Top

BMC Public Health

Published in:

Open Access 01-12-2022 | Hypercholesterolemia | Research

Prevalence and risk factors of prehypertension and hypertension in Algeria

Authors: Abdellatif Moussouni, Adel Sidi-yakhlef, Houari Hamdaoui, Amaria Aouar, Djamel Belkhatir

Published in: BMC Public Health | Issue 1/2022

Abstract

Background

Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population.

Methods

This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization’s (WHO) STEPwise approach.

Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model.

Results

The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2–37.5%) and 31.6% (95% CI: 30.5–32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older.

A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension.

Conclusion

Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.

World Health Organization. Global overview of hypertension. A “silent killer” responsible for a global public health crisis. 2013. Available from: http://apps.who.int/iris/bitstream/handle/10665/85334/WHO_DCO_WHD_2013.2_fre.pdf?sequence=1.

Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet. 2012;380(9841):611–9. https://doi.org/10.1016/s0140-6736(12)60861-7.CrossRefPubMed

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–23. https://doi.org/10.1016/S0140-6736(05)70151-3.CrossRefPubMed

World Health Organization. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization; 2002. https://apps.who.int/iris/handle/10665/67454. Accessed 12 Dec 2020

Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. Plos One. 2014;9(8):e104300. https://doi.org/10.1371/journal.pone.0104300.CrossRefPubMedPubMedCentral

Lenfant C, Chobanian AV, Jones DW, Roccella EJ. Seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails. Hypertension. 2003;41:1178–9. https://doi.org/10.1161/01.HYP.0000075790.33892.AE.CrossRefPubMed

Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001;358:1682–6. https://doi.org/10.1016/S0140-6736(01)06710-1.CrossRefPubMed

Huang Y, Wang S, Cai X, Mai W, Hu Y, Tang H, et al. Prehypertension and incidence of cardiovascular disease: a meta-analysis. BMC Med. 2013;11:177. https://doi.org/10.1186/1741-7015-11-177.CrossRefPubMedPubMedCentral

Agyemang C, Kunst A, Bhopal R, Zaninotto P, Unwin N, Nazroo J, et al. A cross-national comparative study of blood pressure and hypertension between English and Dutch South-Asian- and African-origin populations: the role of national context. Am J Hypertens. 2010;23(6):639–48. https://doi.org/10.1038/ajh.2010.39.CrossRefPubMed

10.

Lane D, Lip GY. Blood pressure in different ethnic groups. Am J Cardiol. 2001;88(10):1218–9. https://doi.org/10.1016/s0002-9149(01)01963-4.CrossRefPubMed

11.

World Health Organization. STEPS country reports. 2015. http://www.who.int/chp/steps/reports/en/. Accessed 19 Dec 2020.

12.

Mammeri A, Tebaibia A. Cardiometabolic risk in Algeria: past and present. Intern Emerg Med. 2020;15(4):531–5. https://doi.org/10.1007/s11739-019-02207-z.CrossRefPubMed

13.

National Institute of Public Health. National health survey (Epidemiological transition and health impact in North Africa): TAHINA Project; 2005. [Contrat no ICA3-CT-2002-10011]

14.

World Health Organization. World health statistics 2012. Geneva: WHO; 2012. https://apps.who.int/iris/handle/10665/44844. Accessed 19 Feb 2021.

15.

Benkhedda B, Chibane A, Temmar M, Aicheur T, Bendaoud N, Azou M, et al. Prevalence of hypertension in Algeria: national survey SAHA Abstract XIV; European conference on arterial hypertension Paris June (2004).

16.

MSPRH - Department of Prevention. Measurement of risk factors for non-communicable diseases in two pilot wilayas in Algeria 2003 (WHO STEPwise approach) Final report - Algeria 2005.

17.

Temmar M, Labat C, Benkhedda S, Charifi M, Thomas F, Bouafia MT, et al. Prevalence and determinants of hypertension in the Algerian Sahara. J Hypertens. 2007;25:2218–26. https://doi.org/10.1097/HJH.0b013e3282dc7549.CrossRefPubMed

18.

