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Epidemiology of hypertension in low-income countries: a cross-sectional population-based survey in rural Uganda

Maher, Dermota,b; Waswa, Labana; Baisley, Kathyb; Karabarinde, Alexa; Unwin, Nigelc

doi: 10.1097/HJH.0b013e3283466e90
Original papers: Epidemiology

Objective Population-based data on burden of hypertension are crucial for planning and implementation of prevention and control strategies but are often limited in developing countries in Africa. We assessed the prevalence of hypertension and related risk factors in a population cohort in rural Uganda initially established for HIV surveys.

Methods In a cross-sectional population-based survey of hypertension and related risk factors in 2009, trained field staff administered a questionnaire and obtained a single measurement of blood pressure, BMI, waist and hip circumference, waist/hip ratio (WHR) and random plasma glucose. All members of the population cohort aged 13 years and above were eligible for survey participation. Logistic regression was used to evaluate factors associated with high blood pressure, defined as SBP (mmHg) ≥140 or DBP ≥90.

Results Of the 4801 men and 5372 women who were eligible, 2719 (56.6%) men and 3959 (73.7%) women participated in the survey. The prevalence of high blood pressure was 22.0%, age standardized to the local population. Factors that were independently associated with high blood pressure were increasing age, BMI and elevated glucose in both sexes, extremes of education level (none and secondary or above) among men, and being unmarried and waist circumference ≥80 cm among women. Levels of reported hypertension were very low, with nine out 10 people unaware of their condition.

Conclusion The use of established research infrastructure, for example, community HIV surveys, can help to generate the population-based data on the prevalence of hypertension and related risk factors needed to inform planning and implementation of effective prevention and control strategies in low-income countries. There is an urgent need to strengthen health services in responding effectively to the large burden of undetected hypertension.

aMedical Research Council/Uganda Virus Research Institute (MRC/UVRI) Uganda Research Unit on AIDS, Entebbe, Uganda

bDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

cThe Faculty of Medical Sciences, The University of The West Indies Cave Hill Campus, Bridgetown, Barbados

Received 12 October, 2010

Revised 27 January, 2011

Accepted 4 March, 2011

Correspondence to Dermot Maher, Senior Clinical Epidemiologist, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) Uganda Research Unit on AIDS, PO Box 49 Entebbe, Uganda Tel +256 417 704000; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.