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Agimas MC, Derseh NM, Mamo F, Abebe MT, Yemanu T, Asmamaw M. Trend, burden and determinants of undiagnosed hypertension in the Horn of Africa: A systematic review and meta-analysis. PLoS One 2024; 19:e0303940. [PMID: 39178236 PMCID: PMC11343413 DOI: 10.1371/journal.pone.0303940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/03/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Hypertension is a silent killer disease and the global report revealed that half of the world's population lives with undiagnosed hypertension. The problem is expected to be worse in low-income countries such as in Horn of Africa countries. Thus, we planned to determine the trend, burden, and determinates of undiagnosed hypertension in this region and provide conclusive and tangible evidence for interventions. METHOD Articles were searched on Google, Google Scholar, PubMed/Medline, EMBASE, SCOPUS, and the published articles' reference list. The JBI critical appraisal checklist was used for quality assessment. A sensitivity test and I2 statistics were conducted to evaluate the heterogeneity. The Begg's statistics in the random effect model were done to evaluate the publication bias. RESULT The pooled prevalence of undiagnosed hypertension in the Horn of Africa was 17% (95% CI: 15%-20%) and it ranges from from 13% in 2006 to 20% in 2023. A trip time to a medical institution of less than 35 minutes (OR = 0.52, 95%CI: 0.35-0.79), no regular exercise (OR = 2.26, 95% CI: 1.54-3.32), age > = 45 years (OR = 2.51, 95% CI: 1.66-3.8), age 35-44 years (OR = 1.88, 95% CI: 1.5-2.37), male (OR = 1.72, 95% CI: 1.34-2.2), poor knowledge (OR = 3.29, 95%CI: 2.39,4.53), normal BMI (OR = 3.84, 95% CI: 2.96-4.98), Overweight (OR = 1.97, 95% CI: 2.96-4.98), poor health seeking (OR = 2.79, 95%CI: 2.01-3.86), low vegetable consumers (OR = 1.99, 95%CI:1.36-2.91), smoking (OR = 1.47, 95%CI: 1.13-1.93), high triglyceride (OR = 1.83, 95%CI:1.33-2.52), chat chewing (OR = 2.18, 95%CI: 1.54-3.09), and alcohol drinking (OR = 1.75, 95%CI: 1.32-2.33) were the determinats of undiagnosed hypertension. CONCLUSION AND RECOMMENDATION The pooled prevalence of undiagnosed hypertension was low in the Horn of Africa but its trend was increased over time. Individual level variables were identified that affect the undiagnosed hypertension. Therefore, healthy lifestyle is recommended.
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Affiliation(s)
- Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Moges Tadesse Abebe
- Department of Nursing, College of Health Science, Debark University, Debark, Ethiopia
| | - Tilahun Yemanu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Meron Asmamaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Adediran E, Owens R, Gardner E, Curtin A, Stuligross J, Forbes D, Wang J, Ose D. Risk factors of undiagnosed and uncontrolled hypertension in primary care patients with hypertension: a cross-sectional study. BMC PRIMARY CARE 2024; 25:311. [PMID: 39164618 PMCID: PMC11334361 DOI: 10.1186/s12875-024-02511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/01/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Hypertension is a common heart condition in the United States (US) and severely impacts racial and ethnic minority populations. While the understanding of hypertension has grown considerably, there remain gaps in US healthcare research. Specifically, there is a lack of focus on undiagnosed and uncontrolled hypertension in primary care settings. AIM The present study investigates factors associated with undiagnosed and uncontrolled hypertension in primary care patients with hypertension. The study also examines whether Black/African Americans are at higher odds of undiagnosed and uncontrolled hypertension compared to White patients. METHODS A cross-sectional study was conducted using electronic health records (EHR) data from the University of Utah primary care health system. The study included for analysis 24,915 patients with hypertension who had a primary care visit from January 2020 to December 2020. Multivariate logistic regression assessed the odds of undiagnosed and uncontrolled hypertension. RESULTS Among 24,915 patients with hypertension, 28.6% (n = 7,124) were undiagnosed and 37.4% (n = 9,319) were uncontrolled. Factors associated with higher odds of undiagnosed hypertension included age 18-44 (2.05 [1.90-2.21]), Hispanic/Latino