Key result
Urban residence linked to ~85% higher prevalence of severe hypertension versus rural areas.
Why the study?
Although data from in-hospital or selected populations were available, no studies had reported the community-level prevalence of severe hypertension in sub-Saharan Africa.
What is the community-level prevalence of severe hypertension in a Sub-Saharan African population?
Cross-Sectional (n=1,182)
Yes
What is the community-level prevalence of severe hypertension in a Sub-Saharan African population?
Absolute Event Rate: 17% vs 9.2%
p-value: p=.02
Severe hypertension is highly prevalent (14.1%) in this Sub-Saharan African community, with a large proportion remaining undiagnosed or untreated, highlighting a major public health issue.
May inform urban hypertension screening priorities; leaves open causality versus confounding in this observational association.
BACKGROUND: Though some data from in-hospital or selected populations are available, there are no studies reporting community-level prevalence of Severe Hypertension (SH) in sub-Saharan Africa. METHODS: Study participants were recruited within the framework of The Heart Fund's global health initiative. Data were collected in August 2016 from 6 randomly selected sites, ensuring representativeness of both urban and rural areas. Blood pressure (BP) was measured twice, 10 min apart, after optimal resting time. SH was defined as systolic blood pressure ≥180 and/or diastolic blood pressure ≥110 mmHg at both readings. Demographics and data on cardiovascular history/risk factors were collected in the field. RESULTS: Among 1785 subjects examined, 1182 aged between 18 and 75 years were included in this analysis. The prevalence of SH was 14.1% (12.5% females vs 17.0% males; P = .03) (Fig. 1). Among participants with severe hypertension, 28.9% were either undiagnosed or untreated. Alarmingly, subjects at high cardiovascular risk (age ≥ 60 years and/or obese) had even higher prevalence of overall SH (29.6% and 24.9%, respectively) as well as undiagnosed/untreated SH (29.4% and 24.6%). SH prevalence was almost double in urban compared to rural areas (17.0% vs. 9.2%, P = .02); however, conversely, undiagnosed/untreated SH was significantly higher in rural areas (50.4% vs 21.9%). CONCLUSION: (s): Our community-based study revealed very high prevalence of SH among adults in Abidjan area, with almost one out of every seven having SH. This underscores SH as a growing public health problem in sub-Saharan Africa.
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Gaye et al. (2019) conducted a cross-sectional in Severe Hypertension (n=1,182). Urban residence vs. Rural residence was evaluated on Severe hypertension (systolic BP ≥180 and/or diastolic BP ≥110 mmHg) (p=.02). Urban residence was associated with a significantly higher prevalence of severe hypertension compared to rural residence (17.0% vs 9.2%, P=0.02).
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