Brouri M, Ouadahi N, Nibouche D, Benabbas Y, El hassar M, Bouraoui S, et al. A subgroup analysis of the “Africa / Middle East Cardiovascular Epidemiological” study. Ann Cardiol Angeiol. 2018;67(2):61–6. [In French]. https://doi.org/10.1016/j.ancard.2018.01.003.CrossRef

19.

Nejjari C, Arharbi M, Chentir MT, Boujnah R, Kemmou O, Megdiche H, et al. Epidemiological Trial of Hypertension in North Africa (ETHNA): an international multicentre study in Algeria, Morocco and Tunisia. J Hypertens. 2013;31(1):49–62. https://doi.org/10.1097/HJH.0b013e32835a6611.CrossRefPubMed

20.

Mayega RW, Makumbi F, Rutebemberwa E, Peterson S, Ostenson CG, Tomson G. Modifiable socio-behavioral factors associated with overweight and hypertension among persons aged 35 to 60 years in eastern Uganda. Plos One. 2012;7:7632. https://doi.org/10.1371/journal.pone.0047632.CrossRef

21.

Riley L, Guthold R, Cowan M, Savin S, Bhatti L, Armstrong T, et al. The World Health Organization STEPwise Approach to Non communicable disease risk-factor surveillance: methods, challenges, and opportunities. Am J Public Health. 2016;106(1):74–8. https://doi.org/10.2105/AJPH.2015.302962.CrossRefPubMedPubMedCentral

22.

STEPwise Algeria 2016-2017 survey: Better knowledge of the health profiles of Algerians for the risk factors of non-communicable diseases. Regional Office for Africa. Available from: https://www.afro.who.int/fr/media-centre/events/enquete-stepwise-algerie-2016-2017-meilleure-connaissance-du-profil-de-sante. Accessed 11 Feb 2021.

23.

NCD Microdata Repository. https://extranet.who.int/ncdsmicrodata/index.php/home. Accessed 14 Feb 2021.

24.

World Health Organization. WHO STEPS surveillance manual: the WHO STEPwise approach to chronic disease risk factor surveillance. Geneva: WHO; 2005. WHO Library Cataloguing-in-Publication Data/. Accessed 14 Feb 2021

25.

World Health Organization. Clinical guidelines for the management of hypertension. 2005. https://www.who.int/iris/handle/10665/119738. Accessed 19 Feb 2021.

26.

Brahamia B. Health economics, evolution and trend of health systems. Edition Bahaeddine Constantine; 2010. p. 363.

27.

World Health Organization. Global database on body mass index. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed 8 Feb 2021.

28.

World Health Organization. Waist circumference and waist–hip ratio: report of a WHO expert consultation. 2011. https://www.who.int/publications-detail redirect/9789241501491. Accessed 19 Feb 2021.

29.

World Health Organization. Global strategy on diet, physical activity and health: World Health Organization; 2018. https://www.who.int/dietphysicalactivity/pa/en/. Accessed 22 Feb 2021

30.

Garriguet D. Diet quality in Canada. Health Rep. 2009;20(3):41–52 PMID: 19813438.PubMed

31.

World Health Organization-Non-Communicable diseases-Country profiles 2014. https://www.who.int/nmh/publications/ncd-profiles-2014/en/ Accessed 28 Mar 2021.

32.

Fuentes R, Ilmaniemi N, Laurikainen E, Tuomilehto J, Nissinen A. Hypertension in developing economies: a review of population-based studies carried out from 1980 to 1998. J Hypertens. 2000;18:521–9. https://doi.org/10.1097/00004872-200018050-00003.CrossRefPubMed

33.

Mammeri A, Guermaz R, Brouri M, Tebaibia A. Prevalence of Prehypertension and its Relationship to Risk Factors for Cardiovascular Diseases in Algeria: Analysis from a Cross-Sectional Survey. Adv Card Res. 2020;3(2):282–7. https://doi.org/10.32474/ACR.2020.03.000160.CrossRef

34.