ethnicity (1.13 [1.03-1.23]), Medicaid (1.43 [1.29-1.58]) or self-pay (1.32 [1.13-1.53]) insurance, CCI 1-2 (1.79 [1.67-1.92]), and LDL-c ≥ 190 mg/dl (3.05 [1.41-6.59]). For uncontrolled hypertension, risk factors included age 65+ (1.11 [1.08-1.34]), male (1.24 [1.17-1.31]), Native-Hawaiian/Pacific Islander (1.32 [1.05-1.62]) or Black/African American race (1.24 [1.11-1.57]) , and self-pay insurance (1.11 [1.03-1.22]). CONCLUSION The results of this study suggest that undiagnosed and uncontrolled hypertension is prevalent in primary care. Critical risk factors for undiagnosed hypertension include younger age, Hispanic/Latino ethnicity, very high LDL-c, low comorbidity scores, and self-pay or medicaid insurance. For uncontrolled hypertension, geriatric populations, males, Native Hawaiian/Pacific Islanders, and Black/African Americans, continue to experience greater burdens than their counterparts. Substantial efforts are needed to strengthen hypertension diagnosis and to develop tailored hypertension management programs in primary care, focusing on these populations.
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Affiliation(s)
- Emmanuel Adediran
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Robert Owens
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Elena Gardner
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Andrew Curtin
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - John Stuligross
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Danielle Forbes
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | - Jing Wang
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Dominik Ose
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA.
- Faculty of Health and Healthcare Sciences, Westsächsische Hochschule Zwickau, Kornmarkt 1, 08056 Zwickau, 08012, Zwickau, Saxony, Germany.
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Mekonen HH, Gebru TH, Kiros KG, Gebrehiwot TG, Tesfamichael YA. Undiagnosed hypertension and associated factors among adult population in central zone of Tigray, Northern Ethiopia 2020: A cross-sectional study. Health Sci Rep 2024; 7:e2052. [PMID: 38655424 PMCID: PMC11035904 DOI: 10.1002/hsr2.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/02/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims Undiagnosed hypertension is a major risk factor for cardiovascular diseases and complications such as heart attack and stroke. Limited information is available on the prevalence of undiagnosed hypertension and its associated factors in Ethiopia, particularly in the study setting. This study aimed to assess the prevalence of undiagnosed hypertension and its associated factors in the central zone of Tigray, Northern Ethiopia. Methods A community-based cross-sectional study was conducted from April 1 to May 31, 2020. A pretested structured questionnaire was used and both face-to-face interview and physical measurement were used to collect the data. Blood pressure was measured on two different days for each study participant, and an average of the measurements were taken. In addition, 736 participants were included in this study, through a systematic random sampling technique. Data were analyzed using SPSS version 23. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with undiagnosed hypertension. Adjusted odds ratios and 95% confidence intervals were used to show the strength of the association and declare statistical significance at p < 0.05. Results In the study, the mean age of the participants was 51.9 (standard deviation: 17.9) years old. Prevalence of undiagnosed hypertension was found 15.4% (N = 113). The factors associated with undiagnosed hypertension were being divorced (adjusted odds ratio [AOR] = 15.2, 95% confidence interval [CI]: 8.2-28.3), alcohol consumption (AOR = 2.07, 95% CI: 1.22-3.51), not eating fruits (AOR = 4.1, 95% CI: 2.37-7.08), not eating vegetables (AOR = 3.47, 95% CI: 2.02-5.96) and poor knowledge (AOR = 3.05, 95% CI: 2.75-7.83). Conclusion Around one in six study participants had undiagnosed hypertension. Being divorced, drinking alcohol, not eating fruits, not consuming vegetables, and having poor knowledge of hypertension were significant factors. Public health interventions, like providing adequate hypertension health information, frequent screening, and implementation of an appropriate intervention for particular factors, are critical for reducing the burden of undiagnosed hypertension.
