Prevalence and predictors of hypertension in Namibia: A national-level cross-sectional study

BACKGROUND: Hypertension has been identified as the single greatest contributor to the global burden of disease and mortality, with estimates suggesting that the highest levels of blood pressure have shifted from high-income countries to low-income countries in sub-Saharan Africa. While evidence suggests a remarkably high prevalence of hypertension among urban residents in Namibia, national estimates to inform on the country-level burden are lacking. This study estimates the prevalence and predictors of hypertension among Namibian adults. METHODS: The analysis is based on 1,795 women and 1,273 men aged 35–64 years from the nationally-representative 2013 Namibia Demographic and Health Survey. Odds radios and 95% confidence intervals were estimated using logistic regression. RESULTS: The age-standardized prevalence of hypertension was 46.0% (men vs. women: 46.1% vs. 46.0%). Mean systolic and diastolic blood pressures for the total population were 128.8 mmHg (95% CI 127.8–129.7) and 83.1 mmHg (95% CI 82.5–83.7), respectively. Mean systolic blood pressure was significantly lower among women (men vs. women: 130.9 mmHg vs. 127.4 mmHg; p<0.001). There were no statistically significant differences in mean diastolic blood pressure between men and women. Older age, urban residence, and being either overweight or obese were positively associated with the odds of hypertension (p<0.01). For women, the odds of hypertension were also significantly increased for those who were diabetic (i.e. had a fasting blood glucose level greater than 7.0 mmol/L) and reduced for those with higher levels of education. CONCLUSION: The prevalence of hypertension among Namibian adults is high and associated with metabolic and socio-demographic factors. Future research examining disease comorbidity and behavioral risk factors could better inform on the disease burden and help target resources to optimize prevention and control.