Prevalence and factors associated with Hypertension among Adult Outpatients at Mpeketoni Sub-County Hospital, Lamu, Kenya

Abstract

Background: Hypertension is a leading cause of cardiovascular diseases and a growing public health problem globally. The STEPS (Stepwise Approach to Non Communicable Disease Risk Factor Surveillance), report (2015) indicated that the prevalence of hypertension in Kenya was approximately 23.8% and that 56% of Kenyans had never been screened for raised blood pressure. Population-based data to inform policy development are scarce in Kenya. According to the Lamu County Integrated Development plan (2018-2022), hypertension is ranked as the fifth cause of outpatient morbidity with a prevalence of 3.5% and a mortality rate of 7.3%. The number of outpatient cases at Mpeketoni sub-County Hospital with hypertension almost doubled from 356 patients in 2014, to 607 in 2017. Objectives: To determine the prevalence and behavioral, social, and metabolic factors associated with hypertension among adults attending Mpeketoni sub-County Hospital. Methods: Hospital-based cross-sectional study design was used. Two hundred and fifty-five participants were recruited using systematic sampling. A trained research assistant assessed the participants and administered the study questionnaire. Variables collected included, body weight, height, waist circumference, blood pressure. Mean, standard deviation and frequencies were used to describe the participant characteristics. Chi square and Logistic regression were used to test associations; variables that were significant at p ≤ 0.05 were entered into Multiple Logistic Regression. Odds ratio was used to determine the level of association between the independent and dependent variables. Results: Two hundred and fifty-five participants aged 19 to 74 years with mean age of 38 ± 12.5 years were enrolled. They comprised of 48.6% males with majority aged between 25-34 years old. The overall prevalence of hypertension was 34.1%. The prevalence of hypertension was higher in females (41.2%) than males (26.6%) (p=0.014), among married than unmarried participants (40.9% vs 19%) (p=0.001). Those who were obese (47.5%), farmers (62%) and were not participating in vigorous intense activities (35.9%) had a higher prevalence of hypertension. Age was an independent predictor of hypertension; (aOR=15.1; 95 % CI=5.6-40.5). Individuals with an elevated waist circumference were more likely to have hypertension than those with normal waist circumference (aOR=3.3; 95% CI=1.6-6.8). Participants with a family history of high blood pressure were more likely to develop hypertension compared to those without a family history of raised BP (aOR=2.7; 95% CI=1.2-6.2). Conclusion: Hypertension affects at least one in three adults attending outpatient department. Age of 45 years and above, being female, a farmer and being obese have higher risk of developing hypertension. Participation in less vigorous activities and having a family history were also more likely to develop hypertension. Conclusion: The Public Health Department of Lamu County needs to put in strategies to ensure residents engage in physical exercise and maintain healthy weight targeting those older than 45 years. By sensitizing the residents on the importance of physical exercise and having accessible facilities where exercise can be done for example sports grounds and fitness centers.