The epidemiology of behavioral risk factors for noncommunicable disease and hypertension: A cross-sectional study from Eastern Uganda

Abstract

In light of the suboptimal noncommunicable disease (NCD) risk factor surveillance efforts, the study’s main objectives were to: (i) characterize the epidemiological profile of NCD risk factors; (ii) estimate the prevalence of hypertension; and (iii) identify factors associated with hypertension in a peri-urban and rural Ugandan population. A population-based cross-sectional survey of adults was conducted at the Iganga-Mayuge Health and Demographic Surveillance System site in eastern Uganda. After describing sociodemographic characteristics, the prevalence of NCD risk factors and hypertension was reported. Prevalence ratios for NCD risk factors were calculated using weighted Poisson regression to identify factors associated with hypertension. Among 3220 surveyed respondents (mean age: 35.3 years (standard error: 0.1), 49.4% males), 4.4% were current tobacco users, 7.7% were current drinkers, 98.5% had low fruit and vegetable consumption, 26.9% were overweight, and 9.3% were obese. There was a high prevalence of hypertension and prehypertension, at 17.1% and 48.8%, respectively. Among hypertensive people, most had uncontrolled hypertension, at 97.4%. When we examined associated factors, older age (adjusted prevalence ratio (APR): 3.1, 95% CI: 2.2–4.4, APR: 5.2, 95% CI: 3.7–7.3, APR: 8.9, 95% CI: 6.4–12.5 among 30–44, 45–59, and 60+-year-old people than 18–29-year-olds), alcohol drinking (APR: 1.6, 95% CI: 1.3–2.0, ref: no), always adding salt during eating (APR: 1.6, 95% CI: 1.1–2.2, ref: no), poor physical activity (APR: 1.3, 95% CI: 1.1–1.6, ref: no), overweight (APR: 1.3, 95% CI: 1.1–1.5, ref: normal weight), and obesity (APR: 2.0, 95% CI: 1.6–2.4, ref: normal weight) had higher prevalence of hypertension than their counterparts. The high prevalence of NCD risk factors highlights the immediate need to implement and scale-up population-level strategies to increase awareness about leading NCD risk factors in Uganda. These strategies should be accompanied by concomitant investment in building health systems capacity to manage and control NCDs.