Prevalence and associated anthropometric and lifestyle predictors of hypertension among adults in Kombolcha town and suburbs, Northeast Ethiopia: a community-based cross-sectional study

Abstract

BackgroundHypertension (HTN) is major public health challenge. Data on HTN prevalence and associated risk factors is necessary to better control it. This study aimed at estimating the prevalence of HTN and associated anthropometric and lifestyle predictors in Kombolcha and suburbs, northeast Ethiopia.MethodsThe study followed a community-based cross-sectional sampling design. Adult (≥18) residents of Kombolcha and suburbs in 11 kebeles (villages) formed the target population. Of these kebeles, 5(3 urban and 2 suburban) were selected randomly. Households (HHs) within the selected kebeles and individuals within HHs were similarly recruited in December 2016–May 2017. Anthropometric and blood pressure measurements were done. World Health Organization (WHO) STEPWISE TOOL was used to capture socio-demographic, physical activity, dietary habit, and nutritional status data.ResultsTotally 318 adults participated in the study. However, only 312 (169(54.2%) males and 143(45.8%) females) were with complete information for statistical analysis. The lowest age was 18 years, the highest 65 and the mean 38.29 ± 10.88. The prevalence of HTN was 30.8% (96/312) (95% confidence interval (CI): 25.9–36.1%), 16.4% male and 14.4% female. While 45 and older age (odds ratio (OR) 7.385, 95% CI 3.563–15.306, p < 0.0001), obesity (OR 126.286, 95% CI 34.481–462.514, p < 0.0001) and overweightness (OR 16.105, 95% CI 7.024–36.927, p < 0.0001), ‘substantially high risk’ (> 102 cm in men and > 88 cm in female) waist circumference (OR 1.788, 95% CI 1.008–3.173, p = 047), light occupational physical activity (OR 12.427, 95% CI 2.891–53.410, p = 0.001), walking or riding a bicycle for lower than 5 days/week (OR 13.000, 95% CI 5.140–32.882, p < 0.0001) and lack of sport activity (OR 18.322, 95% CI 2.430–138.169, p = 005), smoking (OR 2.283, 95% CI 1.284–4.060, p = 0.005), khat (OR 17.390, 95% CI 6.167–49.037, p < 0.0001), alcohol (OR 4.005, 95% CI 2.357–6.803, p < 0.0001), HH size of two (OR 2.474, 95% CI 1.250–4.895, p = 0.009) and ≥ 3 (OR 6.889, 95% CI 2.610–18.186, p < 0.0001); and HTN in family history (OR 19.417, 95% CI 10.251–36.778, p < 0.0001) were significant predictors of HTN in the binary logistic regression analysis; none of these were so in the multivariable model.ConclusionAlthough there was a high prevalence of HTN in the study area, its independent significant predictors were not identified.

Anthropometric measurements as predictors of hypertension in Busia, Vihiga, Trans Nzoia and Siaya counties of Western Kenya

“…This study enrolled 3575 community members from four counties in Western Kenya with a mean age of 43.9 (±15.9) years of whom 1856 (51.6%) were female. This finding is slightly different from a community study conducted in Ethiopia [13] where the mean age of the study participants was 38.3 (±10.9) years, majority (54.2%) of whom were male. Although the difference in gender proportions in both studies was not statistically significant, the study conducted in Ethiopia [13] enrolled fewer (N=312) participants in a single (Kombolcha) town within Northeast Ethiopia compared to this larger community study that enrolled participants from a wider geographic region of Western Kenya.…”

“…This finding is slightly different from a community study conducted in Ethiopia [13] where the mean age of the study participants was 38.3 (±10.9) years, majority (54.2%) of whom were male. Although the difference in gender proportions in both studies was not statistically significant, the study conducted in Ethiopia [13] enrolled fewer (N=312) participants in a single (Kombolcha) town within Northeast Ethiopia compared to this larger community study that enrolled participants from a wider geographic region of Western Kenya. Although both the current study and that from Northeast Ethiopia [13] adopted the World Health Organisation (WHO) recommended STEPWISE tool to capture participants sociodemographic characteristics and nutritional status information; they still had differing community hypertension prevalence of 23.2% and 30.8% [13] respectively.…”

“…On the other hand, WC and WHtR have been reported as optimal techniques to describe more body fat, abdominal and central obesity as well as estimation of visceral adipose tissue that are often associated with metabolic changes that could result in hypertension. This association between anthropometric indices and hypertension have been previously reported in studies conducted in various countries across the globe with differing ethnicities and ancestry [13,[15][16][17] . However, all these studies have reported varying optimal anthropometric techniques and cut-offs for predicting hypertension in the targeted populations [7,13,15,16].…”

“…Although the difference in gender proportions in both studies was not statistically significant, the study conducted in Ethiopia [13] enrolled fewer (N=312) participants in a single (Kombolcha) town within Northeast Ethiopia compared to this larger community study that enrolled participants from a wider geographic region of Western Kenya. Although both the current study and that from Northeast Ethiopia [13] adopted the World Health Organisation (WHO) recommended STEPWISE tool to capture participants sociodemographic characteristics and nutritional status information; they still had differing community hypertension prevalence of 23.2% and 30.8% [13] respectively. Disease prevalence rates differ spatially and this could explain a higher community prevalence of hypertension in Ethiopia's capital city (Addis Ababa) at 30.2% [12] and in Northwest Ethiopia at 28.3% [15].…”

“…However, emerging data from low and middle income countries such as those in Sub-Saharan Africa have reported rising incidence rates for hypertension [6]. This has been attributed to sedentary lifestyle and dietary changes which directly affect the anthropometric characteristics of the affected individuals [5,12,13].…”