Demographics and Clinical Correlates of Blood Pressure Among Ugandans at Risk for Stroke.

BACKGROUND

Stroke risk factors are an emerging public health problem in Sub-Saharan Africa. This analysis examined demographic and clinical correlates of blood pressure (BP) in a Ugandan sample at risk for stroke.

METHODS

This cross-sectional analysis of demographics (age, gender, marital status, education level, rural/suburban/urban status, employment status), stroke risk factors (diabetes, hyperlipidemia, obesity, smoking status, sedentary life-style, problem alcohol use), and clinical variables associated with systolic BP (SBP) and diastolic BP (DBP) were derived from the screening and baseline sample of a prospective, randomized effectiveness-implementation trial. ClinicalTrials.gov identifier: NCT04685408, registered on 28 December 2020, testing a novel stroke risk reduction approach (TargetEd manAgeMent Intervention (TEAM) conducted across 3 Ugandan sites. We examined variables with respect to an established set of guidelines for hypertension (HTN) severity, the European Society of Cardiology (ESC) and European Society of Hypertension (ESH) Guideline (ESC-ESH).

RESULTS

Of this total sample of 247, the mean sample age was 55.4 years (Standard deviation/SD =12.0), and largely female, n=168 (68%). In addition to HTN, the most common sample stroke risk factors were hyperlipidemia (n=199, 80.6%) and obesity (n= 98, 39.7%). The majority (n= 238. 96.4%) were prescribed at least one medication to treat HTN. Mean SBP and DBP at baseline were 143.0 (SD=19.8, range 94.5-206) and 89.3 (SD =14.0, range 61-136) respectively. ESC-ECH classifications were grouped into grades of increasing severity from mildest (Grade 1) to the most severe (Grade 3). An additional < Grade 1 was created to reflect individuals whose ESC-ECH scores dropped below Grade 1 post-screening. There were few significant differences across ESC-ECH groups, except that having diabetes, being sedentary and being a smoker were associated with higher ESC-ECH grades.

CONCLUSIONS

To help reduce stroke burden in Uganda, our findings support the importance of raising awareness of HTN and the helping individuals to manage their HTN with both medications and life-style approaches.