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Hypertension prevalence and risk factors among residents of four slum communities

population-representative findings from Port-au-Prince, Haiti

Tymejczyk, Olgaa,b; McNairy, Margaret L.c,d; Petion, Jacky S.e; Rivera, Vanessa R.c,e; Dorélien, Audreyf; Peck, Mireillee; Seo, Gracec; Walsh, Kathleen F.c,d,e; Fitzgerald, Daniel W.c,d,e; Peck, Robert N.d,g,h,i; Joshi, Ashisha,b; Pape, Jean W.c,d,e; Nash, Denisa,b

doi: 10.1097/HJH.0000000000001966

Objectives: The aim of this study was to estimate the prevalence of hypertension and its risk factors among adults in four slum communities in Port-au-Prince.

Methods: Cluster area random sampling was used to select adults for a health and demographic survey, including anthropometric measurements. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg, or current hypertension treatment, and was age-standardized to WHO world population. Correlates of hypertension were tested using sex-stratified logistic regression.

Results: Overall, 20.3% of adults had hypertension (28.5% age-standardized), including 22.3% of men and 18.9% of women. Three percent of participants reported current hypertension treatment, and 49.5% of them had their hypertension controlled. Overweight/obesity (BMI ≥25) was the most common risk factor (20.6% among men, 48.5% among women), while smoking was less common (11.8 and 3.9%, respectively). Increasing age and hypertension prevalence in immediate surroundings were associated with greater odds of hypertension. Among men, having in-migrated in the 3 years prior (versus ≥3 years) was also associated with hypertension [adjusted odds ratio (aOR)=3.32, 95% confidence interval (95% CI): 1.79–6.17], as was overweight and obesity (aOR = 1.90, 95% CI: 1.09–3.33, and aOR = 5.73, 95% CI: 2.49–13.19, respectively) and nonreceipt of needed medical care in the preceding 6 months (aOR = 2.82, 95% CI: 1.35–5.88) among women.

Conclusion: Hypertension prevalence was high across the age spectrum, in addition to substantial levels of overweight/obesity and unmet healthcare needs. It is important to better understand the possible effects of intraurban migration and environmental risk factors on hypertension and ensure that the benefits of increasingly cost-effective prevention and treatment programmes extend to slum residents.

aInstitute of Implementation Science in Population Health

bGraduate School of Public Health and Health Policy, City University of New York

cCenter for Global Health

dDepartment of Medicine, Weill Cornell Medical College, New York, New York, USA

eHaitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti

fHumphrey School of Public Affairs, University of Minnesota, Minneapolis, Minnesota

gDepartment of Pediatrics, Weill Cornell Medical College, New York, New York, USA

hDepartments of Medicine and Pediatrics, Weill Bugando School of Medicine

iMwanza Interventions Trial Unit, Mwanza, Tanzania

Correspondence to Olga Tymejczyk, Institute for Implementation Science in Population Health, City University of New York, 55 W, 125th St., New York, NY 10027, USA Tel: +1 646 364 9625; fax: +1 646 786 3894; e-mail:

Abbreviations: ACC, American College of Cardiology; aOR, adjusted odds ratio; CI, confidence interval; CVD, cardiovascular disease; GHESKIO, Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections; IQR, interquartile range; JNC-VII, Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure; LMICs, lower- and middle-income countries; NCD, noncommunicable disease; RedCap, Research Electronic Data Capture

Received 11 August, 2018

Accepted 13 September, 2018

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