Prevalence and predictors of adult hypertension in Kabul, Afghanistan

Abstract

BackgroundThe prevalence of hypertension is rising worldwide with an estimated one billion people now affected globally and is of near epidemic proportions in many parts of South Asia. Recent turmoil has until recently precluded estimates in Afghanistan so we sought, therefore, to establish both prevalence predictors in our population.MethodsWe conducted a cross-sectional study of adults ≥40 years of age in Kabul from December 2011-March 2012 using a multistage sampling method. Additional data on socioeconomic and lifestyle factors were collected as well as an estimate of glycaemic control. Bivariate and multivariable analyses were undertaken to explore the association between hypertension and potential predictors.ResultsA total of 1183 adults (men 396, women 787) of ≥ 40years of age were assessed. The prevalence of hypertension was 46.2% (95% CI 43.5 – 49.3). Independent predictors of hypertension were found to be: age ≥50 (OR = 3.86, 95% CI: 2.86 – 5.21); illiteracy (OR = 1.90, 1.05 – 1.90); the consumption of rice >3 times per week (OR = 1.43, 1.07 – 1.91); family history of diabetes (OR = 2.20, 1.30 – 3.75); central obesity (OR = 1.67, 1.23 – 2.27); BMI ≥ 30 Kg/meter squared (OR = 2.08, 1.50 – 2.89). The consumption of chicken and fruit more than three times per week were protective with ORs respectively of 0.73 (0.55-0.97) and 0.64 (0.47 – 0.86).ConclusionsHypertension is a major public health problem in Afghan adults. We have identified a number of predictors which have potential for guiding interventions.

Prevalence and Associated Factors of High Blood Pressure in Urban Setting of Kandahar City in Afghanistan in 2015

“…Body mass index and central obesity were statistically associated with hypertension at both statistical analysis levels. This finding is in agreement with other studies in similar settings (13,14,28). Physical inactivity with respect to reclining in hours per day was also associated with hypertension (31).…”

“…This study revealed that the prevalence of hypertension in the urban setting of Kandahar in Afghanistan is 32.3%, indicating that almost one third of the adult population of this city is suffering from this public health problem. These findings are supported by being comparable to other findings of national (13,14) and international studies (23,24). It further reveals that the country has entered into an epidemic of noncommunicable diseases such as hypertension, while in the last decade the country has focused on infectious diseases, nutrition, and maternal health (25,26).…”

“…In Afghanistan, there is lack of information on NCDs including hypertension due to priority given to communicable diseases. Prevalence of hypertension in Kabul and Jalalabad in adult population is found to be 46.2% and 28.4%, respectively (13,14). Two neighboring countries of Afghanistan, Iran and Pakistan, have estimated the prevalence of hypertension to be 22.1% and 25.3%, respectively (15,16).…”

Validity of Self‐Report Data in Hypertension Research: Findings From The Study on Global Ageing and Adult Health

“…7,8 Such issues of unawareness and poor control of high BP are attributed to high illiteracy levels, poor access to health facilities, and poverty. 9 Faced with existing issues of morbidity and mortality from communicable and infectious diseases, 10 most parts of the developing world pay less attention to the deadly impact of noncommunicable diseases, including hypertension, on its populations. In the developing world, the prevalence of hypertension is more common among urban than rural populations 11 and the wealthy than poor populations, 12,13 and women self-report high BP more than men.…”

The Jumbo issue

“…Contributing factors particularly in the northern states include westernization of lifestyle and urban migration [7]. In this issue, a study from Kabul documents the prevalence of diabetes; hypertension was reported to be common as well [8].…”