Epidemiology of hypertension among adults in Addis Ababa, Ethiopia

Mekonene, Mulugeta; Baye, Kaleab; Gebremedhin, Samson

doi:10.1016/j.pmedr.2023.102159

Cited by 7 publications

(15 citation statements)

References 27 publications

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“…Additionally, the prevalence of HTN in this study was disproportionally higher as compared with that of the community-based studies, which might be explained by selection bias as the tendency of high-risk individuals to get screened is expected to be better at an institution level than in the community. This study revealed a remarkably higher burden of hypertension among men (42%) as compared to women (26.5%), which is consistent with other studies, albeit with less disparity [21,27]. On the contrary, the results of the national NCDs STEPS survey showed that HTN was slightly more prevalent in females (16.3%) as compared to males (15.5%).…”

Section: Discussionsupporting

confidence: 91%

“…Another study done in Hosanna town, southern Ethiopia, also showed that married participants had a higher prevalence of HTN as compared with their unmarried counterparts [29]. However, there was no significant effect of marital status on the prevalence of HTN in other studies done in Addis Ababa [21,23].…”

Section: Discussionmentioning

confidence: 90%

“…The sample size was calculated to be 264 using a single proportion population formula, taking a prevalence of 22.1% for HTN (SBP ≥140 mmHg or DBP ≥ 90 mmHg, similar to the definition used in the current study) among residents of Addis Ababa [13], a 95% confidence level (CI), a standard deviation of 0.5, and a margin of error (d) of 5%. The sample size was corrected to 290 with the addition of a 10% non-response rate, and all eligible participants in the study period were screened using a convenience sampling technique.…”

Section: Sample Sizementioning

confidence: 99%

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Prevalence and Predictors of Newly Diagnosed Hypertension in an Opportunistic Screening Program in Addis Ababa, Ethiopia: An Institution-Based Cross-Sectional Study

Solela,

Tewabe,

Ambachew

et al. 2024

Preprint

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Background: Hypertension is highly prevalent in the general population, and it is a recognized risk factor that underlies the epidemic of cardiovascular diseases. Because of its major role as a cause of death and morbidity, its detection is crucially important for public health, and in line with this, guidelines like the European Society of Hypertension recommend opportunistic screening for hypertension in all adults. However, there are no studies on the prevalence and predictors of hypertension using opportunistic screening strategies in many African countries, including Ethiopia. Hence, this study aimed to assess the prevalence and predictors of newly diagnosed hypertension in an opportunistic screening program in Ethiopia. Methods: This was an institution-based cross-sectional study conducted on adult participants (≥ 18 years old) in an opportunistic hypertension screening program at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. Data were collected using a pretested and structured questionnaire, which was prepared using the WHO STEPwise approach to non-communicable disease risk factor surveillance (STEPS). The data was analyzed using SPSS version 26. The descriptive analysis was used to compile the sociodemographic data, lifestyle factors, and clinical profiles of the participants. Bivariate and multivariable logistic regression analyses were performed to determine the predictors of hypertension by using the crude odds ratio (COR) and adjusted odds ratio (AOR) with the accompanying 95% confidence interval (CI). Results: A total of 301 adult participants were included in this study. The mean age of the participants was 47.6 years (standard deviation: 13.5), and 62% were males. Only 13% had obesity; 62.5% had physical inactivity; and 81.4% were consuming vegetables and/or fruits ≤ 5 days a week. The prevalence of newly diagnosed hypertension was 36.2%. Multivariable logistic analysis revealed that male sex (adjusted odds ratio (AOR) = 2.06, 95% confidence interval (CI): 1.05, 4.04), being married (AOR = 4.8, 95% CI: 1.84, 2.77) or widowed (AOR = 5.14, 95% CI: 1.23, 1.46), less frequent intake of vegetables and/or fruits (<5 days a week) [<3 days per week (AOR = 2.88, 95% CI: 1.12, 7.39, P value = 0.028), and 3 to 5 times per week (AOR = 2.22, 95% CI: 1.02, 4.86, P value = 0.046)], physical inactivity (AOR = 2.26, 95% CI: 1.21, 4.22), and body mass index (AOR = 1.17, 95% CI: 1.09, 1.26), had significant associations with hypertension. Conclusion: In this study, one out of three individuals had newly diagnosed hypertension in an opportunistic screening program in Addis Ababa, Ethiopia. It has also been shown that important predictors of hypertension were male sex, being married or widowed, less frequent intake of vegetables and/or fruits, physical inactivity, and body mass index. Therefore, targeted interventions are required to improve public awareness about hypertension, and expanding institution-based opportunistic screening programs is a cost-effective approach for early detection of hypertension and improving access to its treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

Section: Sample Sizementioning

confidence: 99%

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Prevalence and Predictors of Newly Diagnosed Hypertension in an Opportunistic Screening Program in Addis Ababa, Ethiopia: An Institution-Based Cross-Sectional Study

Solela,

Tewabe,

Ambachew

et al. 2024

Preprint

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“…The methodology of the original study has been described elsewhere. 18 We conducted the original community-based survey in June 2021, among 600 adults 18–64 years of age. Study subjects were selected randomly using multistage sampling approach, irrespective of their medical history, from 20 villages drawn from all subcities of Addis Ababa.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) – for predicting cardiometabolic risk among adults in Addis Ababa