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Affiliation(s)
- Haftea Hagos Mekonen
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
| | - Tsegu Hailu Gebru
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
| | - Kbrom Gemechu Kiros
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
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Adal AB, Kassa RN, Habte MH, Jebesa MG, Ademe S, Tiruneh CT, Andualem A, Aynalem ZB, Bewket B. Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study. PLoS One 2024; 19:e0292890. [PMID: 38359046 PMCID: PMC10868739 DOI: 10.1371/journal.pone.0292890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/01/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.
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Affiliation(s)
- Abebaw Bires Adal
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Rahel Nega Kassa
- Department of Nursing, St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | - Sewunet Ademe
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | | | - Atsedemariam Andualem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Zewdu Bishaw Aynalem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Bekalu Bewket
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
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Fifita SST, Nonaka D, Cama MT, Filise MI. Factors associated with undiagnosed hypertension among Tongan adults: a cross-sectional study. Trop Med Health 2024; 52:4. [PMID: 38163919 PMCID: PMC10759494 DOI: 10.1186/s41182-023-00570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Hypertension is responsible for many premature deaths worldwide. However, many individuals with hypertension remain undiagnosed. Tonga is one of the countries that has had a steep increase in hypertension, thus undiagnosed hypertension could also be increasing. Purpose of this study was to assess the prevalence and factors associated with undiagnosed hypertension among Tongan adults. METHODS This cross-sectional study used data collected from conveniently sampled 473 participants using electronic questionnaire and digital sphygmomanometer through household visits between February and March 2023. Inclusion criteria were age of 18-65 years, residence in the villages for at least six months, and not being pregnant. Fisher's exact test and mixed-effect logistic regression were performed using the EZR software to assess the association between undiagnosed hypertension and predictor variables. RESULTS The prevalence of undiagnosed hypertension was 22.4% (106/473). Five variables that were significantly associated with undiagnosed hypertension in Fisher's exact test were included in the multivariate logistic regression. Overall, only three variables remained significant. First, participants who never had their blood pressure measured had higher prevalence compared to those who had it checked recently (33.3% vs. 19.1%); odds ratio: 2.24). Secondly, participants who were not aware of the risk of developing hypertension were significantly more likely to have undiagnosed hypertension compared to those who were aware (27.9% vs. 16.7%; odds ratio: 1.81). Lastly, middle-aged participants (30-49 years) and older (50-65 years), were significantly more likely to have undiagnosed hypertension compared to those who were 18-29 years old (30.0% and 23.7% vs. 11.8%; odds ratio: 3.58 and 3.38 vs. 1.00). CONCLUSION The prevalence of undiagnosed hypertension could be substantial among Tongan adults, implicating a need to address this issue by doing further research and review current public health work to address hypertension in Tonga. Undiagnosed hypertension was associated with having no experience of blood pressure measurement, lack of awareness about hypertension, and age. Tongan government should provide people with more opportunities to have their blood pressure measured and to improve their awareness.
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Affiliation(s)
- Seini Siahi Talanoafoou Fifita
- Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.
- Faculty of Nursing and Health Sciences, Tonga National University, Nuku'alofa, Tonga.
