Burden of newly diagnosed hypertension in Burundi and 10-year cardiovascular risk: A Bayesian logistic regression and Framingham score-based study

Background Arterial hypertension is a major global public health concern. It coexists with other non-communicable and communicable diseases in Burundi, creating complex health challenges difficult to address. We aimed to assess the burden of newly diagnosed hypertension, identify associated risk factors, and assess 10-year cardiovascular risk among hypertensive and non-hypertensive patients. Knowing at-risk populations and level of risk could guide evidence-based interventions. Methods We conducted a modelling study on 714 patients admitted at Kamenge Teaching Hospital between January 2018 and December 2022. Retrospective data were obtained from medical records. Bayesian belief update methods, Bayesian logistic regression with bootstrapping, and Bayesian linear models were used to respectively estimate prevalence, risk factors, and associations between diastolic blood pressure (DBP) and cardiovascular risk. The 10-year cardiovascular risk was evaluated using the Canadian Framingham Risk Score. Findings: The prevalence of newly diagnosed hypertension was 16.9% (95% CrI: 14.2–19.7). Higher rates were observed among women (18%), patients aged 40–59 (21.3%) and ≥ 60 years (33.9%), those with higher education (up to 28.9%), and individuals with obesity, overweight, or family history of hypertension. Significant predictors included age ≥ 40, tobacco use, higher education, and excess weight. Moderate or severe 10-year cardiovascular risk was found in 24.9% of patients, with more than 60% of hypertensive patients classified as high risk. DBP showed a positive correlation with cardiovascular risk in both hypertensive and non-hypertensive groups. Interpretation: Newly detected hypertension and its strong association with elevated cardiovascular risk highlight missed opportunities for early diagnosis and prevention. Targeted screening and management of modifiable risk factors could reduce cardiovascular risk in this population and support national efforts to curb the growing burden of non-communicable diseases in Burundi. Conclusion The burden of newly diagnosed hypertension and its association with increased cardiovascular risk underscore the need for systematic screening, early diagnosis, and preventive strategies in Burundi. Interventions addressing modifiable risk factors could support national policies and resource allocation to reduce cardiovascular disease burden in line with the 2030 agenda.