Gebremedhin,

Bekele

2024

BMJ Open

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ObjectiveVarious anthropometric indices had been proposed to predict cardiometabolic risk, yet few were validated in the African population. We evaluated the diagnostic accuracy of a novel anthropometric index—weight adjusted for waist-to-height ratio (W-WHR)—as a predictor of cardiometabolic risk among adults 18–64 years in Addis Ababa, Ethiopia; and compared its performance with other indices commonly used in the literature.DesignCross-sectional study.SettingCommunity-based study in Addis Ababa, Ethiopia.ParticipantsRandomly selected adults (n=600) completed serum lipid, blood pressure, blood glucose and anthropometric measurements.Primary and secondary outcome measuresThe primary outcomes of interest were dyslipidaemia, hypertension and hyperglycaemia. Having at least one of the three outcomes was considered as a secondary outcome. Receiver-operating characteristic curve (ROC) used to measure the diagnostic accuracy of W-WHR and another 13 indices for predicting the primary and secondary outcomes. Optimal thresholds were determined using Youden’s index.ResultsW-WHR demonstrated an acceptable diagnostic accuracy (area under the curve (AUC), 95% CI) for correctly classifying dyslipidaemia (0.80, 0.76 to 0.84), hypertension (0.74, 0.70 to 0.78), hyperglycaemia (0.76, 0.70 to 0.82) and the secondary outcome of interest (0.79, 0.75 to 0.83). Depending on the outcomes, thresholds between 32.6 and 36.7 concurrently maximised sensitivity and specificity of the index. ROC analysis indicated, W-WHR (AUC=0.80), abdominal volume index (AVI) (AUC=0.78) and waist circumference (WC) (AUC=0.78) for dyslipidaemia; W-WHR (AUC=0.74) and WC (AUC=0.74) for hypertension; and waist-to-height ratio (AUC=0.80) and body roundness index (AUC=0.80) for hyperglycaemia, had the highest diagnostic accuracy. Likewise, W-WHR (AUC=0.79), AVI (AUC=0.78) and WC (AUC=0.78) had better performance for the secondary outcome. Most indices have better utility among younger than older adults, and per cent body fat had the highest diagnostic accuracy among women (AUC 0.74–0.83).ConclusionW-WHR is a useful index for predicting cardiometabolic risk, especially among young adults.

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“…Women were excluded if they had a self-reported pregnancy or gave birth within the past 12 months of the survey. The detailed methods of the original study have been described elsewhere 24…”

Section: Methodsmentioning

confidence: 99%

Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study

Mekonene,

Gebremedhin,

Bikila

et al. 2023

BMJ Open

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ObjectiveIn low-income countries, such as Ethiopia, few studies have evaluated the risk of cardiovascular disease (CVD) among hypertensive patients. We assessed the 10-year CVD risk of hypertensive patients.DesignThis cross-sectional study was part of a larger survey conducted in Addis Ababa. The 10-year CVD risk was calculated using the Framingham Risk Score (FRS) algorithm based on seven sex-specific risk factors as well as a country-specific Globorisk score. Fruits and vegetables (FV) consumption, salt intake and stress levels were measured with 24-hour dietary recall, INTERSALT equation and Cohen’s Perceived Stress Scale, respectively. A multiple linear regression model was fitted to explore the association.SettingAddis Ababa, Ethiopia, 2021.ParticipantsA sample of 191 patients diagnosed with hypertension.Outcome measuresPredicted 10-year cardiovascular risk of hypertensive patients.ResultsA total of 42.4%, 27.7% and 29.8% of hypertensive patients were at low, moderate and high CVD risks, respectively. The majority (80.1%) of patients consumed inadequate FV, 95.7% consumed salt >5 g/day and 58.1% had moderate to high-stress levels. There was a substantial agreement between the FRS and Globorisk prediction models (weighted kappa 0.77). In the unadjusted model, FV consumption (>450 g/day) and total fruit intake in the highest tertile were associated with 14.2% and 6.7% lower CVD risk, respectively. After adjusting for lifestyle factors, increasing FV intake from 120 to 450 g/day was significantly related to 11.1%–15.2% lower CVD risk in a dose–response manner. Additionally, total fruit, but not total vegetable intake in the highest tertile, was significantly associated with decreased CVD risk.ConclusionWe found a high prevalence of CVD risk among hypertensive patients. High FV consumption was inversely associated with CVD risk. This suggests that patients should be advised to increase FV intake to minimise CVD risk.

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Epidemiology of hypertension among adults in Addis Ababa, Ethiopia

Cited by 7 publications

References 27 publications

Prevalence and Predictors of Newly Diagnosed Hypertension in an Opportunistic Screening Program in Addis Ababa, Ethiopia: An Institution-Based Cross-Sectional Study

Prevalence and Predictors of Newly Diagnosed Hypertension in an Opportunistic Screening Program in Addis Ababa, Ethiopia: An Institution-Based Cross-Sectional Study

Evaluating the performance of a novel anthropometric index: weight adjusted for waist-to-height ratio (W-WHR) – for predicting cardiometabolic risk among adults in Addis Ababa

Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study

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