Prevalence of hypertension and associated cardiovascular risk factors in an urban slum in Nairobi, Kenya: A population-based survey

BMC Public Health

Kenneth Kipyegon Mutai³  Erastus Kennedy Njeru¹  Joshua Kyateesa Kayima²  Rosemary Wanjiru²  Elijah Kaharo Njau²  Richard Ayah¹  Mark David Joshi² 

[1] School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya;Department of Clinical Medicine and Therapeutics, School of Medicine, College of Health Sciences, University of Nairobi, P.O. BOX 19676-00202, KNH, Nairobi, Kenya;University of Nairobi Partnership for Advanced Care and Treatment (PACT) – Centre of Excellence, Nairobi, Kenya

关键词: Non-communicable diseases;    Africa South of the Sahara;    Poverty areas;    Urban health;    Hypertension prevalence;   

Others  :  1122951
DOI  :  10.1186/1471-2458-14-1177

 received in 2014-02-27, accepted in 2014-10-24,  发布年份 2014

【 摘 要 】

Background

Urbanisation has been described as a key driver of the evolving non-communicable disease (NCD) epidemic. In Africa, hypertension is the commonest cardiovascular problem. We determined the prevalence and risk factor correlates of hypertension in the largest Nairobi slum.

Methods

In 2010 we conducted a population-based household survey in Kibera, a large informal settlement in Nairobi City; utilising cluster sampling with probability proportional to size. Households were selected using a random walk method. The WHO instrument for stepwise surveillance (STEPS) of chronic disease risk factors was administered by trained medical assistants, who also recorded blood pressure (BP) and anthropometric measures. BP was recorded using a mercury sphygmomanometer utilising the American Heart Association guidelines. Hypertension was defined as per the 7th Report of the Joint National Committee or use of prescribed antihypertensive medication. Those with hypertension or with random capillary blood sugar (RCBS) >11.1 mmol/l had an 8 hours fasting venous blood sugar sample drawn. Age standardised prevalence was computed and multivariate analysis to assess associations.

Results

We screened 2200 and enrolled 2061 adults; 50.9% were males; mean age was 33.4 years and 87% had primary level education. The age-standardised prevalence of hypertension (95% CI) was 22.8% (20.7, 24.9). 20% (53/258) were aware of their hypertensive status; 59.3% had pre-hypertension; 80% reported high levels of physical activity and 52% were classified as harmful alcohol drinkers; 10% were current smokers and 5% had diabetes. Majority of males had normal BMI and waist circumference, whereas a third of females were obese or overweight and 40% had central obesity. Older age, higher general and central obesity were independently associated with hypertension and higher SBP and DBP readings.

Conclusions

Our findings of high prevalence of hypertension, in association with excess body weight in this poor urban slum community, point to the need for greater awareness and implementation of primary preventive strategies.

【 授权许可】

   
2014 Joshi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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