Abstract
BackgroundPersons 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.MethodsData 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.ResultsThe 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.ConclusionsMore 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.
Highlights
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 defined as a systolic blood pressure (SBP) of 120 to less than 140 mmHg or diastolic blood pressure (DBP) of 80 to less than 90 mmHg in patients not on medication for hypertension [1]
For people above 40 years the complications associated with increasing blood pressure begin at a SBP/DBP of 115/75 mm Hg, with the risk of cardiovascular disease doubling with each increment of 20/10 mm Hg [10]
Summary
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. For people above 40 years the complications associated with increasing blood pressure begin at a SBP/DBP of 115/75 mm Hg, with the risk of cardiovascular disease doubling with each increment of 20/10 mm Hg [10] Modifications of lifestyle such as losing weight, increased physical activity reduction in consumption of alcohol and modified diet for all people with pre-hypertension and the addition of drug therapy for patients who have other compelling indicators, including multiple diseases are recommended for control of pre-hypertension in high income countries [1]. The healthcare system in Uganda is largely constrained by communicable diseases and non communicable diseases (NCDs) including prehypertension/hypertension are still largely not routinely detected [13]
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