Undiagnosed hypertension in Sudan: results of the cross-sectional national STEPS survey in 2016.

INTRODUCTION

the rate of hypertension has been increasing in Africa. The study aimed to estimate the prevalence and associated factors of undiagnosed hypertension (HTN) among adults in Sudan.

METHODS

cross-sectional data were analyzed from 7,226 persons (18-69 years, median 37 years, interquartile range 27-49 years, 4557 were females) who participated in the 2016 Sudan STEPS survey, had complete blood pressure measurement and non-pregnant, and responded to a questionnaire, physical measures, and biomedical tests. Logistic regression was used to determine the predictors of undiagnosed HTN.

RESULTS

the prevalence of undiagnosed HTN was 26.2% (n=2057) (79.2% of total HTN), diagnosed HTN 6.9% (n=690) and total HTN 33.1% (n=2747). In multivariable analysis older age (50-69 years) (adjusted risk ratio-aRR: 2.49, 95% CI: 2.02-3.09; p<0.001), obesity (aRR: 2.51, 95% CI: 1.97-3.21; p<0.001), diabetes (aRR: 1.59, 95% CI: 1.17-2.16; p=0.002) and elevated total cholesterol (aRR: 1.48, 95% CI: 1.19-1.84; p<0.001) were positively associated and health care advice (aRR: 0.79, 95% CI: 0.64-0.98; p=0.036) was negatively associated with undiagnosed HTN versus no HTN. Male sex (adjusted odds ratio-aOR: 2.22, 95% CI: 1.63-3.01; p<0.001) was positively associated, and older age (50-69 years) (aOR: 0.31, 95% CI: 0.21-0.46; p<0.001), married (aOR: 0.45, 95% CI: 0.33-0.62; p<0.001), urban residence (aOR: 0.70, 95% CI: 0.51-0.96; p=0.022), health care advice (aOR: 0.32, 95% CI: 0.22-0.45; p<0.001), ever cholesterol measured (aOR: 0.43, 95% CI: 0.27-0.67; p<0.001), overweight (aOR: 0.63, 95% CI: 0.47-0.85; p=0.003) and heart attack or stroke (aOR: 0.31, 95% CI: 0.17-0.55; p<0.001) were negatively associated with undiagnosed HTN versus diagnosed HTN.

CONCLUSION

one in four adults in Sudan had undiagnosed HTN (eight in ten of total HTN) and several associated factors that can help guide interventions were identified.