| | - Daisuke Nonaka
- Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Mele Tilema Cama
- Faculty of Nursing and Health Sciences, Tonga National University, Nuku'alofa, Tonga
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Wireko MB, Hendricks J, Bedu-Addo K, Van Staden M, Ntim EA, Larbi JA, Owusu IK. Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study. J Prim Care Community Health 2024; 15:21501319241235594. [PMID: 38477301 PMCID: PMC10938620 DOI: 10.1177/21501319241235594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The effect of hypertension is aggravated by lifestyle factors such as alcohol consumption. This study sought to determine the association between alcohol consumption and the level of blood pressures among HIV seronegative and seropositive cohorts. METHODS This secondary analysis was performed on a cross-sectional survey data of 17 922 participants during the period between 2018 and 2020. A questionnaire was used to obtain participants' alcohol consumption history, which was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy alcohol consumers. A linear regression model was used to establish relationships among participants with raised blood pressure (BP ≥ 140/90 mmHg). RESULTS Out of the total participants, 3553 (19.82%) were hypertensives. Almost 13% of the hypertensives (n = 458; 12.89%) were undiagnosed, and 12.44 % (442) had uncontrolled hypertension. About 14.52% of the hypertensives (3553) were not on any antihypertensive medication. Male non-consumers of alcohol had the highest systolic and diastolic BP; uncontrolled systolic BP (165.53 ± 20.87 mmHg), uncontrolled diastolic BP (102.28 ± 19.21mmHg). Adjusted for covariates, moderate alcohol consumption was associated with HTN among participants who were HIV seropositive [unadjusted (RR = 1.772, P = .006, 95% CI (1.178-2.665)], [RR = 1.772, P = .005, 95% CI (1.187-2.64)]. [unadjusted RR = 1.876, P = .036, 95% CI (1.043-3.378)], adjusted RR = 1.876, P = .041, 95% CI (1.024-3.437). Both moderate and heavy alcohol consumption were significantly related to hypertension among HIV sero-negative [unadjusted model, moderate consumption RR = 1.534 P = .003, 95% CI (1.152-2.044)], [adjusted model, moderate alcohol consumption RR = 1.535, P = .006, 95% CI (1.132-2.080)], [unadjusted model, heavy alcohol consumption, RR = 2.480, P = .030, 95% CI (1.091-5.638)], [adjusted model RR = 2.480, P = .034, 95% CI (1.072-5.738)]. CONCLUSION Alcohol consumption is significantly related to increase BP regardless of HIV infection.
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Affiliation(s)
- Manasseh B. Wireko
- Department of Applied and Theoretical Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jacobus Hendricks
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Marlise Van Staden
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | - Emmanuel A. Ntim
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John A. Larbi
- Department of Applied and Theoretical Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac K. Owusu
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Directorate of Medicine, Komfo Anokye Teaching Hospital. Kumasi, Ghana
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Suliman A, Tadesse S, Abute L, Selamu M. Prevalence of undiagnosed hypertension and associated factors among adults in Durame town, Southern Ethiopia: a cross-sectional study. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1205857. [PMID: 38455904 PMCID: PMC10910906 DOI: 10.3389/fepid.2023.1205857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/16/2023] [Indexed: 03/09/2024]
Abstract
Background Undiagnosed hypertension is a major public health problem causing severe cardiovascular disorders that are responsible for a high proportion of morbidities and mortalities, especially among adults living in low-income countries. However, there is a paucity of information that describes its epidemiology in Ethiopia. This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among adults in Durame town, southern Ethiopia. Methods A community-based cross-sectional study was conducted from July to September 2022. Data were collected from 526 randomly selected adults aged ≥18 years using a pre-tested questionnaire. The binary logistic regression models were used to identify factors associated with undiagnosed hypertension. Results The prevalence of undiagnosed hypertension among adults in Durame town, southern Ethiopia, was found to be 14.0% (95% CI: 11.2-17.1). Family history of hypertension [AOR = 6.9, 95% CI: (3.62, 13.27)], drinking too much alcohol [AOR = 5.7, 95% CI: (2.97, 10.75)], physical inactivity [AOR = 2.5, 95% CI: (1.34, 4.73)], consuming street foods regularly [AOR = 2.8, 95% CI: (1.28, 6.01)], and seeking healthcare for hypertensive symptoms without serious illness [AOR = 2.4, 95% CI: (1.28, 4.56)] were significantly associated with developing undiagnosed hypertension. Conclusion The study has revealed that one in seven adults had undiagnosed hypertension in the study area. Thus, interventions to prevent hypertension should target increasing awareness among people with a family history of hypertension, controlling excessive alcohol consumption, promoting physical exercise, regulating street food markets, and improving the health-seeking behavior of adults in urban settings.
