Risk factors for hypertension and frequency of target organ damage in hypertensive adults in Kampala

Abstract

Background: Hypertension is the leading risk factor for premature death and disability worldwide. Epidemiologic data on risk factors for hypertension among adults in urban Uganda is currently lacking.

Objectives: 1) To determine the risk factors of hypertension in adults in Kampala; 2) To determine the prevalence of left-ventricular hypertrophy and micro-albuminuria in hypertensive adults of Kampala.

Materials and methods: We recruited 315 cases and 315 controls attending a community hypertension screening program at two large churches and one mosque. Participants were interviewed, physically examined and provided a blood sample for testing; cardiac imaging and urinalysis were performed on cases to assess for target organ damage.

Result: The study enrolled 315 hypertensive who were matched with equal number of none hypertensive by age group and sex. The participants had mean age of 44.3 years (range= 18 – 85). At overall model analysis, compared to those with a normal BMI, being overweight increased the odds of hypertension by 50% (OR=1.5, 95%CI: 1.18-2.05, p= 0.01) and obesity by 101% (OR =2.0, 95% CI: 1.23-3.27, p= 0.01). There was a significant increase in the odds of hypertension for: smokers vs nonsmokers (OR=1.64, 95%CI: 1.08-2.5, p=0.06), positive family history of diabetes vs none (OR=1.4, 95% CI: 0.98-1.98) and abnormal waist hip ratio vs normal (OR= 1.5, 95% CI: 0.94-2.45, p=0.09) in males. The prevalence of target organ was 32.2% for micro-albuminuria and 28% for LVH.

Conclusion: In an urban population in Uganda, risk of hypertension increases with high BMI, smoking, abnormal waist-hip ratio and family history of diabetes. The high prevalence of target organ damage indicates a high burden of advanced hypertension in the community that may be undiagnosed. Public health interventions targeted at risk reduction and early diagnosis will be essential in addressing the burden of hypertension among urban dwellers