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

Abstract

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: We conducted a cross-sectional analysis of demographics, stroke risk factors, and selected clinical variables associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Demographics (age, gender, marital status, education level, rural/suburban/urban status, and employment status), stroke risk factors (diabetes, hyperlipidemia, obesity, smoking status, sedentary lifestyle, and problem alcohol use), and clinical variables associated with SBP and DBP were derived from the screening and baseline sample of a prospective, randomized effectiveness-implementation trial testing a novel stroke risk reduction approach (TargetEd manAgeMent Intervention (TEAM)) conducted across three Ugandan sites. We examined variables with respect to an established set of guidelines for hypertension (HTN) severity, the European Society of Cardiology and the European Society of Hypertension (ESC-ESH) Guideline. Results: Of the total sample of 247, the mean sample age was 55.4 years (standard deviation (SD) = 12.0), with a female predominance (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-ESH classifications were grouped into grades of increasing severity from the mildest (grade 1) to the most severe (grade 3). An additional < grade 1 was created to reflect individuals whose ESC-ESH scores dropped below grade 1 post-screening. There were few significant differences across ESC-ESH groups, except that having diabetes, being sedentary, and being a smoker were associated with higher ESC-ESH grades. Conclusions: To help reduce the stroke burden in Uganda, our findings support the importance of raising awareness of HTN and helping individuals to manage their HTN with both medications and lifestyle approaches. J Neurol Res. 2024;14(2):74-85 doi: https://doi.org/10.14740/jnr830