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Blood pressure levels among children in rural Uganda: results from 1913 children in a general population survey

Journal of Human Hypertension volume 36, pages 1021–1026 (2022)Cite this article

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Abstract

Despite increasing levels of adult hypertension in sub-Saharan Africa (SSA), there is limited information on elevated blood pressure among children in SSA. We described the distribution of blood pressure among children in rural Uganda and estimated hypertension prevalence. We conducted a cross-sectional study in south-western Uganda, collecting demographic, anthropometric and blood pressure measurements from children aged 6–12 years. Children with elevated blood pressure (systolic and/or diastolic blood pressure greater or equal to the 95th percentile for age, height and sex) were invited for two further assessments 6–18 months later. We described blood pressure distribution at first assessment, assessed associations with demographic and anthropometric characteristics and estimated prevalence of hypertension as defined by having elevated blood pressure on three separate occasions months apart. Blood pressure (BP) was measured in 1913 children (50% male, 3% overweight or obese, 22% stunted) at the first assessment. Mean (SD) systolic and diastolic BP at first assessment was 113.4 mmHg (±10.8) and 69.5 mmHg (±8.3), respectively, and 44.2% had elevated BP. Older age, higher BMI, and being female were associated with higher BP, and stunted height was associated with lower BP. An estimated 7.8% [95% CI:(6.6–9.1)], (males: 6.8%, females: 9.0%), had elevated BP on three separate occasions, and were considered hypertensive. High blood pressure levels among adults in SSA may be set early in life. In this study, obesity (a common lifestyle modifiable risk factor in other settings) was largely irrelevant. More research is needed to understand the main drivers for elevated blood pressure in SSA further.

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Fig. 1: A Flow diagram showing follow up of rural Ugandan children (6–12 years) for required visits to assess elevated blood pressure.

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Data availability

The datasets generated and/or analysed during this study are available from the corresponding author upon reasonable request. https://doi.org/10.17037/DATA.00002387.

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Acknowledgements

We would like to thank all the participants of the General Population Cohort, the field and clinic team, and the laboratory staff.

Funding

This work was supported by Medical Research Council (MRC), UK [grant numbers G0801566 and G090121392157] awarded to MRC/UVRI Uganda Research Unit on AIDS. CH also received funding from the Medical Research Council (MRC), UK [grant number: MR/K012126/1].

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Author notes

  1. These authors jointly supervised this work: Christian Holm Hansen, Robert Newton.

Authors and Affiliations

  1. Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda

    Sheila Kansiime, Sylvia Kusemererwa, Swaib A. Lule, Anxious J. Niwaha, Janet Seeley, Alex Karabarinde, Christian Holm Hansen & Robert Newton

  2. Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK

    Sheila Kansiime, Emily L. Webb & Christian Holm Hansen

  3. University College London, Institute for Global Health, London, UK

    Swaib A. Lule

  4. Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK

    Janet Seeley

  5. Department of Health Sciences, University of York, York, UK

    Robert Newton

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  1. Sheila Kansiime
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Contributions

SK (first author) conceived and designed the analysis, performed the analysis, was involved in interpreting of the results and took the lead in writing the manuscript. All authors were involved in the writing of the manuscript. In addition; EW designed the analysis, performed the analysis, and was involved in the interpretation of the results; SK collected the data and was involved in study oversight; SL was involved in the interpretation of the results and reviewed the manuscript, AN was involved in the interpretation of the results and reviewed the manuscript, JS was involved in designing of the study, collecting the data, and study oversight; AK collected the data, and was involved in study oversight; CH (joint last author) conceived and designed the analysis, performed the analysis, and was involved in interpretation of the results, RN (joint last author), was involved in designing of the study, study oversight, data collection and was involved in the interpretation of the results. All authors reviewed the manuscript.

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Correspondence to Sheila Kansiime.

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Kansiime, S., Webb, E.L., Kusemererwa, S. et al. Blood pressure levels among children in rural Uganda: results from 1913 children in a general population survey. J Hum Hypertens 36, 1021–1026 (2022). https://doi.org/10.1038/s41371-021-00610-8

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