Undiagnosed Hypertension and Associated Factors Among Adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: A Community-Based Cross-Sectional Study

Trend, burden and determinants of undiagnosed hypertension in the Horn of Africa: A systematic review and meta-analysis

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.

Prevalance and determinants of hypertension among adults in Somalia using Somalia demographic health survey data, SDHS 2020

BACKGROUND

Hypertension, a major global health concern, continues to affect millions of adults worldwide, leading to significant morbidity and mortality. The burden of hypertension is particularly pronounced in low- and middle-income countries, where limited healthcare resources and infrastructure pose unique challenges for effective prevention and management. Despite the pressing need for accurate data on hypertension prevalence and determinants, there is a dearth of research focusing on the Somali population. In this study, we aim to fill this critical knowledge gap by analyzing the latest available data from the Somalia Demographic Health Survey (SDHS) conducted in 2020.

METHOD

The SDHS 2020 employed a three-stage stratified cluster sampling design to collect data from 48,796 individuals. Hypertension was measured through survey questions related to chronic diseases. Explanatory variables included age, sex, region, residence, tobacco use, wealth index, marital status, and body mass index (BMI). Statistical analysis involved univariate and multivariable logistic regression.

RESULTS

The prevalence of hypertension in Somalia was found to be 2.11%, lower than previous studies in Hargeisa and the SLHDS 2020 report. Females had a higher prevalence than males, and urban areas exhibited higher rates compared to rural areas. Age, BMI, region, and wealth index were identified as significant factors associated with hypertension.

DISCUSSION

The study's findings contribute to the understanding of hypertension in the Somali population and can inform public health interventions. The study benefits from its representative sample, multivariate analysis, and comparison with earlier studies. However, limitations include the cross-sectional design, limited information on lifestyle behaviors, and lack of data on treatment and control of hypertension.

CONCLUSION

Hypertension is a public health concern in Somalia, and targeted interventions are needed to reduce its burden. Addressing factors such as age, gender, urban residence, BMI, and wealth index can contribute to hypertension management and control strategies. Future research should consider longitudinal studies and incorporate additional factors for a comprehensive assessment of hypertension etiology and management.

Undiagnosed hypertension and associated factors among adult population in central zone of Tigray, Northern Ethiopia 2020: A cross-sectional study

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.

Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study

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.

How well do obesity indices predict undiagnosed hypertension in the Persian cohort (Shahedieh) adults community population of all ages?

Background and Aims

Hypertension is the leading preventable risk factor for cardiovascular disease, chronic kidney disease and cognitive impairment, and mortality and disability worldwide. Since prevention, early detection, and treatment of blood pressure improve public health, the aim of present study was to determine the best obesity indices and estimate the optimal cut-off point for each one to predict the risk of elevated/stage 1 and undiagnosed hypertension in the population of center of Iran based on American ACC/AHA 2020 guidelines.

Methods

This cross-sectional study was performed on 9715 people who enrolled in 2018 in Persian Adult Cohort in Shahedieh area of Yazd, Iran in 2018. The anthropometric indices including body mass index (BMI) and waist circumference (WC), wrist circumference, hip circumference, waist-to-hip ratio, and waist-to height ratio of individuals, were extracted. The receiver operating characteristic curve was utilized to determine the optimum cut-off point of each anthropometric index to predict hypertension stages and compare their predictive power by age-sex categories. Statistical analysis was done using SPSS version 23.0.

Results

The results showed that BMI has the best predictive power to recognize the risk of elevated/stage 1 hypertension for female (area under the curve [AUC] = 0.72 and optimal cut-off = 30.10 kg/m2) and WC for male (AUC = 0.66 and optimal cut-off = 93.5 cm) in 35-45 age group. BMI had the best predictive power for the risk of undiagnosed hypertension for 35-45 years old male (AUC = 0.73 and optimal cut-off = 28.90 kg/m2) and female (AUC = 0.75 and optimal cut-off = 5.10 kg/m2), and hip circumference revealed similar predictive power for female as well (AUC = 0.75 and optimal cut-off = 112 cm).

Conclusion

Based on our findings, BMI and WC, which are simple, inexpensive, and noninvasive means, are the best markers to predict the risk of elevated/stage 1 and undiagnosed hypertension in young Iranians. It shows that the approach of reducing hypertension prevalence through primary prevention, early detection, and enhancing its treatment is achievable.

Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study

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.