Yang G, Ma Y, Wang S, Su Y, Rao W, Fu Y, et al. Prevalence and correlates of prehypertension and hypertension among adults in Northeastern China: a Cross-Sectional Study. Int J Environ Res Public Health. 2016;13(1):82. https://doi.org/10.3390/ijerph13010082.CrossRef

35.

Silva DA, Petroski EL, Peres MA. Prehypertension and hypertension among adults in a metropolitan area in Southern Brazil: population-based study. Rev Saude Publica. 2012;46(6):988–98 PMID: 23503537.CrossRef

36.

Islam SMS, Mainuddin AKM, Islam MS, Karim MA, Mou SZ, Arefin S, et al. Prevalence of risk factors for hypertension: a cross-sectional study in an urban area of Bangladesh. Global Cardiol Sci Pract. 2015;4(43). https://doi.org/10.5339/gcsp.2015.43.

37.

Rahmanian K, Shojaie M. The prevalence of pre-hypertension and its association to established cardiovascular risk factors in South of Iran. BMC Res Notes. 2012;5:386. https://doi.org/10.1186/1756-0500-5-386.CrossRefPubMedPubMedCentral

38.

Tsai PS, Ke TL, Huang CJ, Tsai JC, Chen PL, Wang SY, et al. Prevalence and determinants of prehypertension status in the Taiwanese general population. J Hypertens. 2005;23:1355–60. https://doi.org/10.1097/01.hjh.0000173517.68234.c3.CrossRefPubMed

39.

Ataklte F, Erqou S, Kaptoge S, Taye B, et al. Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension. 2015;65(2):291–8. https://doi.org/10.1161/HYPERTENSIONAHA.114.04394.CrossRefPubMed

40.

Ben Romdhane H, Ben Ali S, Skhiri H, Traissac P, Bougatef S, Maire B, et al. Hypertension among Tunisian adults: results of the TAHINA project. Hypertens Res. 2012;35(3):341–7. https://doi.org/10.1038/hr.2011.198.CrossRefPubMed

41.

Awadalla H, Elmak NE, El-Sayed EF, Almobarak AO, Elmadhoun WM, Osman M, et al. Hypertension in Sudanese individuals and associated risk factors: the critical intersection between salt and sugar intake. Cardiovasc Diagn Ther. 2018;8(4):432–8. https://doi.org/10.21037/cdt.2018.04.05.CrossRefPubMedPubMedCentral

42.

Khdour MR, Hallak HO, Shaeen M, Jarab AS, Al-Shahed QN. Prevalence awareness, treatment and control of hypertension in the Palestinian population. J Hum Hypertens. 2013;27(10):623–8. https://doi.org/10.1038/jhh.2013.26.CrossRefPubMed

43.

Cifkova R, Fodor G, Wohlfahrt P. Changes in hypertension prevalence, awareness, treatment, and control in high-, middle-, and low-Income countries: an update. Curr Hypertens Rep. 2016;18:62. https://doi.org/10.1007/s11906-016-0669-y.CrossRefPubMed

44.

El Achhab Y, Nazek L, Maalej M, Alami M, Nejjari C. Prevalence, control and risk factors related to hypertension among Moroccan adults: a multicentre study. East Mediterr Health J. 2019;25(7):447–56. https://doi.org/10.26719/emhj.18.057.CrossRefPubMed

45.

Abd El-Aty MA, Meky FA, Morsi MM, Al-Lawati JA, El Sayed MK. Hypertension in the adult Omani population: predictors for unawareness and uncontrolled hypertension. J Egypt Public Health Assoc. 2015;90(3):125–32. https://doi.org/10.1097/01.EPX.0000470547.32952.cf.CrossRefPubMed

46.

Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence and Risk Factors of Prehypertension and Hypertension in Southern China. Plos One. 2017;12(1):e0170238. https://doi.org/10.1371/journal.pone.0170238.CrossRefPubMedPubMedCentral

47.