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Affiliation(s)
- Abebe Suliman
- School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Sebsibe Tadesse
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lonsako Abute
- School of Public Health, Wachemo University, Hossana, Ethiopia
| | - Markos Selamu
- School of Public Health, Wachemo University, Hossana, Ethiopia
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Ejigu BA, Tiruneh FN. The Link between Overweight/Obesity and Noncommunicable Diseases in Ethiopia: Evidences from Nationwide WHO STEPS Survey 2015. Int J Hypertens 2023; 2023:2199853. [PMID: 38023617 PMCID: PMC10667048 DOI: 10.1155/2023/2199853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/28/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Each year, 15 million adults die from NCDs; more than 85% of these premature deaths occur in low- and middle-income nations. Evidence indicates that overweight and obesity are the main risk factors for NCDs. Although the literature indicates that the burden of NCDs is increasing in Ethiopia, no research has been conducted to demonstrate a link between overweight/obesity and NCDs. Therefore, the aim of this study is to examine the association between overweight/obesity and the common NCDs while adjusting for other important factors. Methods We analysed data from the 2015 Ethiopia WHO STEPS survey, which was conducted in 2015. A total weighted sample of 9,800 participants (15-69 years) was included. The relationship between nutritional status and NCDs was assessed using bivariate and multivariable logistic regression models while adjusting for covariates. Results Among the 9,800 participants, 2053 (21% with (95% CI: 19.8-22.1) had hypertension and 1368 (14% with (95% CI: 13.1-15.0) had high cholesterol levels. According to the multivariable logistic regression analysis, being overweight/obese (AOR = 2.0; 95% CI: 1.7-2.3), alcohol consumption, received lifestyle advice, being female, living in urban areas, increased age, having government occupation, and living in SNNP region were positively associated with hypertension. While being underweight (AOR = 0.6; 95% CI: 0.5-0.7), living in the Afar, Somali, and Tigray regions were negatively associated with hypertension. Being overweight/obese (AOR = 1.4; 95% CI: 1.1-1.7), being female, having older age, and living in Somali region were positively associated with a high cholesterol level. Whereas being underweight (AOR = 0.7; 95% CI: 0.6-0.9), received lifestyle advice, reside in rural areas, being farmer, student, and housewife, and living in Gambela region were negatively associated with a high cholesterol level. Conclusion This study found a statistically positive association between the common NCDs, namely, overweight/obesity, hypertension, and high cholesterol levels. Our findings imply that there is a need for effective interventions to prevent overweight/obesity by encouraging people to increase physical activity, minimize sedentary behavior, and maintain a healthy dietary pattern in order to reduce the risk of hypertension and high cholesterol levels.
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Affiliation(s)
| | - Fentanesh Nibret Tiruneh
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
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Solbana LK, Chaka EE, Tola DE. Undiagnosed hypertension and its associated factors in Ethiopia: A systematic review and meta-analysis. Health Sci Rep 2023; 6:e1696. [PMID: 38028693 PMCID: PMC10643311 DOI: 10.1002/hsr2.1696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Early identification and treatment of hypertension could lower the risk of cardiovascular diseases; which share the largest proportion of death. The findings of previous studies done in Ethiopia on undiagnosed hypertension were inconsistent. Therefore, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of undiagnosed hypertension among adults in Ethiopia. Methods A protocol with registration number CRD42023395445 was registered to Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search of observational studies done on undiagnosed hypertension was identified in PubMed, Google Scholar, Cochrane Library, Hinari databases, and other sources available until January 10, 2023. The quality of the identified studies using the set criteria and necessary data was extracted and exported to R version 4.2.3 and STATA version 15.0 for analysis. The pooled prevalence of undiagnosed hypertension and its associated factors were identified. The risk of bias was evaluated using a funnel plot and Egger's test. The findings were presented using tables, figures, and statements. This study was not funded by any organization. Results Eleven studies having 6132 participants were included in the analysis. The pooled prevalence of undiagnosed hypertension was 21% (95% confidence interval [CI]: 16-27). In subanalysis, according to the American Heart Association ( ≥ 130/80 mmHg), the pooled prevalence was 29% (95% CI: 18-40). However, according to the International Society of Hypertension ( ≥ 140/90), the pooled prevalence was 16% (95% CI: 13-20).Sex (AOR = 2.49, 1.48-3.49), age ≥55 years (AOR = 2.68, 1.16-4.21), alcohol drinking (AOR = 2.68, 1.68-3.69), body mass index ≥25 kg/m2 (AOR = 2.62, 1.77-3.48), and high triglyceride levels (AOR = 1.87, 1.22-2.51) were significantly associated with it. Conclusion In Ethiopia, about one in five adults ≥ 18 years has undiagnosed hypertension; therefore raising public awareness for medical checkups, early hypertension detection, and treatment is suggested. However, these findings cannot be generalized to pediatrics.
