia, hosting about 25% of the urban population in the country. A probabilistic sample of adult males and females, 25–64 years of age residing in Addis Ababa city participated in structured interviews and physical measurements. We employed a population based, cross sectional survey, using the World Health Organization instrument for stepwise surveillance (STEPS) of chronic disease risk factors. Data on selected socio-demographic characteristics and lifestyle behaviours, including physical activity, as well as physical measurements such as weight, height, waist and hip circumference, and blood pressure were collected through standardized procedures. Multiple linear regression analysis was performed to estimate the coefficient of variability of blood pressure due to selected socio-demographic and behavioural characteristics, and physical measurements.ResultsA total of 3713 adults participated in the study. About 20% of males and 38% of females were overweight (body-mass-index ≥ 25 kg/m2), with 10.8 (9.49, 12.11)% of the females being obese (body-mass-index ≥ 30 kg/m2). Similarly, 17% of the males and 31% of the females were classified as having low level of total physical activity. The age-adjusted prevalence (95% confidence interval) of high blood pressure, defined as systolic blood pressure (SBP) ≥ 140 mmHg (millimetres of mercury) or diastolic blood pressure (DBP) ≥ 90 mmHg or reported use of anti-hypertensive medication, was 31.5% (29.0, 33.9) among males and 28.9% (26.8, 30.9) among females.ConclusionHigh blood pressure is widely prevalent in Addis Ababa and may represent a silent epidemic in this population. Overweight, obesity and physical inactivity are important determinants of high blood pressure. There is an urgent need for strategies and programmes to prevent and control high blood pressure, and promote healthy lifestyle behaviours primarily among the urban populations of Ethiopia.
Highlights
The prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries
According to the World Health Report 2002, cardiovascular disease accounted for 9.2% of total deaths in the African region in 2001 [2], and hypertension remains the most important risk factor with national prevalence levels ranging from 25% to 35% in adults aged 25–64 years [3]
Description of the study population A total of 3713 adults in the age group 25–64 years, from ten of the 99 kebeles in Addis Ababa participated in the study
Summary
The prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries. According to the World Health Report 2002, cardiovascular disease accounted for 9.2% of total deaths in the African region in 2001 [2], and hypertension remains the most important risk factor with national prevalence levels ranging from 25% to 35% in adults aged 25–64 years [3]. Limited data on the trends of prevalence of hypertension suggest that it has increased in economically developing countries in recent years while it remained stable or decreased in developed countries [5]. Most of the world's hypertensive people live in developing countries, where cardiovascular disease has an early onset and higher mortality than in developed countries [6]. Studies have shown that hypertension is a strong contributor to the hazards of cardiovascular disease (CVD) in black Africans, with an odds ratio (OR) of 7.0 versus 2.3 to 3.9 in other ethnic groups, with P < 0.0002 [7]
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