A systemic review and meta-analysis on the prevalence and associated factors of hypertension among adult clients in Ethiopia

Background

Hypertension is a major risk factor for premature mortality and excessive morbidity in the world. It is a growing public health problem in developing countries including Ethiopia. It is a silent killer. Information on the prevalence of hypertension and its associated factors is to be considered vital to focus on early diagnosis and improve prevention and control of cardiovascular diseases. However, on the prevalence and contributing factors of hypertension in Ethiopia, there is a dearth of information. Thus, this review aimed to estimate the pooled prevalence of hypertension and its contributing factors among Ethiopia's adult population.

Objective

The main objective of this study was to provide pooled evidence on the prevalence of hypertension among the adult population in Ethiopia.

Methods and material

This systematic review and meta-analysis were searched through MEDLINE/ Pub Med, Cochrane Library, and Google Scholar by using different search terms on the prevalence of hypertension and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies. Egger's test was used to show the publication bias. The pooled prevalence of HDP and the odds ratio (OR) with 95% confidence interval were presented using forest plots.

Results

A total of 22 studies with 14,202 participants were included in this review and the overall estimated prevalence of hypertension among the adult population in Ethiopia was 28.02% (95% CI (23.89%, 32.15%). Age 4.37(2.71, 6.04), sex (AOR=2.54, 95% CI: 1.00-4.09), family history of hypertension (AOR=3.05, 95% CI, 1.89, 4.21), inactive physical exercise (AOR=2.67, 95% CI: 1.38, 3.97), being obese (AOR=3.94, 95CI:2.83, 5.06), khat chewing (AOR=3.73, 95% CI: 2.65, 4.80), salt consumption (AOR=4.20, 95% CI: 1.55, 6.86) were significantly associated factors. Subgroup meta-analysis done by region showed that a higher in Tigray region 52.19(46.54, 57.66), and the lower was observed in Harare region1 2.71 (9.54, 15.87).

Conclusion

The prevalence of hypertension among the adult population in Ethiopia is high. Healthcare professionals and other stakeholders should give attention to the early detection of hypertension in Ethiopia to reduce the burden of the disorder.

Prevalence of undiagnosed hypertension and associated factors among adults in Durame town, Southern Ethiopia: a cross-sectional study

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.

Undiagnosed hypertension and its associated factors in Ethiopia: A systematic review and meta-analysis

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.

Undiagnosed Hypertension Among Market Salespersons in Kitgum Central Market, Northern Uganda

Introduction

Hypertension may be common among market salespersons who are mostly physically inactive throughout the day. However, the burden of hypertension in this population remains unknown. In this study, we determined the prevalence of undiagnosed hypertension and associated factors among market salesperson in Kitgum central market, Kitgum district, Northern Uganda.

Methods

A cross-sectional study, recruiting market salespersons aged 18 years or older without a prior diagnosis of hypertension or currently on anti-hypertensive therapy was conducted. A standardized questionnaire was administered, and body mass index (BMI) estimated. Hypertension was defined as two consistent measurements of systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg measured 4 hours apart. Multivariable logistic regression analysis was performed to determine factors independently associated with undiagnosed hypertension. P<0.05 was considered statistically significant.

Results

We enrolled 240 participants. The mean age was 39.4 ± 12.8 years. Most (83.3%, n=199) participants were female and urban dwellers (88.3%, n=212). The prevalence of undiagnosed hypertension was 16.7% (n=40). Of the 40 participants with hypertension, 16 (40%) were younger than 40 years. Factors associated with undiagnosed hypertension were, age >50 years (adjusted odds ratio (aOR): 7.0, 95% confidence interval (CI): 1.9-25.6, p=0.003), male gender (aOR: 4.2, 95CI: 1.5-11.1, p=0.005), alcohol consumption (aOR: 2.6, 95CI: 1.1-6.0, p=0.021), and being overweight (aOR: 3.6, 95CI: 1.5-8.8, p=0.005).

Conclusion

About one in six of market salespersons had undiagnosed hypertension, with a disproportionately high burden among those younger than 40 years. A larger multi-centric study is recommended to confirm our findings.

Co-occurrence of hypertension and type 2 diabetes: prevalence and associated factors among Haramaya University employees in Eastern Ethiopia

Background

Both hypertension (HTN) and diabetes are public health concerns in low- and middle-income countries, particularly in sub-Saharan African countries. The co-occurrence of HTN and diabetes is associated with an increased risk of mortality, morbidity, and reduced productivity in the working force. In Ethiopia, there is limited evidence on the co-occurrence of HTN and type 2 diabetes (T2DM). Therefore, this study was conducted to assess the co-occurrence of HTN and T2DM and their associated factors among Haramaya University employees in Eastern Ethiopia.