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Affiliation(s)
| | | | - Diriba Etana Tola
- Department of Nursing, College of Health SciencesAssosa UniversityAssosaEthiopia
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Ambaw Kassie G, Alemu A, Yosef Gebrekidan A, Asmare Adella G, Eshetu K, Wolie Asres A, Sisay Asgedom Y. Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:278. [PMID: 37244992 PMCID: PMC10225092 DOI: 10.1186/s12872-023-03300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/13/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Hypertension is a major public health problem, resulting in 10 million deaths annually. Undiagnosed hypertension affects more people than ever before. It is more likely to be linked to severe hypertension, which can lead to stroke, cardiovascular disease, and ischemic heart disease. Thus, this systematic review and meta-analysis aimed to synthesize the prevalence of undiagnosed hypertension and its associated factors in Ethiopia. METHODS Databases, such as Medline/PubMed, Google Scholar, Science Direct, AJOL, and the Cochrane Library, were systematically searched to find potential studies published until December 2022. A Microsoft Excel spreadsheet was used to enter the extracted data. The pooled prevalence of undiagnosed hypertension and its associated factors was estimated using a random effect model. I2 statistics and the Cochrane Q-test were used to assess statistical heterogeneity across the studies. Begg's and Egger's tests were performed to identify possible publication bias. RESULTS A total of ten articles with 5,782 study participants were included in this meta-analysis. In the random effects model, the pooled prevalence of undiagnosed hypertension was 18.26% (95% CI = 14.94-21.58). Being older (OR = 3.8, 95% CI = 2.56, 5.66), having a body mass index > 25 kg/m2 (OR = 2.71, 95% CI = 2.1, 3.53), having a family history of hypertension (OR = 2.22, 95% CI = 1.47, 3.36), and having DM comorbidity (OR = 2.44, 95% CI = 1.38, 4.32) were significantly associated with undiagnosed hypertension. CONCLUSION In this meta-analysis, the pooled prevalence of undiagnosed hypertension was found to be high in Ethiopia. Being older, having a BMI > 25 kg/m2, having a family history of hypertension, and having DM comorbidity were found to be risk factors for undiagnosed hypertension.
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Affiliation(s)
- Gizachew Ambaw Kassie
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Afework Alemu
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Abiyot Wolie Asres
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Moloro AH, Seid AA, Jaleta FY. A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa. SAGE Open Med 2023; 11:20503121231172001. [PMID: 37181276 PMCID: PMC10170600 DOI: 10.1177/20503121231172001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Objective This systematic review and meta-analysis will investigate the pooled prevalence of hypertension and associated factors among bank workers in Africa. Methods Studies published with full texts in English will be searched in the PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, African Journals Online, and Google Scholar databases. Checklists from the Joanna Briggs Institute will be used to assess the studies' methodology quality. Data extraction, critical appraisal, and screening of all retrieved articles will be conducted by two independent reviewers. Statistical analysis will be performed using STATA-14 software packages. A random effect will be employed to demonstrate pooled estimates of hypertension among bank workers. For determinants of hypertension, an effect size with a 95% confidence interval will be analyzed. Results Data extraction and statistical analyses will begin after identifying the most pertinent studies and evaluating their methodological quality. Data synthesis and the presentation of the results are scheduled for completion by the end of 2023. After the review is completed, the results will be presented at relevant conferences and published in a peer-reviewed journal. Conclusion Hypertension is a major public health concern in Africa. More than 2 out of 10 people aged older than 18 years suffer from hypertension. A number of factors contribute to hypertension in Africa. These factors include female gender, age, overweight or obesity, khat chewing, alcohol consumption, and family history of hypertension and diabetes mellitus. To address the alarming rise in hypertension in Africa, behavioral risk factors should be given primary attention. Protocol registration This systematic review and meta-analysis protocol is registered in PROSPERO with the registration ID and link as follows: CRD42022364354;CRD-register@york.ac.ukhttps://www.york.ac.uk/inst/crd.
