Hypertension prevalence and risk factors among residents of four slum communities: population-representative findings from Port-au-Prince, Haiti

Abstract

Objectives:

To estimate the prevalence of hypertension and its risk factors among adults in four slum communities in Port-au-Prince.

Methods:

Cluster area random sampling was used to select adults for a health and demographic survey, including anthropometric measurements. Hypertension was defined as systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mmHg, or current hypertension treatment, and was age-standardized to WHO world population. Correlates of hypertension were tested using sex-stratified logistic regression.

Results:

Overall, 20.3% of adults had hypertension (28.5% age-standardized), including 22.3% of men and 18.9% of women. Three percent of participants reported current hypertension treatment, and 49.5% of them had their hypertension controlled. Overweight/obesity (BMI≥25) was the most common risk factor (20.6% among men, 48.5% among women), while smoking was less common (11.8% and 3.9%, respectively). Increasing age and hypertension prevalence in immediate surroundings were associated with greater odds of hypertension. Among men, having in-migrated in the 3 years prior (versus ≥3 years) was also associated with hypertension (adjusted odds ratio [aOR]=3.32, 95% confidence interval [CI]:1.79-6.17); as was overweight and obesity (aOR=1.90, 95% CI:1.09-3.33, and aOR=5.73, 95% CI:2.49-13.19, respectively) and non-receipt of needed medical care in the preceding six months (aOR=2.82, 95% CI:1.35-5.88) among women.

Conclusions:

Hypertension prevalence was high across the age spectrum, in addition to substantial levels of overweight/obesity and unmet healthcare needs. It is important to better understand the possible effects of intraurban migration and environmental risk factors on hypertension, and ensure that benefits of increasingly cost-effective prevention and treatment programs extend to slum residents.