Prevalence and associated factors of prehypertension in Afghanistan: a secondary data analysis of the 2018 STEPS survey

Background: In Afghanistan, approximately 40% of adults aged 30-79 years are living with hypertension. The stage of prehypertension represents a critical point for early detection and prevention of hypertension and its complications. This study aims to determine the prevalence of prehypertension and explore its associations with socio-demographic, behavioural, and biological factors in the Afghan adult population. Methods: This study utilised data from the 2018 Afghanistan STEPS survey; a nationally representative, household-based, cross-sectional survey conducted from February to October 2018. Weighted estimates and multivariate logistic regression analyses were used to assess the prevalence of prehypertension and explore its associations with sociodemographic, behavioural, and biological factors. Results: The prevalence of prehypertension was 38.4%, and it was more prevalent among males (46.2%) than females (29.8%). Male sex (AOR: 2.66; 95% CI: 1.99-3.55) and high waist circumference (AOR: 2.14; 95% CI: 1.47-3.12) were found with higher odds of prehypertension. The prevalence of hypertension was 30.47%. Older age (45-69 years), obesity and high waist circumference associated with hypertension. Adults from the western and northeastern regions had lower odds of both prehypertension and hypertension. Conclusion: Prehypertension and hypertension are highly prevalent in Afghanistan. We identified high risk groups that could inform the development of interventions and modifiable risk factors which could be targeted in these interventions. Further research should focus on the development of contextualised, evidence-based prevention strategies.