Abstract:
ABSTRACT
Background: Prevalence of hypertension is rising in sub-Saharan Africa, especially among urban middle-class individuals. In Tanzania, majority of previous studies on hypertension were based on elevation of clinic blood pressure (BP). However, clinic BP may over-estimate the true prevalence of hypertension due to white coat effect, may miss to diagnose individuals with masked hypertension and miss to identify nocturnal non-dippers. There is also increasing evidence that Ambulatory Blood Pressure Monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk.
Objective: To determine the prevalence of hypertension using ABPM and to explore the relationship between ABPM profiles with cardiovascular risk factors among MUHAS employees.
Methods: A descriptive cross-sectional study was conducted from October 2018 to February 2019. A structured questionnaire was used to gather information on socio-demographic characteristics and cardiovascular risk history. Anthropometric measurements were taken and blood samples were collected and analyzed for glucose, creatinine, cholesterol and uric acid. Two sets of BP were taken; one at the clinic and another using 24hrs ABPM. Data analysis was done using SPSS Version 20, and a p-value of <0.05 was considered statistically significant.
Results: This study had 390 participants. Their mean (SD) age was 40.5(8.9)years, and 53.6% were men. Prevalence of hypertension was found to be 23.1%. Prevalence for white coat, masked and nocturnal non dippers were 16.2%, 11.6% and 66.7% respectively. The mean 24-hours BP showed the best correlations with traditional cardiovascular risk factors. In multivariate analysis, independent factors associated with hypertension were male gender (OR=7.96), age ≥40 years (OR=3.94), family history of hypertension (OR=5.6), central obesity (OR=8.98), hypercholesterolemia (OR=3.84) and hyperuricemia (OR=7.9), all p<0.01.
Conclusion and Recommendation: The prevalence of hypertension among MUHAS employees is 23.1% and is associated with traditional cardiovascular risk factors. Ambulatory BP correlates better with cardiovascular risk factors and is the best measure of one’s true BP Work-based hypertension control programs are recommended at MUHAS.
