Objective:The main objectives of our screening survey is to detect the prevalence, control, awareness and risk factors of hypertension Design and method: This cross-sectional screening survey was conducted among 23168 adults, during the May Measurement Month 2018 campaign in six states. Volunteers ≧ 18 years were recruited through opportunistic sampling. Each participant had three blood pressure measurements and completed a questionnaire on demographic and medical history. Hypertensive patients were defined as those having systolic BP ≧ 130mmHg or diastolic BP ≧ 80 mmHg, or taking antihypertensive medication, control of hypertension was defined a systolic BP ≦140 mmHg and a diastolic BP ≦ 90 mmHg. Results:The overall prevalence of hypertension was 25.9% among the study participants (14.8% for males and 11.1% for females). The majority of identified hypertensive participants (74.1%) had no previous history of known hypertension. Overall 63.0% were on treatment and 35.6 % had controlled blood pressure. In the multivariable regression model, factors associated with increased awareness of having hypertension included female sex (OR 1.37 95% CI 1.12: 1.69), older age > 60 years (OR 1.81 95%, CI 1.36: 2.40), frequently measured their BP (OR 21.3 95% CI 15.3: 29.7), and presence of comorbidities (P < 0.001), Compared to individuals with a normal BMI, overweight participants were more likely to have hypertension (OR 1.63, 95% CI 1.48: 1.79) and more likely to have the disease uncontrolled (OR1.47, 95% 1.33: 1.63). Diabetic patients also had less BP control, while a history of myocardial infarction or stroke did not influence the rates of BP control among hypertensive subjects. Conclusion:Our study suggests that the prevalence of hypertension is increasing. Our data also demonstrated a striking lack of awareness of the disease and alarming levels of poor disease control particularly among young adults, overweight subjects and diabetics.

Background: The identification of the critical regions within angiotensin-converting enzyme (ACE) gene which predict hypertension and/or influence ACE activity would have significant implications for precision medicine. Studies investigating the association of ACE gene polymorphisms and the risk of developing hypertension have yielded inconsistent results. Objective: The aim of the study is to identify single nucleotide polymorphisms (SNPs) or haplotype markers in exon 13 of ACE gene and their association with essential hypertension in a sample of Sudanese population. Methods: Amplified fragments of 550bp across exon 13 of ACE gene were outsourced to the Macrogen Company, Seoul, South Korea for sequencing. Finch TV program was used to view the chromatogram. Gene sequences were translated into amino acid sequence, using GeneMark version 4.25. The structural effect of a point mutation in a protein sequence was analyzed using PROJECT HOPE online website. Linkage disequilibrium between polymorphic variants was determined using Haploview v4.2. Results: Seven polymorphisms of ACE gene were identified in the sequenced fragments: four exonic SNPs (Rs4316, rs4317, rs4318 and one unreported SNP); an intronic SNP (rs12720723); one SNP at the intronic-exonic boundary site (rs4320); and an intronic I/D (rs4319). Haplotype analysis identified two blocks within 550bp spanning area of the ACE gene. Both blocks were composed of six SNPs: rs12720723; unreported SNP; rs4316; rs4317; rs4318 and rs4319. Each block consisted of five haplotype structures. Block 1 included B1-H1 (GCC), B1-H2 (ACC), B1-H3 (GCT), B1-H4 (GAT) and B1-H5 (AAT), whereas block 2 included B2-H1 (TAC), B2-H2 (CGC), B2-H3 (TAA), B2-H4 (CAC) and B2-H5 (TGC). Rs4317 and rs4318 were in moderate linkage disequilibrium (LD) (D’ value=0.69) among hypertensive patients. Rs4316; rs4319 and rs4320 were in moderate to high LD and displayed relatively high MAF among hypertensive participants. Conclusion: The results of our study suggest that the 3 SNPs within exon 13 of the ACE gene (rs4316, rs4319 and rs4320) could be genetic markers for developing hypertension as evidenced by the high LD and MAF observed in hypertensive participants. Moreover, rs4318 being in LD with rs4317 could highlight the importance of block 2 in predicting hypertension among blacks.