Hypertension prevalence and care in an urban and rural area of Tanzania

Objective To describe the prevalence, detection, treatment and control of h ypertension in an urban and rural area of Tanzania. Design Two linked cross-sectional population-based surveys. Setting A middle-income urban district of Dar es Salaam (Ilala) and a villa ge in the relatively prosperous rural area of Kilimanjaro (Shari). Participants Seven hundred and seventy adults (>15 years) in Ilala and 928 adults in Shari were studied. Results Hypertension prevalence (blood pressure greater than or equal to 14 0 and/or 90 mmHg, or known hypertensives receiving antihypertensive treatme nt) was 30% (95% confidence interval, 25.1-34.9%) in men and 28.6% (24.3-32 .9%) in women in Ilala, and 32.2% (27.7-36.7%) in men and 31.5% (27.8-35.2% ) in women in Shari. Age-standardized hypertension (to the New World Popula tion) prevalence was 37.3% (32.2-42.5%) among men and 39.1% (34.2-44.0%) in women in Ilala, and 26.3% (22.4-30.4%) in men and 27.4% (24.4-30.4%) in wo men in Shari. In both areas, just under 20% of hypertensive subjects were a ware of their diagnosis, approximately 10% reported receiving treatment and less than 1% were controlled (blood pressure <140/90 mmHg). Hypertensive s ubjects were older, had greater body mass indices and waist:hip ratios, and had more risk factors for hypertension and its complications (smoking, hea vy alcohol consumption, physical inactivity, obesity and diabetes) than non -hypertensives. Conclusions There is a high prevalence of hypertension in rural and urban a reas of Tanzania, with low levels of detection, treatment and control. This demonstrates the need for cost-effective strategies for primary prevention , detection and treatment of hypertension and the growing public health cha llenge of non-communicable diseases in Sub-Saharan Africa. J Hypertens 2000 , 18:145-152 (C) Lippincott Williams & Wilkins.