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Affiliation(s)
- Abdulkerim Hassen Moloro
- Abdulkerim Hassen Moloro, Department of Nursing, College of Medicine and Health Science, Samara University, Samara, P.O. Box 132, Afar, Ethiopia.
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Hossain A, Suhel SA, Chowdhury SR, Islam S, Akther N, Dhor NR, Hossain MZ, Hossain MA, Rahman SA. Hypertension and undiagnosed hypertension among Bangladeshi adults: Identifying prevalence and associated factors using a nationwide survey. Front Public Health 2022; 10:1066449. [PMID: 36561867 PMCID: PMC9763893 DOI: 10.3389/fpubh.2022.1066449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background Although undiagnosed hypertension (HTN) is a serious concern worldwide, it is less of an importance in Bangladesh, where there is a dearth of research on the subject. So, we aimed to identify the prevalence and associated factors for diagnosed and undiagnosed HTN. Methods We analyzed the recent 2017-2018 Bangladesh Demographic and Health Survey data. We included 11,981 participants aged 18 years and above for the analysis. The prevalence rates of both diagnosed and undiagnosed hypertension were computed for all individuals and subgroups. The influence of socio-demographic, household, and community-related variables on HTN and undiagnosed HTN was investigated using multinomial regression analysis. Results The study finds 1,464 (12.2%) of the 11,981 respondents [6,815 females [56.9 %]; mean age 39.4 years] had diagnosed HTN, whereas 1 898 (15.8%) had undiagnosed HTN. The HTN and undiagnosed HTN were significantly prevalent in the elderly, type 2 diabetic (T2DM), and overweight and obese individuals. In terms of residential regions, people from coastal region had a significantly higher prevalence of both HTN (RRR: 1.37; 95% CI: 1.17-1.62) and undiagnosed HTN (RRR: 1.35; 95% CI: 1.17-1.56) compared to those from the central region of Bangladesh. Conclusions The high prevalence of undetected hypertension in Bangladesh suggests that screening procedures for the current chronic illness may be inadequate in routine clinical practice. All populations should have access to hypertension screening, but it is especially crucial for the elderly, those with diabetes, those who are overweight or obese, and those from coastal and northern regions of Bangladesh.
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Affiliation(s)
- Ahmed Hossain
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,Department of Public Health, North South University, Dhaka, Bangladesh
| | | | - Saifur Rahman Chowdhury
- Department of Public Health, North South University, Dhaka, Bangladesh,Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada,*Correspondence: Saifur Rahman Chowdhury
| | - Shofiqul Islam
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Nayma Akther
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Nipa Rani Dhor
- Department of Public Health, North South University, Dhaka, Bangladesh
| | | | | | - Syed Azizur Rahman
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Ayalew TL, Wale BG, Zewudie BT. Burden of undiagnosed hypertension and associated factors among adult populations in Wolaita Sodo Town, Wolaita Zone, Southern Ethiopia. BMC Cardiovasc Disord 2022; 22:293. [PMID: 35761173 PMCID: PMC9238150 DOI: 10.1186/s12872-022-02733-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Hypertension is defined as two or more measurements of systolic blood pressure equal to or greater than 130 mm Hg or diastolic blood pressure equal to or greater than 80 mm Hg. At the community level, symptoms of hypertension are not often detected in the early stages and it leads to many people being left undiagnosed with the disease. Undiagnosed hypertension increases the risk of complications like heart failure, kidney failure, myocardial infarction, stroke, and premature death. There is a paucity of studies concerning the burden of undiagnosed hypertension in Ethiopia including the study area. Therefore, this study aimed to assess the burden of undiagnosed hypertension among adults in Wolaita Sodo Town, Wolaita Zone, Southern Ethiopia,2021. Methods and materials A community-based cross-sectional study involving 662 study participants was conducted at Wolaita Sodo Town from May 3 to July 3, 2021. A systematic random sampling technique was used to select the total number of participants. The data was entered