title: Hypertension-related diseases as a common cause of hospital mortality in Tanzania: a 3-year prospective study.
abstract: OBJECTIVE
  Hypertension is believed to be an increasingly common driver of the epidemic of noncommunicable diseases (NCDs) in sub-Saharan Africa, but prospective data are scarce. The objective of this prospective study was to determine the contribution of hypertension to deaths, admissions, and hospital days at a Tanzanian zonal hospital.
  
  
  METHODS
  Between 2009 and 2011, diagnoses were recorded for all medical admissions together with age, sex, length of hospitalization and in-hospital mortality.
  
  
  RESULTS
  Among 11045 consecutive admissions, NCDs accounted for nearly half of all deaths, admissions, and hospital days. Among NCDs, hypertension-related diseases were the most common and accounted for 314 (33.9%) of the total NCD deaths, 1611 (29.9%) of the NCD admissions, and 12837 (27.8%) NCD hospital days. Stroke (167 deaths) was the leading cause of hypertension-related death. Hypertension was the leading cause of death in patients over the age of 50 years and 57% of hypertension-related deaths occurred in patients less than 65 years old.
  
  
  CONCLUSIONS
  NCDs account for half of all deaths, admissions and hospital days at our Tanzanian hospital and hypertension-related diseases were the most common NCD. Hypertension accounted for 34% of NCD deaths and 15% of all deaths. Hypertension was the second most common cause of death overall and the leading cause of death in patients more than 50 years old. More than half of hypertension-related deaths occurred before retirement age. These findings have important implications for public health and medical education in sub-Saharan Africa, wherein hypertension and related diseases have not traditionally been given a high priority.
authors.affiliation: aDepartment of Medicine, Bugando Medical Centre, Mwanza bDepartment of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania cCenter for Global Health, Weill Cornell Medical College, New York dCornell University, Ithaca, New York, USA eDepartment of Physiology, Weill Bugando School of Medicine fDirector General, Bugando Medical Centre, Mwanza, Tanzania.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Peck
authors.forename: Ethan
authors.initials: E
authors.lastname: Green
authors.forename: Jacob
authors.initials: J
authors.lastname: Mtabaji
authors.forename: Charles
authors.initials: C
authors.lastname: Majinge
authors.forename: Luke R
authors.initials: LR
authors.lastname: Smart
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Downs
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000401:mortality*; D007674:Kidney Diseases / Q000378:metabolism; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D020521:Stroke / Q000503:physiopathology; D013636:Tanzania