title: Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic.
abstract: BACKGROUND
  The prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries. This study aims to describe the epidemiology of high blood pressure among adults in Addis Ababa, so as to inform policy and lay the ground for surveillance interventions.
  
  
  METHODS
  Addis Ababa is the largest urban centre and national capital of Ethiopia, hosting about 25% of the urban population in the country. A probabilistic sample of adult males and females, 25-64 years of age residing in Addis Ababa city participated in structured interviews and physical measurements. We employed a population based, cross sectional survey, using the World Health Organization instrument for stepwise surveillance (STEPS) of chronic disease risk factors. Data on selected socio-demographic characteristics and lifestyle behaviours, including physical activity, as well as physical measurements such as weight, height, waist and hip circumference, and blood pressure were collected through standardized procedures. Multiple linear regression analysis was performed to estimate the coefficient of variability of blood pressure due to selected socio-demographic and behavioural characteristics, and physical measurements.
  
  
  RESULTS
  A total of 3713 adults participated in the study. About 20% of males and 38% of females were overweight (body-mass-index > or = 25 kg/m2), with 10.8 (9.49, 12.11)% of the females being obese (body-mass-index > or = 30 kg/m2). Similarly, 17% of the males and 31% of the females were classified as having low level of total physical activity. The age-adjusted prevalence (95% confidence interval) of high blood pressure, defined as systolic blood pressure (SBP) > or = 140 mmHg (millimetres of mercury) or diastolic blood pressure (DBP) > or = 90 mmHg or reported use of anti-hypertensive medication, was 31.5% (29.0, 33.9) among males and 28.9% (26.8, 30.9) among females.
  
  
  CONCLUSIONS
  High blood pressure is widely prevalent in Addis Ababa and may represent a silent epidemic in this population. Overweight, obesity and physical inactivity are important determinants of high blood pressure. There is an urgent need for strategies and programmes to prevent and control high blood pressure, and promote healthy lifestyle behaviours primarily among the urban populations of Ethiopia.
authors.affiliation: School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia. ttfikru@yahoo.com
authors.forename: Fikru
authors.initials: F
authors.lastname: Tesfaye
authors.forename: Peter
authors.initials: P
authors.lastname: Byass
authors.forename: Stig
authors.initials: S
authors.lastname: Wall
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data*; D004196:Disease Outbreaks; D005002:Ethiopia / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects; D017673:Sodium Chloride, Dietary / Q000009:adverse effects; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents; D017673:Sodium Chloride, Dietary
references.citation: Educ Health (Abingdon). 2003 Jul;16(2):230
references.pmid: 14741909
references.citation: Hypertension. 1992 Mar;19(3):237-41
references.pmid: 1548050
references.citation: Ethn Dis. 2003 Summer;13(2 Suppl 2):S48-52
references.pmid: 13677414
references.citation: Lancet. 2005 Jan 15-21;365(9455):217-23
references.pmid: 15652604
references.citation: East Afr Med J. 1997 Jun;74(6):376-81
references.pmid: 9487400
references.citation: J Hum Hypertens. 2000 Oct-Nov;14(10-11):739-47
references.pmid: 11095164
references.citation: Prev Chronic Dis. 2008 Jul;5(3):A89
references.pmid: 18558039
references.citation: Circulation. 2005 Dec 6;112(23):3554-61
references.pmid: 16330696
references.citation: Eur Heart J. 2002 Jan;23(1):13-25
references.pmid: 11741358
references.citation: Cardiovasc Drugs Ther. 1999 Apr;13(2):95-104
references.pmid: 10372224
references.citation: Coron Artery Dis. 1997 Jul;8(7):463-8
references.pmid: 9383608
references.citation: J Hum Hypertens. 2003 Sep;17(9):655-775
references.pmid: 13679955
references.citation: J Hypertens. 2000 Feb;18(2):145-52
references.pmid: 10694181
references.citation: Lancet. 1997 May 3;349(9061):1269-76
references.pmid: 9142060
references.citation: Acta Trop. 2001 Jun 22;79(3):231-9
references.pmid: 11412807
references.citation: Obes Res. 1996 May;4(3):221-8
references.pmid: 8732956
references.citation: West Afr J Med. 2002 Jul-Sep;21(3):208-11
references.pmid: 12744569
references.citation: Med Sci Sports Exerc. 2003 Aug;35(8):1381-95
references.pmid: 12900694
references.citation: J Hum Hypertens. 1999 Jan;13(1):23-7
references.pmid: 9928748
references.citation: J Hum Hypertens. 1997 Aug;11 Suppl 1:S9-18
references.pmid: 9321735
references.citation: J Hum Hypertens. 2006 Jan;20(1):59-65
references.pmid: 16151443
references.citation: J Hum Hypertens. 1999 Jan;13(1):13-21
references.pmid: 9928747
references.citation: Int J Epidemiol. 2004 Aug;33(4):751-8
references.pmid: 15105409
references.citation: Int J Epidemiol. 2002 Feb;31(1):240-7
references.pmid: 11914327
references.citation: J Hypertens. 2004 Jan;22(1):11-9
references.pmid: 15106785
references.citation: J Hum Hypertens. 1998 Feb;12(2):91-110
references.pmid: 9504351
references.citation: Ann N Y Acad Sci. 1999;896:262-77
references.pmid: 10681903
references.citation: Hypertension. 2002 May;39(5):1000-6
references.pmid: 12019283
references.citation: J Hum Hypertens. 2000 Dec;14(12):779-87
references.pmid: 11114693
references.citation: J Hum Hypertens. 2007 Jan;21(1):28-37
references.pmid: 17066088