Geographic differences in the prevalence of hypertension in Uganda: Results of a national epidemiological study.
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BACKGROUND:Hypertension accounts for more than 212 million global disability-adjusted life-years, and more than 15 million in sub-Saharan Africa. Identifying factors underlying the escalating burden of hypertension in sub-Saharan Africa may inform delivery of targeted public health interventions. METHODS:As part of the cross-sectional nationally representative Uganda National Asthma Survey conducted in 2016, we measured blood pressure (BP) in the general population across five regions of Uganda. We defined hypertension as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, or on-going use of medications for the purpose of lowering BP among adults (≥18 years of age); pre-hypertension as systolic BP between 120 and 140 mmHg and/or diastolic BP bteween 80 and 90 mmHg among adolescents and adults (≥12 years of age). FINDINGS:Of 3416 participants who met inclusion criteria, 38.9% were male, and mean age ± SD was 33.8 ± 16.9 years. The age- and sex-adjusted prevalence of hypertension was 31.5% (95% confidence interval [CI] 30.2 to 32.8). The adjusted prevalence of hypertension was highest in the Central Region (34.3%; 95% CI 32.6 to 36.0), and it was comparable to that in the West and East Regions. However, compared with the Central Region, hypertension was significantly less prevalent in the North (22.0%; 95 CI 19.4 to 24.6) and West Nile Regions (24.1%; 95% CI 22.0 to 26.3). Adjustment for demographic characteristics (occupation, monthly income, and educational attainment) of participants did not account for the significantly lower prevalence of hypertension in the North and West Nile Regions. The prevalence of pre-hypertension was 38.8% (95% CI 37.7 to 39.8), and it was highly prevalent among young adults (21-40 years of age: 42.8%; 95% CI 41.2-44.5%) in all regions. CONCLUSIONS:Hypertension is starkly prevalent in Uganda, and numerous more people, including young adults are at increased risk. The burden of hypertension is highest in the Central, Western, and Eastern regions of the country; demographic characteristics did not fully account for the disparate regional burden of hypertension. Future studies should explore the potential additional impact of epidemiological shifts, including diet and lifestyle changes, on the development of hypertension.
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Published Version (Please cite this version)10.1371/journal.pone.0201001
Publication InfoLunyera, Joseph; Kirenga, Bruce; Stanifer, John W; Kasozi, Samuel; van der Molen, Thys; Katagira, Wenceslaus; ... Kalyesubula, Robert (2018). Geographic differences in the prevalence of hypertension in Uganda: Results of a national epidemiological study. PloS one, 13(8). pp. e0201001. 10.1371/journal.pone.0201001. Retrieved from https://hdl.handle.net/10161/18545.
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I am a clinical epidemiologist with a life-long desire is to advance our understanding of etiologic mechanisms of kidney disease, and to advocate for policies that promote the highest quality care for individuals with kidney disease. Specifically, I am interested in delineating mechanisms by which exposures in the social environment perpetuate disparate adverse kidney outcomes such as chronic kidney disease and acute kidney injury.
Adjunct Assistant Professor of Medicine
John W. Stanifer, MD, MSc-GH, is a nephrologist and clinical researcher with a focus on using translational and trans-disciplinary methods to uncover mechanisms of global health disparities in kidney disease. John completed his residency training in internal medicine and global health at Duke, completing the Master of Science in Global Health program in 2014. He also completed his sub-specialty training in nephrology at Duke, and during that time, he also completed a fellowship in c
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