Stroke-Risk Factors Differ between Rural and Urban Communities: Population Survey in Central Uganda

Abstract

Background: Socioeconomic transition is changing stroke risk factors in Sub-Saharan Africa. This study assessed stroke-risk factors and their associated characteristics in urban and rural Uganda. Methods: We surveyed 5,420 urban and rural participants and assessed the stroke-risk factor prevalence and socio-behavioural characteristics associated with risk factors. Results: Rural participants were older with higher proportions of men and fewer poor compared to urban areas. The most prevalent modifiable stroke-risk factors in all areas were hypertension (27.1% rural and 22.4% urban, p = 0.004), overweight and obesity (22.0% rural and 42% urban, p < 0.0001), and elevated waist hip ratio (25.8% rural and 24.1% urban, p = 0.045). Diabetes, smoking, physical inactivity, harmful alcohol consumption were found in ≤5%. Age, family history of hypertension, and waist hip ratio were associated with hypertension in all, while BMI, HIV were associated with hypertension only in urban dwellers. Sex and family history of hypertension were associated with BMI in all, while age, socio-economic status and diabetes were associated with BMI only in urban dwellers. Conclusions: The prevalence of stroke-risk factors of diabetes, smoking, inactivity and harmful alcohol consumption was rare in Uganda. Rural dwellers belonging to a higher age group tended to be with hypertension and elevated waist hip ratio. Unlike high-income countries, higher socioeconomic status was associated with overweight and obesity.

Determinants of Hypertension in Urban Uganda: A Community-Based Case-Control Study

“…Previous studies of risk factors for hypertension in rural, urban, and mixed rural-urban populations in Uganda 7,9-15 also reported significant associations of higher BMI with hypertension while certain studies reported significant associations of random or fasting blood glucose levels, 10,12,15 alcohol consumption, 9,12,15 WHR, 10,15 or education level 9,10 with hypertension. Notably, our study is the first investigation in Uganda to find significantly reduced odds of raised blood pressure with regular physical activity.…”

“…7,[9][10][11][12][13][14][15] We undertook this study to identify the determinants of raised blood pressure in an exclusively urban population in Kampala, the capital of Uganda.…”

Kidney disease in Uganda: a community based study

“…Between August 2012 and August 2013, MEPI-CVD (Medical Education Partnership Initiative on Cardiovascular Diseases) conducted a cross-sectional community based survey in an urban and a rural sub-county in Wakiso district to determine the prevalence and risk factors for cardiovascular disease [15]. The detailed methods of the MEPI-CVD survey have been described elsewhere [15, 16].…”

“…The detailed methods of the MEPI-CVD survey have been described elsewhere [15, 16]. All the sub-counties in Wakiso district were stratified into rural and urban and then one sub-county was chosen from each stratum by simple random sampling.…”

Association of genetic variation with blood pressure traits among East Africans

“…The methods of the MEPI‐CVD survey have been described in detail elsewhere . The MEPI‐CVD survey was a cross‐sectional study conducted between September 2012 and May 2013 in Wakiso district of central Uganda among men and women aged 18 years and older to describe CVD risk factors in a peri‐urban Ugandan population.…”