Epidemiology of hypertension among adults in Addis Ababa, Ethiopia.

The public health significance of hypertension is increasing in low- and middle-income countries. However, there is limited epidemiological evidence in Ethiopia. We assessed the prevalence of hypertension and explored its predictors among adults in Addis Ababa, Ethiopia. A community-based cross-sectional study was conducted from April to May 2021 among randomly selected adults aged 18-64 years. A face-to-face interview using an adapted STEPwise Approach to NCD Risk Factor Surveillance (STEPS) questionnaire was conducted. Multilevel mixed-effects logistic regression model was fitted to determine factors associated with hypertension. The sample consisted of a total of 600 adults (mean age: 31.2 ± 11.4 years, 51.7% women). The overall age-standardized prevalence of hypertension was 22.1% and 47.8% according to the Seventh Joint National Commission (JNC7) and the 2017 American Heart Association (AHA) guidelines, respectively. About 25.6% were newly diagnosed with hypertension. The age groups of 40-54 years (AOR = 8.97; 95% CI: 2.35,34.23), and 55-64 years (AOR = 19.28; 95% CI: 3.96,93.83) as compared to the 18-24 age group, male sex (AOR = 2.90; 95% CI: 1.22,6.87), obesity (AOR = 1.92; 95% CI: 1.02,3.59), abdominal obesity (AOR = 4.26; 95% CI: 1.42,12.81), and very poor sleep quality (AOR = 3.35; 95% CI: 1.15,9.78) were independent predictors of hypertension. This study revealed that the burden of hypertension among adults is very high. Hypertension is independently associated with older age group, male sex, obesity, abdominal obesity, and poor sleep quality. Therefore, the study highlights the need to develop regular blood pressure surveillance programs, weight loss intervention, and improvement of sleep quality.

Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study.

OBJECTIVE: In low-income countries, such as Ethiopia, few studies have evaluated the risk of cardiovascular disease (CVD) among hypertensive patients. We assessed the 10-year CVD risk of hypertensive patients. DESIGN: This cross-sectional study was part of a larger survey conducted in Addis Ababa. The 10-year CVD risk was calculated using the Framingham Risk Score (FRS) algorithm based on seven sex-specific risk factors as well as a country-specific Globorisk score. Fruits and vegetables (FV) consumption, salt intake and stress levels were measured with 24-hour dietary recall, INTERSALT equation and Cohen's Perceived Stress Scale, respectively. A multiple linear regression model was fitted to explore the association. SETTING: Addis Ababa, Ethiopia, 2021. PARTICIPANTS: A sample of 191 patients diagnosed with hypertension. OUTCOME MEASURES: Predicted 10-year cardiovascular risk of hypertensive patients. RESULTS: A total of 42.4%, 27.7% and 29.8% of hypertensive patients were at low, moderate and high CVD risks, respectively. The majority (80.1%) of patients consumed inadequate FV, 95.7% consumed salt >5 g/day and 58.1% had moderate to high-stress levels. There was a substantial agreement between the FRS and Globorisk prediction models (weighted kappa 0.77). In the unadjusted model, FV consumption (>450 g/day) and total fruit intake in the highest tertile were associated with 14.2% and 6.7% lower CVD risk, respectively. After adjusting for lifestyle factors, increasing FV intake from 120 to 450 g/day was significantly related to 11.1%-15.2% lower CVD risk in a dose-response manner. Additionally, total fruit, but not total vegetable intake in the highest tertile, was significantly associated with decreased CVD risk. CONCLUSION: We found a high prevalence of CVD risk among hypertensive patients. High FV consumption was inversely associated with CVD risk. This suggests that patients should be advised to increase FV intake to minimise CVD risk.

Association between normal-weight obesity and cardiometabolic risk factors among adults in Addis Ababa, Ethiopia.

The relationship between normal-weight obesity (NWO)-high percent body fat (%BF) in individuals with normal body mass index (BMI)-and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18-64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (ß = 2.55; 95% CI - 0.82, 5.92); however, diastolic blood pressure (ß = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (ß = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (ß = 8.73: 1.56, 15.90), triglyceride (ß = 20.99: 0.78, 41.22), total cholesterol (ß = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (ß = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements.