Assessing Differences in Hypertensive Status, Cascade of Care, and Fruit and Vegetable Consumption Between Rural and Urban Populations in Northwestern Tanzania.

Abstract

Hypertension (HTN) remains a major contributor to preventable cardiovascular deaths in Tanzania, with its prevalence influenced by rapid urbanization, dietary shifts, and healthcare disparities. This cross-sectional study assessed differences in uncontrolled HTN, the care cascade, and dietary patterns between rural and urban communities across 12 districts in Northwestern Tanzania.Among 6,957 participants (59% urban, 61% female, median age 42 years), key findings revealed that 30% consumed alcohol, 6.1% were smokers, 21% had diabetes, and 78% earned less than 100,000 TZN. HTN prevalence was higher in rural areas (32%) compared to urban areas (29%), with urban residents having lower odds of HTN (0.866). Notably, only 26% had ever undergone blood pressure screening, and no significant differences emerged in HTN management between rural and urban settings, apart from a higher past HTN diagnosis in rural areas (45% vs. 39%). Dietary trends showed no major differences in fruit consumption, but vegetable intake was higher at medium levels (1.12) yet lower at high levels (0.684) in urban areas. Despite urban areas having better healthcare infrastructure, gaps in early HTN detection remain the primary barrier in both settings. The findings underscore the need for targeted interventions to enhance screening, diagnosis, and dietary awareness, particularly in rural communities where the HTN burden is higher.