Prevalence of hypertension and associated factors in Jalalabad City, Nangarhar Province, Afghanistan

Main Article Content

Khwaja Mir Islam Saeed

Abstract

Background: Hypertension affects an estimated one billion people, worldwide. It is a public health challenge characterized by increased morbidity, mortality, as well as cost to the community and health systems. The goal of this study is to determine the prevalence of hypertension and characterize associated risk factors in an urban setting in Afghanistan.

Methods: A cross-sectional study of adults aged 25-65 years was conducted in Jalalabad city from May to June 2013 using the World Health Organization STEPwise approach to surveillance (WHO STEPS). A multistage technique was used to enroll 1,200 participants in the study. Demographic and socio-economic variables were collected via individual interviews using the WHO STEPS survey, after which blood samples were collected using a locally developed standard operating procedure (SOP). Bivariate and multivariable analyses were performed to explore the association between hypertension and associated factors.

Results: A total of 1,180 adults (40% males, 60% females) of 25-65 years of age were surveyed. The response rate was 98.5 % and the prevalence of hypertension was 28.4. Independent risk factors of hypertension were found to be: age ? 50 (AOR = 3.42, 95% CI: 2.50 – 4.76); sex (AOR = 0.58, 95% CI: 0.38 – 0.88); obesity (AOR = 2.1, 95% CI 1.49 – 2.94); and diabetes (AOR = 1.75, 95% CI: 1.10 – 2.79). Independent protective factors were physically demanding occupations (AOR = 0.55, 95% CI: 0.36 – 0.85); physical activity itself (AOR = 0.69, 95% CI: 0.47 – 0.99) and consuming more vegetables (AOR = 0.59, 95% CI: 0.38 – 0.93).

Conclusion: This urban setting in Afghanistan evidenced a high prevalence of hypertension; age, obesity, and diabetes were identified as risk factors and physical activity and consuming more vegetables were protective. These findings have implications for future public health intervention and clinical efforts.

Article Details

How to Cite
Saeed, K. M. I. (2015). Prevalence of hypertension and associated factors in Jalalabad City, Nangarhar Province, Afghanistan. Central Asian Journal of Global Health, 4(1). https://doi.org/10.5195/cajgh.2015.134
Section
Research
Author Biography

Khwaja Mir Islam Saeed, Afghanistan National Public Health Institute, Ministry of Public Health, Kabul

Surveillance Director

References

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365(9455):217-223.

Mohan V, Seedat YK, Pradeepa R. The rising burden of diabetes and hypertension in southeast asian and african regions: Need for effective strategies for prevention and control in primary health care settings. Int J Hypertens. 2013.

Medscape Cardiology. Hypertension, but not "prehypertension," increases stroke risk: Global prevalence of hypertension may be close to 30%. 2004; http://www.medscape.com/viewarticle/471536_8

Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. J Public Health (Oxf). 2009;31(1):47-58.

Fauci AS, Braunwald E, Kasper DL, et al. Harrison's principles of internal medicine. 17th ed: The McGraw-Hill Companies; 2008.

The American Heart Association. Factors that contribute to high blood pressure. http://www.americanheart.org/presenter.jhtml?identifier=4650.

World Health Organization. A global brief on hypertension: Silent killer, global public health crisis. 2013; http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1.

Singh RB, Suh IL, Singh VP, et al. Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention. J Hum Hypertens. 2000;14(10-11):749-763.

Unwin N, Setel P, Rashid S, et al. Noncommunicable diseases in sub-Saharan Africa: Where do they feature in the health research agenda? Bull World Health Organ. 2001;79(10):947-953.

Wolf-Maier K, Cooper RS, Banegas JR, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289(18):2363-2369.

Ibrahim MM, Rizk H, Appel LJ, et al. Hypertension prevalence, awareness, treatment, and control in Egypt. Results from the Egyptian National Hypertension Project (NHP). NHP Investigative Team. Hypertension. 1995;26(6 Pt 1):886-890.

Puavilai W, Laorugpongse D, Prompongsa S, et al. Prevalence and some important risk factors of hypertension in Ban Paew District, second report. J Med Assoc Thai. 2011;94(9):1069-1076.

Bener A, Al-Suwaidi J, Al-Jaber K, Al-Marri S, Dagash MH, Elbagi IE. The prevalence of hypertension and its associated risk factors in a newly developed country. Saudi Med J. 2004;25(7):918-922.

World Health Organization. Non-communicable diseases: Hypertension. 2011; http://www.emro.who.int/ncd/hypertension.htm.

Saeed KMI. Prevalence of risk factors for non-communicable diseases in the adult population of urban areas in Kabul City, Afghanistan. CAJGH. 2013;2(2).

Haghdoost AK, Behnam Sadeghirad B, Rezazadehkermani M. Epidemiology and heterogeneity of hypertension in Iran: A systematic review. Arch Iranian Med. 2008;11(4):444-452.

Safdar S, Omair A, Faisal U, Hasan H. Prevalence of hypertension in a low income settlement of Karachi, Pakistan. J Pak Med Assoc. 2004;54(10):506-509.

Afghan Public Health Institute Ministry of Public Health (APHI/MoPH) [Afghanistan], Central Statistics Organization (CSO) [Afghanistan], ICF Macro IIoHMRII, [Egypt] WHOROftEMWE. Afghanistan Mortality Survey 2010. Maryland, USA: Calverton; 2011.

Bonita R, deCourten M, Dwyer T, K. J, Winkelmann R. Surveillance of risk factors for non-communicable disease: the WHO STEPwise approach. Geneva: World Health Organization;2002.

World Health Organization. Obesity: Preventing and managing the global epidemic; report of a WHO consultation. Geneva: World Health Organization;2000.

International Diabetes Federation. The IDF consensus worldwide definitions of the metabolic symdrome. 2006; http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf.

Whitworth JA, World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21(11):1983-1992.

Epi Info [computer program]. Version 3.5.12008.

IBM SPSS Statistics for Windows [computer program]. Version 20.0. Armonk, NY2011.

Yoon SS, Burt V, Louis T, Carroll MD. Hypertension among adults in the United States, 2009–2010. NCHS data brief, no 107. 2012; Hyattsville, MD.

Gudina EK, Michael Y, Assegid S. Prevalence of hypertension and its risk factors in southwest Ethiopia: A hospital-based cross-sectional survey. Integr Blood Press Control. 2013;6:111-117.

Yadav S, Boddula R, Genitta G, et al. Prevalence of prehypertension, hypertension and cardiovascular risk factors in a Belarus urban population. Indian J Med Res. 2008;128(6):Indian J Med Res.

Pooja YM. Prevalence of hypertension and its determinants in an urban area of Uttarakhand. AJBPS. 2013;3(21):12-16.

Prabakaran J, Vijayalakshmi N, VenkataRao E. Prevalence of hypertension among urban adult population (25-64 years) of Nellore, India. Int J Res Dev Health. 2013;1(2).

The World Bank. NCDs policy brief - Afghanistan. 2011; http://siteresources.worldbank.org/SOUTHASIAEXT/Resources/223546-1296680097256/7707437-1296680114157/NCD_AF_Policy_Feb_2011.pdf.

Ministry of Public Health Afghanistan. National strategy for prevention and control of noncommunicable diseases (NCDs) 2013-2018. 2013; http://www.iccp-portal.org/sites/default/files/plans/NCDStrategy_Draft_Final_from%20Af%20MoH.pdf.