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Hypertension-related diseases as a common cause of hospital mortality in Tanzania: a 3-year prospective study

Peck, Robert N.; Green, Ethan; Mtabaji, Jacob; Majinge, Charles; Smart, Luke R.; Downs, Jennifer A.; Fitzgerald, Daniel W.

doi: 10.1097/HJH.0b013e328362bad7

Objective: Hypertension is believed to be an increasingly common driver of the epidemic of noncommunicable diseases (NCDs) in sub-Saharan Africa, but prospective data are scarce. The objective of this prospective study was to determine the contribution of hypertension to deaths, admissions, and hospital days at a Tanzanian zonal hospital.

Methods: Between 2009 and 2011, diagnoses were recorded for all medical admissions together with age, sex, length of hospitalization and in-hospital mortality.

Results: Among 11 045 consecutive admissions, NCDs accounted for nearly half of all deaths, admissions, and hospital days. Among NCDs, hypertension-related diseases were the most common and accounted for 314 (33.9%) of the total NCD deaths, 1611 (29.9%) of the NCD admissions, and 12 837 (27.8%) NCD hospital days. Stroke (167 deaths) was the leading cause of hypertension-related death. Hypertension was the leading cause of death in patients over the age of 50 years and 57% of hypertension-related deaths occurred in patients less than 65 years old.

Conclusion: NCDs account for half of all deaths, admissions and hospital days at our Tanzanian hospital and hypertension-related diseases were the most common NCD. Hypertension accounted for 34% of NCD deaths and 15% of all deaths. Hypertension was the second most common cause of death overall and the leading cause of death in patients more than 50 years old. More than half of hypertension-related deaths occurred before retirement age. These findings have important implications for public health and medical education in sub-Saharan Africa, wherein hypertension and related diseases have not traditionally been given a high priority.

aDepartment of Medicine, Bugando Medical Centre, Mwanza

bDepartment of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania

cCenter for Global Health, Weill Cornell Medical College, New York

dCornell University, Ithaca, New York, USA

eDepartment of Physiology, Weill Bugando School of Medicine

fDirector General, Bugando Medical Centre, Mwanza, Tanzania

Correspondence to Dr Robert N. Peck. Bugando Medical Centre, Bugando Hill Road, Box 1370, Mwanza, Tanzania. Tel: +255 687 084 038; fax: +255 282 500 789; e-mail:

Abbreviations: BMC, Bugando Medical Centre; HIV, human immunodeficiency virus; ICD-10, International Classification of Diseases version 10; JNC-7, joint national convention 7; NCDs, noncommunicable diseases; WCMC, Weill Cornell Medical College

Received 8 January, 2013

Revised 3 April, 2013

Accepted 29 April, 2013

Previous presentations: part of this work was presented as a poster at the 2012 conference of the American hypertension association in Washington, DC.

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