Prevalence of Undiagnosed Hypertension and its Associated Factors in Ndera Sector, Gasabo District of Rwanda: A Cross-Sectional Study

Abstract

Background Hypertension remains a significant global health challenge, especially in low- and middle-income countries. It affects millions worldwide, with nearly half of the cases left undiagnosed. In Rwanda, a lack of adequate information and healthcare services impacts healthcare-seeking behaviours, contributing to undiagnosed hypertension in rural areas. Therefore, there exists a need to determine the incidence of undiagnosed hypertension and its associated factors. Methods A cross-sectional study of 393 adults was conducted in Ndera Sector, in Rwanda's Gasabo District, through a multistage sampling technique. Data was gathered using the WHO STEP-wise approach to non-communicable disease risk factor surveillance (STEPS) questionnaire; physical examination was done for blood pressure and body-mass index (BMI), after which the data collected were analyzed using SPSS. Results In Ndera Sector, 15% of the sample population had undiagnosed hypertension. Survey respondents had a mean age of 37 years (range 15 to 82), and 43% were male. Physical activity levels varied, with 41% reporting regular activity, and 59% reporting a lack thereof. Significant factors associated with undiagnosed hypertension (p value < 0.05) included age categories 45–54 years and ≥ 55 years, residing in Kibenga Cell, and having a BMI greater than 25.0 kg/m2. Bivariate analysis revealed significant associations of undiagnosed hypertension with age (≥ 55), having a BMI greater than 30.0 kg/m2 (obesity), and location of residence. The knowledge gap on hypertension also emerged as a significant factor, with those lacking awareness displaying a higher prevalence of undiagnosed hypertension. Sex, marital status, and other lifestyle habits showed no significant associations with undiagnosed hypertension. Conclusions High prevalence of undiagnosed hypertension in Ndera Sector was found to be associated with older age, high BMI, location of residence, and a lack of knowledge related to hypertension. This underscores the importance of health education initiatives, targeted healthcare initiatives in specific areas, tailored healthcare strategies for older age groups, and weight management initiatives to enhance awareness and early detection of hypertension.