Methods

A cross-sectional survey was conducted among 1,200 employees at Haramaya University using a simple random sampling technique from December 2018 to February 2019. Demographic and behavioral factors were collected on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Blood glucose and lipid profile measurements were performed by collecting 6 ml of venous blood samples after 8 h of overnight fasting. Data were entered into EpiData 3.1 version and analyzed using Stata 16 software. Bivariable and multivariable logistic regressions were applied to observe the association between independent variables with co-occurrence of HPN and T2DM using odds ratio, 95% confidence interval (CI), and p-values of ≤ 0.05 were considered statistically significant.

Results

The prevalence of HTN and T2DM was 27.3 and 7.4%, respectively. The co-occurrence of HTN and T2DM was 3.8%. The study found that being older (AOR = 3.97; 95 % CI: 1.80-8.74), khat chewing (AOR = 2.76; 95 % CI: 1.23-6.18), body mass index ≥ 25 kg/m² (AOR = 5.11; 95 % CI: 2.06-12.66), and sedentary behavior ≥8 h per day (AOR = 6.44; 95 % CI: 2.89-14.34) were statistically associated with co-occurrence of HTN and T2DM. On the other hand, consuming fruits and vegetables (AOR = 0.10; 95 % CI: 0.04-0.22) and a higher level of education (AOR = 0.39; 95% CI: 0.17-0.89) were negatively statistically associated with the co-occurrence of HTN and T2DM.

Conclusion

The co-occurrence of HTN and T2DM was prevalent among the study participants. This may create a substantial load on the healthcare system as an end result of increased demand for healthcare services. Therefore, rigorous efforts are needed to develop strategies for screening employees to tackle the alarming increase in HTN and T2DM in university employees.

Prevalence of Undiagnosed Hypertension and Associated Factors among Adults in Mizan-Aman Town, Bench Sheko Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study

Objectives

This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among people aged 18 years and above in Mizan-Aman town of Bench Sheko Zone in Southwest Ethiopia. Study Design. A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town.

Methods

A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Seven hundred fifty-nine subjects were selected by the multistage sampling technique. A structured pretested STEPwise questionnaire was used to interview the participants. Data entry and analysis were done using EpiData 3.1 and SPSS version 25 statistical software, respectively. Descriptive analysis was undertaken, and the results were presented using frequency tables, graphs, and statistical summaries. The dependent variable has a dichotomized response of yes and no, and hence binary logistic regression was used to predict a dependent variable based on independent variables, and predictors having p ≤ 0.25 on the bivariable analysis were considered as candidates for the multivariable analysis. Odds ratios with their 95% confidence intervals were calculated to measure the strength of association, and finally a p value <0.05 was considered statistically significant.

Result

The prevalence of undiagnosed hypertension was 14.8% with 95% CI [12.3-15.6]. Older age (AOR = 3.1, 95% CI [1.5-6.5]), male (AOR = 2.2, 95% CI [1.3-3.9]), low physical activity (AOR = 3.9, 95% CI [1.8-8.3]), low consumption of fruit and vegetable (AOR = 4.5, 95% CI [2.4-8.8]), and higher BMI (AOR = 2.7, 95% CI [1.6-4.6]) were significantly associated with undiagnosed hypertension.

Conclusion

The current study outlined that the prevalence of undiagnosed hypertension was high in the study area. In addition, most of the risk factors identified were modifiable, and hence community-based preventive approaches like lifestyle modification, increasing awareness, and strengthening routine screening at primary health service facilities resulted in a substantial change in tackling the burden effectively.

Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis

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.

Employees of the banking sector in Guizhou Province in China: prevalence of migraine, symptoms, disability and occupational risk factors

BACKGROUND

Although studies have identified a high prevalence of migraine among employees in the banking sector, the symptoms of migraine, related disability and occupational risk factors are not well understood.

AIMS

To determine migraine prevalence, symptoms and disability among bank employees in Guizhou province in China and to examine occupational risk factors associated with migraine positivity and symptoms.

METHODS

In a cross-sectional survey, two-stage probability sampling was used to select bank employees in Guizhou province, China. From May to October 2022, uniformly trained interviewers conducted face-to-face interviews using the HARDSHIP questionnaire. Logistic regression was used to examine factors associated with migraine positivity and symptoms.

