Abstract
BackgroundHypertension is an emerging public health problem in Sub Saharan Africa (SSA) and urbanization is considered to favor its emergence. Given a paucity of information on hypertension and associated risk factors among urban slum dwellers in SSA, we aimed to characterize the distribution of risk factors for hypertension and investigate their association with hypertension in an urban slum in Kenya.MethodsWe conducted a community based cross-sectional survey among adults 35 years and older living in Kibera slum Nairobi, Kenya. Trained interviewers collected data on socio demographic characteristics and self reported health behaviours using modified World Health Organization stepwise surveillance questionnaire for chronic disease risk factors. Anthropometric and blood pressure measurements were performed following standard procedures. Multiple logistic regression was used for analysis and odds ratios with 95 % confidence intervals were calculated to identify risk factors associated with hypertension.ResultA total of 1528 adults were surveyed with a mean age of 46.7 years. The age-standardized prevalence of hypertension was 29.4 % (95 % CI 27.0–31.7). Among the 418 participants classified as hypertensive, over one third (39.0 %) were unaware they had hypertension. Prevalence of current smoking and alcohol consumption was 8.5 and 13.1 % respectively. Over one quarter 26.2 % participants were classified as overweight (Body Mass Index [BMI] ≥25 to ≤29.9 kg/m2), and 17 % classified as obese (BMI ≥30 kg/m2). Overweight, obesity, current smoking, some level of education, highest wealth index, moderate physical activity, older age and being widowed were each independently associated with hypertension. When fit in a multivariable logistic regression model, being a widow [AOR = 1.7; (95 % CI, 1.1–2.6)], belonging to the highest wealth index [AOR = 1.6; (95 % CI, 1.1–2.5)], obesity [AOR = 1.8; 95 % CI, 1.1–3.1)] and moderate physical activity [AOR = 1.9; (95 % CI, 1.2–3.0)], all remained significantly associated with hypertension.ConclusionHypertension in the slum is a public health problem affecting at least one in three adults aged 35–64 years. Age, marital status, wealth index, physical inactivity and body mass index are important risk factors associated with hypertension. Prevention measures targeting the modifiable risk factors associated with hypertension are warranted to curb hypertension and its progressive effects.
Highlights
Hypertension is an emerging public health problem in Sub Saharan Africa (SSA) and urbanization is considered to favor its emergence
Marital status, wealth index, physical inactivity and body mass index are important risk factors associated with hypertension
Prevention measures targeting the modifiable risk factors associated with hypertension are warranted to curb hypertension and its progressive effects
Summary
Hypertension is an emerging public health problem in Sub Saharan Africa (SSA) and urbanization is considered to favor its emergence. The increasing prevalence of hypertension in low income countries represent a substantial public health problem with associated economic and social impacts [5]. The urban poor often adopt less healthy lifestyles They are more sedentary than rural residents and tend to consume foods high in saturated fat, salt and sugar [7]. They have limited access to healthcare (especially when compared with wealthier urban residents), partly related to their poor purchasing ability which places them at a higher risk for complications resulting from untreated hypertension [8]. Studies document higher prevalence of hypertension and its associated risk factors in urban areas compared to the rural areas [4, 10, 11]
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