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The high prevalence of hypertension in rural-dwelling Tanzanian older adults and the disparity between detection, treatment and control: a rule of sixths?

Journal of Human Hypertension volume 27, pages 374–380 (2013)Cite this article

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Abstract

There are limited, reliable data on the prevalence of hypertension in East African populations. The aim of this study was to document the prevalence of hypertension in the rural Hai district of Tanzania. All consenting individuals aged 70 years and over who were living in 12 randomly-selected villages in the district underwent three consecutive sitting blood pressure (BP) measurements. An average of the last two measurements was taken. Prior diagnosis of, and treatment for, hypertension was recorded. Of the 2223 subjects, 1553 (69.9%, 95% CI 68.0–71.8) had hypertension (BP ⩾140/90). Of those with hypertension 733 (47.2%) had isolated systolic hypertension. Only 586 (37.7%) hypertensives had been previously diagnosed, 94 (6.1%) were currently treated and 14 (0.9%) were adequately controlled. This is the first large-scale prevalence study of hypertension in the elderly in sub-Saharan Africa (SSA). Our results approximate to a ‘rule of sixths’; 2/6 of hypertensives were previously detected, 1/6 of those previously detected were on treatment and 1/6 of those on treatment were adequately controlled. Hypertension is a large problem in the elderly population in SSA, and there are a growing number of elderly who are at risk of hypertensive sequelae owing to lack of detection and treatment.

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Acknowledgements

We wish to acknowledge the help of all health care workers, officials, carers and family members who assisted in identification of cases, examination and assessment, and in data collection. This work was supported in part by a grant from the Peel Medical Research Trust, and Northumbria Healthcare NHS Foundation Trust. The sponsors of this study had no role in designing the study; in the collection, analysis, and interpretation of data; in the writing of the report or in the decision to submit the paper for publication.

Author contributions: Design/conception—Richard Walker, Matthew Dewhurst. Literature search—Richard Walker, Matthew Dewhurst. Data collection—Felicity Dewhurst, Matthew Dewhurst, Golda Orega. Data analysis—William K Gray, Matthew Dewhurst. Interpretation of results—Richard Walker, Matthew Dewhurst, Paul Chaote, William K, Gray, Felicity Dewhurst. Writing of paper and review—Richard Walker, William K Gray, Matthew Dewhurst, Paul Chaote, Golda Orega.

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Authors and Affiliations

  1. Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK

    M J Dewhurst, F Dewhurst, W K Gray & R W Walker

  2. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

    M J Dewhurst, F Dewhurst & R W Walker

  3. District Medical Office, Hai District Hospital, Boman’gombe, Hai, United Republic of Tanzania,

    P Chaote

  4. Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania

    G P Orega

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Correspondence to M J Dewhurst.

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Dewhurst, M., Dewhurst, F., Gray, W. et al. The high prevalence of hypertension in rural-dwelling Tanzanian older adults and the disparity between detection, treatment and control: a rule of sixths?. J Hum Hypertens 27, 374–380 (2013). https://doi.org/10.1038/jhh.2012.59

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