RESULTS

Of 1,985 contactable eligible subjects, 1,929 (male 45.4%, female 54.6%) completed the survey. The one-year prevalence of migraine was 27.2% (95% CI 25.2-29.2%). Of migraine-positive individuals, 11.2% had a monthly frequency ≥ 15 days, 11.8% had an attack duration > 72 h, and 14.9% had severe pain intensity. The median of days lost from work, housework and social activities due to migraine during a three-month period was 4, 3 and 2 days, respectively, with more than half (52.8%) patients reporting Grade III or IV disability. In multivariable analyses, positions in data analysis (OR = 1.8 [95% CI 1.2-2.8], p < 0.01) and information technology (OR = 3.8 [95% CI 1.7-8.3], p < 0.01) were occupational risk factors for migraine positivity. It was also found that professional positions were predictive of migraine attacks ≥ 15 days per month, administrative positions were predictive of duration > 72 h and severe pain intensity of migraine attacks, and working in remote branches was predictive of duration > 72 h.

CONCLUSIONS

Migraine is prevalent among employees in the banking sector in Guizhou province in China, with a large proportion of sufferers carrying a high burden of symptoms and disability. The practical implication of this study is that the risk factors identified here could be translated to the focus of workplace monitoring and interventions to manage and prevent migraine.

Blood Pressure Examination Habit and Its Determinants Among Civil Servants in Arba Minch Town: A Cross-Sectional Study - Using Hurdle Poisson Regression Model

Background

Hypertension is a common non-communicable disease detected through blood pressure measurement that makes periodic health examinations crucial for the detection, prevention, and timely treatment.

Objective

To assess the frequency of blood pressure examination and its determinant among civil servants in Arba Minch Town, south Ethiopia.

Methods

From February to March 2020 an organization-based cross-sectional study design was employed among civil servants in Arba Minch town. Data were collected from 580 randomly selected civil servants using a well-structured questionnaire. Hurdle Poisson regression model was conducted to identify determinants of frequency of blood pressure examination using R version 4.0.2.

Results

A total of 407 (70.2%) civil servants had never examined their blood pressure within a year before the study time. The mean frequency of blood pressure examination was 0.71 with a standard deviation of 1.46. The hurdle Poisson regression analysis indicates age above 40 years (IRR = 6.11, p < 0.001), elevated blood pressure (IRR = 1.48, p < 0.001), no family history of hypertension (IRR = 0.59, p < 0.001) had significant effects on the expected number of non-zero counts blood pressure examination. And education status (OR; 2.39, p < 0.05), poor knowledge about hypertension, not getting advice from health professionals (OR = 8.93, p < 0.001), and age above 40 years had significant effects on not taking blood pressure examination.

Conclusion

The frequency of blood pressure examinations among civil servants was found to be low. This study reveals age, elevated blood pressure, family history of hypertension, getting advice, and knowledge on hypertension were found to be determinants of the frequency of blood pressure examination. Thus, concerned health authorities and medical workers should work on these factors to prevent and detect hypertension among apparently healthy civil servants.

Undiagnosed status and associated factors of hypertension among adults living in rural of central, Ethiopia, 2020: Uncovering the hidden magnitude of hypertension

BACKGROUND

Hypertension is a major risk factor for cardiovascular (CVD) disease related deaths worldwide. It affects more than 20% of adults in Ethiopia, making it a major public health concern. Although it is important to uncover the hidden extent of hypertension, there is limited information on the proportion of undiagnosed hypertension in rural areas of the country.

OBJECTIVE

This study aimed to determine the magnitude of undiagnosed hypertension and associated factors among adults living in the rural Dano district, Central Ethiopia 2020.

METHODS AND MATERIALS

A quantitative, community-based cross-sectional study conducted from May to July 2020. A three-stage sampling technique was used to select a total of 605 study participants. A Validated tool was used to assess the participant's behavioral characteristics. Blood pressure was measured using digital blood pressure apparatus. The mean of three blood measurements was used to classify hypertension after intra-class correlation was tested. Standardized instruments were used to assess participants' health-seeking behavior and knowledge of the hypertensive disease. The proportion of undiagnosed hypertension was determined among patients with hypertension. The regression analyses were done to determine factors associated with undiagnosed hypertension. The adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was set at a p-value < 0.05.

RESULTS

The prevalence of undiagnosed hypertension was 21.32% (CI: 19.95%, 25.8%). Living in a household with the low wealth index [(AOR: 3.5,95%CI: (1.6,6.4)], far distance to health facility, [(AOR: 0.155,95%CI: (0.11.0.67)], underweight, [AOR = 2.2.1,95%CI:(2.00,4.22)], use of smokeless tobacco products, [AOR = 3.2,95%Cl:(1.88,4.75)], and participants' knowledge of hypertension were independently associated with undiagnosed hypertension.

