title: Epidemiology and awareness of hypertension in a rural Ugandan community: a cross-sectional study.
abstract: BACKGROUND
  Hypertension is one of the largest causes of preventable morbidity and mortality worldwide. There are few population-based studies on hypertension epidemiology to guide public health strategies in sub-Saharan Africa. Using a community-based strategy that integrated screening for HIV and non-communicable diseases, we determined the prevalence, awareness, treatment rates, and sociodemographic factors associated with hypertension in rural Uganda.
  
  
  METHODS
  A household census was performed to enumerate the population in Kakyerere parish in Mbarara district, Uganda. A multi-disease community-based screening campaign for hypertension, diabetes, and HIV was then conducted. During the campaign, all adults received a blood pressure (BP) measurement and completed a survey examining sociodemographic factors. Hypertension was defined as elevated BP (≥ 140/≥ 90 mmHg) on the lowest of three BP measurements or current use of antihypertensives. Prevalence was calculated and standardized to age distribution. Sociodemographic factors associated with hypertension were evaluated using a log-link Poisson regression model with robust standard errors.
  
  
  RESULTS
  Community participation in the screening campaign was 65%, including 1245 women and 1007 men. The prevalence of hypertension was 14.6%; awareness of diagnosis (38.1%) and current receipt of treatment (20.6%) were both low. Age-standardized to the WHO world standard population, hypertension prevalence was 19.8%, which is comparable to 21.6% in the US and 18.4% in the UK. Sociodemographic factors associated with hypertension included increasing age, male gender, overweight, obesity, diabetes, alcohol consumption, and family history. Prevalence of modifiable factors was high: 28.3% women were overweight/obese and 24.1% men consumed ≥ 10 alcoholic drinks per month.
  
  
  CONCLUSIONS
  We found a substantial burden of hypertension in rural Uganda. Awareness and treatment of hypertension is low in this region. Enhanced community-based education and prevention efforts tailored to addressing modifiable factors are needed.
authors: Prashant
authors: P
authors: Kotwani
authors: Dalsone
authors: D
authors: Kwarisiima
authors: Tamara D
authors: TD
authors: Clark
authors: Jane
authors: J
authors: Kabami
authors: Elvin H
authors: EH
authors: Geng
authors: Vivek
authors: V
authors: Jain
authors: Gabriel
authors: G
authors: Chamie
authors: Maya L
authors: ML
authors: Petersen
authors: Harsha
authors: H
authors: Thirumurthy
authors: Moses R
authors: MR
authors: Kamya
authors: Edwin D
authors: ED
authors: Charlebois
authors: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, UCSF Box 0874, San Francisco, California 94110, USA. dhavlir@php.ucsf.edu.
authors: Diane V
authors: DV
authors: Havlir
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult