Prevalence and predictors of adult hypertension in Kabul, Afghanistan
1 Surveillance/DEWS Directorate, Afghan National Public Health Institute (ANPHI), Ministry of Public Health, 3rd Floor, Room # 9, Massoud Square, Kabul, Afghanistan
2 Salisbury District Hospital Visiting Faculty, Salisbury, Wiltshire, UK
3 Aga Khan University, Karachi, Pakistan
4 Southampton University Hospitals Trust Visiting fellow, University of Southampton, Southampton, Hampshire, UK
BMC Public Health 2014, 14:386 doi:10.1186/1471-2458-14-386Published: 23 April 2014
The prevalence of hypertension is rising worldwide with an estimated one billion people now affected globally and is of near epidemic proportions in many parts of South Asia. Recent turmoil has until recently precluded estimates in Afghanistan so we sought, therefore, to establish both prevalence predictors in our population.
We conducted a cross-sectional study of adults ≥40 years of age in Kabul from December 2011-March 2012 using a multistage sampling method. Additional data on socioeconomic and lifestyle factors were collected as well as an estimate of glycaemic control. Bivariate and multivariable analyses were undertaken to explore the association between hypertension and potential predictors.
A total of 1183 adults (men 396, women 787) of ≥ 40years of age were assessed. The prevalence of hypertension was 46.2% (95% CI 43.5 – 49.3). Independent predictors of hypertension were found to be: age ≥50 (OR = 3.86, 95% CI: 2.86 – 5.21); illiteracy (OR = 1.90, 1.05 – 1.90); the consumption of rice >3 times per week (OR = 1.43, 1.07 – 1.91); family history of diabetes (OR = 2.20, 1.30 – 3.75); central obesity (OR = 1.67, 1.23 – 2.27); BMI ≥ 30 Kg/meter squared (OR = 2.08, 1.50 – 2.89). The consumption of chicken and fruit more than three times per week were protective with ORs respectively of 0.73 (0.55-0.97) and 0.64 (0.47 – 0.86).
Hypertension is a major public health problem in Afghan adults. We have identified a number of predictors which have potential for guiding interventions.