CONCLUSION

This study shows that undiagnosed hypertension is a major public health problem in the study area. Living in a household with a low wealth index, being far from a health facility, being underweight, using smokeless tobacco products, and having little knowledge about hypertension increase the likelihood of having undiagnosed Hypertension. Hypertension health information, particularly to smokes tobacco users, could improve the perceived susceptibility to hypertensive disease, and reduce the hidden extent of hypertension.

Burden of undiagnosed hypertension and associated factors among adult populations in Wolaita Sodo Town, Wolaita Zone, Southern Ethiopia

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.

Undiagnosed hypertension and associated factors among adults in Debre Markos town, North-West Ethiopia: A community-based cross-sectional study

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.

Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis

OBJECTIVES

Non-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults.

RESEARCH DESIGN AND METHODS

This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings.

RESULTS

From 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years.

CONCLUSIONS

A signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.

Undiagnosed hypertension in Peru: analysis of associated factors and socioeconomic inequalities, 2019

OBJECTIVE

To determine the factors associated and measure the socioeconomic inequalities in people with undiagnosed hypertension in Peru.

MATERIALS AND METHODS

An observational, cross-sectional, analytical study was performed using data from the 2019 Demographic and Family Health Survey (ENDES, acronym in Spanish) database. The dependent variable was the presence of undiagnosed hypertension (mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg in the two blood pressure measurements and with no prior diagnosis of hypertension by a health care professional). Adjusted prevalence ratios were estimated to determine the factors associated with undiagnosed hypertension. The socioeconomic inequality in undiagnosed hypertension was estimated using concentration curves and the Erreygers concentration index.

RESULTS

67.2% of 3697 persons with hypertension had not been diagnosed. Non-diagnosis of hypertension was more prevalent in men who were residents of the Coast and in inhabitants residing at more than 3000 m above sea level. Being 50 years of age or older, having health insurance, being obese and having diabetes mellitus were associated with a lower prevalence of undiagnosed hypertension. Inequality of the non-diagnosis of hypertension was found to be concentrated in the poorest population.

CONCLUSIONS

At least one out of every two adult Peruvians with hypertension have not been diagnosed with this condition. Socioeconomic inequality was found, as well as socio-demographic and health-related factors associated with undiagnosed hypertension. Our findings identify some population subgroups in which interventions for screening and treatment of hypertension should be prioritized in order to reduce both inequalities and complications of hypertension among the most vulnerable.

Undiagnosed hypertension and associated factors among bank workers in Bahir Dar City, Northwest, Ethiopia, 2020. A cross-sectional study

Background

Undiagnosed hypertension is defined as individuals who were hypertensive but did not report having been told by a health professional that they have hypertension. It is an important risk factor for development of chronic kidney disease, cardiovascular disease and all-cause mortality. Despite those problems and benefits of finding individuals with undiagnosed hypertension to prevent its outcomes, no enough investigations have been done regarding the prevalence and associated factors of undiagnosed hypertension. Therefore, the objective of this study was to assess the prevalence of undiagnosed hypertension and its associated factors among bank workers in Ethiopia.

Methods

An institutional based cross-sectional study was held at Bahir Dar city bank workers. The simple random sampling technique was used to select the study participants. Self-administered structured questionnaire and physical measurement were used to collect data. The data were entered into EPI data 3.1 versions and exported to SPSS version 23.0 statistical software for further analysis. In order to decide the association between independent and dependent variables; multivariate logistic regression analysis was implemented. A P-value of < 0.05 was used as the criterion for statistical significance and OR with 95% confidence interval was used to indicate the strength of association.

Result

In this study from a total of 524 participants 513 were completed the questionnaire correctly, which gives a response rate of 97.9%. The overall prevalence of undiagnosed hypertension among bank workers was 24.8% with (95% CI 21.1–28.5). Multivariate logistic regression revealed that age 35–44 [AOR = 2.56, 95% CI: (1.60–4.09)], being male [AOR = 3.61, 95% CI: (1.84–7.05)], having moderate knowledge [AOR = 3.81, 95% CI: (2.29–6.34)], having poor knowledge [AOR = 6.19, 95% CI: (3.07-)12.48], and being physically inactivity [AOR = 2.91, 95% CI: (1.26–6.76)] were variables significantly associated with undiagnosed hypertension.

Conclusion

The prevalence of undiagnosed hypertension among bank workers in Bahir Dar city was found to be high. An age group of 35–44 years, being male, having moderate and poor knowledge and being physically inactivity was the variables that were significantly associated with undiagnosed hypertension. Therefore, creating awareness, frequent screening and implementation of an appropriate intervention for this vulnerable group is important.