Predictors of Hypertension among Rural Women <I>The Case of Amagoro in Western Kenya</I>

Abstract

Background: Hypertension's association with other chronic illnesses such as cardiovascular diseases, Diabetes, cause common health burden to individuals and societies resulting to a significant loss of quality life-years. It is becoming a major health hazard with a national prevalence of 24.5% and a rural prevalence of 21.4%. In 2017, WHO ranked hypertension as the 12th leading cause of death in Kenya [3-7]

Objective: Investigations to establish the predictors of hypertension amongst rural women, informed the researhers to interview residents of Amagoro Division, Busia County, in Western Kenya.

Methodology: A descriptive survey involving 260 women aged 15- 90 years drawn from various households in Amagoro Division predominantly Tesos. Cluster and proportional sampling was employed. Data was collected using a pre-tested structured questionnaire through face-to-face interviews. Weight, height, Waist Circumference (WC) and Hip Circumference (HC) measurements were taken. Body
mass index was then computed as weight (kg)/height2 and waist-to-hip ratio was computed as WC/HC. Blood pressure measurements were taken twice and average recorded. Hypertension was defined by blood pressure ≥140/90mmHg or taking anti-hypertensive drugs.

Results: The prevalence of hypertension was 22.3%. Age and household income emerged as the strongest independent risk factors  (p<0.05). increased prevalence of hypertension with increasing BMI despite the fact that majority of participants had BMI below normal [28], marital status, gender, ethnicity, scarcity of formal employment, work frustrations, such as meger renumerations were all strongly associated. Suggestion that being disadvantaged in early and adult life may be associated with hypertension [40] was a reality. The concentrations of homocysteine including its metabolites were significantly higher in the hypertensive patients (p<0.01).

Conclusion: All other factors being constant, aging and household income can predict the risk of hypertension in a population. The increasing prevalence with age could be due to elevated homocysteine levels which have been found to increase gradually with age. The concentrations of High homocystein level and stiffening of the arteries during ageing [10] could be used to explain the increasing  prevalence of hypertension with age in this study. Those who spent 6 hours or more resting are more likely to suffer from hypertension as opposed to those spending 1 to 3 hours (OR=3.74, p=0.354). Beside enthinicity being a factor, there was no association due to the fact that
91% came from the same ethnic grouping.

Recommandation: With rising life expectancy, hypertension intervention strategies should not target only the elderly but also young people to encourage them modify their lifestyle.

Key words: blood pressure, hypertension, elderly, women, Kenya