using Epidata version 3, and analyzed by SPSS version 25 respectively. Binary logistic regression was used to check for a possible association. P-values < 0.05 and 95% CI were used on multi-variable analysis as the threshold for the significant statistical association. Results A total of 644 have participated in the study giving a response rate of 97.3%. The mean (± SD) age of the study participants was 39.18 (± 10.64) years. This finding showed that the burden of undiagnosed hypertension was 28.8% (95% CI: 24.7–33.2%). Body mass index with overweight (AOR = 2.83, 95% CI: 1.17–6.86), the presence of unrecognized diabetic mellitus (AOR = 1.31 95% CI: 1.11–2.15) habit of alcohol drinking (AOR = 2.91, 95% CI: 1.31–4.48), triglyceride (AOR = 3.48 95% CI: 1.22–9.95), age 31–43 years (AOR = 1.50, 95% CI: 1.02–2.01) were significantly associated factors with undiagnosed hypertension. Conclusions The burden of undiagnosed hypertension findings was high. Body mass index with overweight, unrecognized diabetic mellitus the habit of alcohol drinking, triglyceride, and age 31–43 years were the factors with undiagnosed hypertension. These findings suggested that preventing risk factors and screening for hypertension at the community level should be encouraged for early detection, and monitoring of the burden of hypertension with ages more than 30 years old, high body mass index, and undiagnosed diabetic mellitus in the population. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02733-3.
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Essa E, Shitie D, Yirsaw MT, Wale MZ. Undiagnosed hypertension and associated factors among adults in Debre Markos town, North-West Ethiopia: A community-based cross-sectional study. SAGE Open Med 2022; 10:20503121221094223. [PMID: 35558191 PMCID: PMC9087240 DOI: 10.1177/20503121221094223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Globally, hypertension is an important risk factor for cardiovascular diseases and all-cause mortality. Despite this high public health burden, no community-based evidence regarding the magnitude and related factors of hypertension has been reported in the study area. Objective: The aim of this study was to determine the prevalence and associated factors of undiagnosed hypertension in Debre Markos town, North-West Ethiopia, 2020. Method: A community-based cross- sectional study design was conducted from January to March 2020. Socio-demographic and behavioral characteristics of the participants were collected using interviewer-administered semi-structured questionnaires. Physical measurements including body mass index, waist circumference, and blood pressure were collected using standardized measuring instruments. Statistical analysis was collected using SPSS version 21 software. Univariate logistic regression model was used to present the results. The p value less than 0.05 in a multivariable analysis was considered statistically significant at 95% confidence interval. Results: From a total of 630 samples, 600 participants, 270 (45%) males and 330 (55%) females with a mean age of 36.32 ± 12.48 years, were participated giving a response rate of 95.2%. The prevalence of undiagnosed hypertension among adults was 12.7%. Of these, 5.5% were males and 7.2% were females. Factors including age (above 60 years) (adjusted odds ratio = 2.92, 95% confidence interval (1.05, 8.06), p = 0.03), body mass index (overweight and obese) (adjusted odds ratio = 3.85, 95% confidence interval (2.16, 6.87), p < 0.01), fatty diet consumption (adjusted odds ratio = 1.88, 95% confidence interval (1.03, 3.42), p = 0.04), family history of hypertension (adjusted odds ratio = 2.21, 95% confidence interval (1.04, 4.69), p = 0.04) were significantly associated with hypertension. Conclusion: The prevalence of undiagnosed hypertension among adults was found to be remarkable. Therefore, a community-based health education and hypertension screening strategies are needed to prevent the problem early in life in Debre Markos town and the nation at large.
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Affiliation(s)
- Enatnesh Essa
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Dessalegn Shitie
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mesenbet Terefe Yirsaw
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistu Zelalem Wale
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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