Undiagnosed hypertension in a rural community in Sudan and association with some features of the metabolic syndrome: how serious is the situation?

Abstract

Background: Hypertension is the leading risk factor for death and disability globally. Its prevalence is increasing worldwide especially in low and middle income countries. It is considered a silent killer because it has no specific symptoms and thus can go unnoticed for many years, only presenting for the first time with serious complications. The situation of undiagnosed hypertension in Sudan has not been fully investigated before. Objective: To determine the prevalence of undiagnosed hypertension in the rural communities of River Nile State (RNS), Sudan and to assess the associated risk factors. Methods: A cross-sectional community-based study, in which 1099 volunteer adult participants from the rural communities in RNS, not known to be hypertensive, were included. Blood pressure was measured as well as anthropometric measurements. The WHO stepwise approach for non-communicable diseases surveillance was used for data collection. A p value below 0.05 was considered statistically significant. Results: There were 461 males (41.9%) and 683 females (58.1%). The male to female ratio was 1:1.4. The age range was 18-90 years, with a mean age of 39.6 (STD ± 15.9). The prevalence of undiagnosed hypertension was 38.2%, with a prevalence of 36.7% among males and 39.3% among females. There were significant associations between undiagnosed hypertension and increasing age, obesity, illiteracy and diabetes mellitus (p50.05). Conclusion: This study uncovers a hidden epidemic of a silent killer in the rural communities of RNS. Urgent interventions are required to address this serious health epidemic.

Prevalence and associated factors of hypertension among adults in Gadarif in eastern Sudan: a community-based study

“…This result is consistent with the recent findings of one study, which reported that 39.6% of the village inhabitants in Northern Sudan had hypertension [20]. A similar rate (38.2%) of undiagnosed hypertension was reported in rural communities along the Nile River in Northern Sudan [6]. Approximately one-third (35.7%) of 954 individuals in Northern Sudan were found to have hypertension [7].…”

“…The sample size of 600 individuals was selected based on previous studies on the prevalence of hypertension in Sudan [6,7,15], where 25.0% of participants were expected to have hypertension. The proportions of the main proposed risk factor (obesity) were expected to be 37.5% for hypertensive individuals and 25% for nonhypertensive individuals.…”

“…Hypertension is the leading risk factor worldwide for mortality from cardiovascular diseases, such as stroke and ischaemic heart disease [4,5]. Various factors, such as an individual's age [6,7], smoking [8], consuming alcohol [9] and obesity [8,[10][11][12], were reported as factors associated with hypertension.…”

“…The epidemiology of hypertension (prevalence and associated risk factors) has been extensively investigated in many African countries, e.g., Ethiopia [9,10], Tanzania [13], Uganda [14] and Madagascar [12], but little published data exist on the epidemiology of hypertension in Sudan [6,7,15]; in addition, there are no published data on the prevalence of and risk factors for hypertension in Eastern Sudan. The current study was conducted to investigate the prevalence and associated factors of hypertension in Gadarif in Eastern Sudan.…”

Prospective cohort study of persistent hypertension following pre-eclampsia at Medani Hospital, Sudan

“…Persistent hypertension following pre‐eclampsia could be unrepresentative of the wider community because the patients included in these studies (pregnant women) undergo regular medical follow‐up, and similar rates of hypertension could be undetected among groups of individuals who are not monitored as closely, such as male patients and non‐pregnant women. In a recent study performed in Sudan, Bushara et al [18] reported that the prevalence of undiagnosed hypertension was 38.2%, with the incidence being slightly higher in female patients in comparison with male patients (39.3% vs 36.7%).…”