Determinants of hypertension in a young adult Ugandan population in epidemiological transition-the MEPI-CVD survey
Determinants of hypertension in a young adult Ugandan population in epidemiological transition-the MEPI-CVD survey
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DOI：
10.1186/s12889-015-2146-y
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发表时间：
2015-08-28
影响因子：
4.5
通讯作者：
Kamya, Moses R.
中科院分区：
文献类型：
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作者：
Kayima, James;Nankabirwa, Joaniter;Kamya, Moses R.
背景：高血压是非洲年轻人中风、心力衰竭和肾衰竭的主要危险因素。与老年人相比，控制高血压与年轻人发病率和死亡率的大幅降低有关；然而，由于缺乏有关高血压患病率以及影响高血压认识、治疗和控制的因素的数据，年轻人的血压控制工作受到阻碍。我们的目的是描述乌干达城郊地区年轻人中高血压前期和高血压的患病率以及与该人群发生高血压相关的因素。方法：这项横断面研究于2012年8月至2013年5月在瓦基索区进行，瓦基索区是乌干达首都坎帕拉周围的一个郊区。我们使用修改后的 STEPs 问卷从多阶段整群抽样选出的 3685 名 18-40 岁受试者中收集了有关社会人口特征和高血压状况的数据。使用标准化方案进行血压和人体测量。使用静脉血样本确定空腹血糖和艾滋病毒状况。使用逻辑回归评估高血压状况与各种生物社会因素之间的关联。结果：高血压的总体患病率为 15% (95% CI 14.2-19.6)，40% 为高血压前期。在 553 名高血压参与者中，76 名（13.7%）知道自己的诊断，所有这些参与者都已开始治疗，20% 的治疗对象达到了目标血压控制。高血压与年龄较大、男性和肥胖显着相关。 HIV OR 0.6 的参与者中高血压患病率显着较低（95% CI 0.4-0.8，P = 0.007）。结论：诊断和控制效果欠佳的乌干达城郊年轻人群高血压患病率较高。以前没有记录过高治疗率，这是一个独特的发现，可以用来推动控制高血压的努力。应制定针对青少年高血压的早期诊断和治疗的具体方案，以提高高血压的控制水平。 HIV感染与血压之间的关系需要通过纵向研究进一步阐明。
Background: High blood pressure is the principal risk factor for stroke, heart failure and kidney failure in the young population in Africa. Control of hypertension is associated with a larger reduction in morbidity and mortality in younger populations compared with the elderly; however, blood pressure control efforts in the young are hampered by scarcity of data on prevalence and factors influencing awareness, treatment and control of hypertension. We aimed to describe the prevalence of prehypertension and hypertension among young adults in a peri-urban district of Uganda and the factors associated with occurrence of hypertension in this population.Methods: This cross-sectional study was conducted between August, 2012 and May 2013 in Wakiso district, a suburban district that that encircles Kampala, Uganda's capital city. We collected data on socio-demographic characteristics and hypertension status using a modified STEPs questionnaire from 3685 subjects aged 18-40 years selected by multistage cluster sampling. Blood pressure and anthropometric measurements were performed using standardized protocols. Fasting blood sugar and HIV status were determined using a venous blood sample. Association between hypertension status and various biosocial factors was assessed using logistic regression.Results: The overall prevalence of hypertension was 15 % (95 % CI 14.2-19.6) and 40 % were pre-hypertensive. Among the 553 hypertensive participants, 76 (13.7 %) were aware of their diagnosis and all these participants had initiated therapy with target blood pressure control attained in 20 % of treated subjects. Hypertension was significantly associated with the older age-group, male sex and obesity. There was a significantly lower prevalence of hypertension among participants with HIV OR 0.6 (95 % CI 0.4-0.8, P = 0.007).Conclusion: There is a high prevalence of high blood pressure in this young periurban population of Uganda with sub-optimal diagnosis and control. There is previously undocumented high rate of treatment, a unique finding that may be exploited to drive efforts to control hypertension. Specific programs for early diagnosis and treatment of hypertension among the young should be developed to improve control of hypertension. The relationship between HIV infection and blood pressure requires further clarification by longitudinal studies.