Hypertension in Urban Tanzania: A ticking time bomb

Background: Globally, elevated blood pressure is the leading single cause of morbidity and mortality, and a growing epidemic of public health importance in sub Saharan Africa (SSA). Despite of the rapidly increasing prevalence of hypertension in SSA; the detection, treatment and control rates are staggeringly low in the region.   We aimed to determine the prevalence, treatment and control rates of hypertension among residents of Tanzania’s largest city and economic capital, Dar es Salaam.

Methods: 2773 adults were recruited in a cross-sectional, community-based survey in June 2019. Physical activity was assessed using the physical activity vital sign scale (PAVS). Qualified nurses measured and recorded blood pressure and anthropometric measurements. Hypertension was defined according to the 8th Report of the Joint National Committee (JNC 8) or use of blood pressure lowering medications. Chi-square and student’s t-test techniques were employed in the comparison of categorical and continuous variables respectively. Multivariate logistic regression analyses were performed to assess for the factors associated with elevated blood pressure.

Results: The mean age of participants was 45.8 years and 61.8% were women. 6.8% were ever smokers, 13.1% were alcohol drinkers, 64.9% had excess body weight, and 87.3% were physically inactive. 1652 (59.6%) of individuals had elevated blood pressure or were using anti-hypertensive medications; 943 (57%) of these were unaware of their hypertensive status. Among those with hypertension awareness, 36% were on regular treatment and 17.5% had their blood pressure controlled. Age ≥40 (OR 5.7, 95% CI 4.2-7.8, p<0.001), male sex (OR 1.6, 95% CI 1.1-2.2, p<0.01) and BMI ≥25 (OR 3.9, 95% CI 3.1-5.1, p<0.001) were strongly associated with ‘newly diagnosed hypertensive’ status.

Conclusions: Our findings suggest that excess body weight is a single modifiable risk factor strongly associated with high blood pressure. In view of this; strategic, collaborative and aggressive pan-African measures to control the obesity epidemic is fundamental in the fight against hypertension. 


Pedro Pallangyo

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