Yameogo NV, Kagambega LJ, Millogo RC, Kologo KJ, Yameogo AA, Mandi GD, et al. Factors associated with poor blood pressure control in hypertensive black Africans: cross-sectional study of 456 hypertensive patients from Burkina Faso. Annales de cardiologie et d’angeiologie. 2013;62(1):38–42. https://doi.org/10.1016/j.ancard.2012.05.001.CrossRefPubMed

48.

Boukli Hacène L, Meguenni K. Cardiovascular risk factors in the urban community of Tlemcen (Algeria). Cah Sante. 2007;17(3):153–8 [In French]. http://bdspehesp.inist.fr/vibad/index.php?action=getRecordDetail&idt=374134.

49.

Hall JE, Guyton AC. Guyton and Hall textbook of medical physiology. 12th ed. Philadelphia: Saunders Elsevier; 2011.

50.

Franklin SS, Gustin W 4th, Wong ND, Larson MG, Weber MA, Kannel WB, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation. 1997;96(1):308–15. https://doi.org/10.1161/01.cir.96.1.308.CrossRefPubMed

51.

Staessen JA, Celis H, Fagard R. The epidemiology of the association between hypertension and menopause. J Hum Hypertens. 1998;12(9):587–92. https://doi.org/10.1038/sj.jhh.1000670.CrossRefPubMed

52.

Tailakh A, Evangelista LS, Mentes JC, Pike NA, Phillips LR, Morisky DE. Hypertension prevalence, awareness, and control in Arab countries: a systematic review. Nurs Health Sci. 2014;16(1):126–30. https://doi.org/10.1111/nhs.12060.CrossRefPubMed

53.

Rahman M, Zaman M, Islam JY, Chowdhury J, Ahsan HN, Rahman R, et al. Prevalence, treatment patterns, and risk factors of hypertension and pre-hypertension among Bangladeshi adults. J Hum Hypertens. 2018;32:334–48. https://doi.org/10.1038/s41371-017-0018-x.CrossRefPubMed

54.

Kavishe B, Biraro S, Baisley K, Vanobberghen F, Kapiga S, Munderi P, et al. High prevalence of hypertension and of risk factors for noncommunicable diseases (NCDs): a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern Uganda. BMC Med. 2015;13:126. https://doi.org/10.1186/s12916-015-0357-9.CrossRefPubMedPubMedCentral

55.

Midha T, Krishna V, Nath B, Kumari R, Rao YK, Pandey U, et al. Cut-off of body mass index and waist circumference to predict hypertension in Indian adults. World J Clin Cases. 2014;2(17):272–8. https://doi.org/10.12998/wjcc.v2.i7.272.CrossRefPubMedPubMedCentral

56.

Rahmouni K, Correia MLG, Haynes WG, Mark AL. Obesity-associated hypertension: New insights into mechanisms. Hypertension. 2005;45(1):9–14. https://doi.org/10.1161/01.HYP.0000151325.83008.b4.CrossRefPubMed

57.

Bouhenni H, Daoudi H, Djemai H, Noirez P, Rouabah A, Vitiello D, et al. Relationships between metabolic profile, hypertension and uric acid with cardiometabolic risk in adolescents with abdominal obesity: impact of geodemographic factors on the prevalence of abdominal obesity. Int J Adolesc Med Health. 2017;32(2) /j/ijamh.2020.32.issue-2/ijamh-2017-0107/ijamh-2017-0107.xml. https://doi.org/10.1515/ijamh-2017-0107.

58.

Seow LSE, Subramaniam M, Abdin E, Vaingankar JA, Chong SA. Hypertension and its associated risks among Singapore elderly residential population. J Clin Gerontol Geriatr. 2015;6(4):125–32. https://doi.org/10.1016/j.jcgg.2015.05.002.CrossRef

59.

Pessinaba S, Mbaye A, Yabeta GA, Kane A, Ndao CT, Ndiaye MB, et al. Prevalence and determinants of hypertension and associated cardiovascular risk factors: data from a population-based, cross-sectional survey in Saint Louis. Senegal Cardiovasc J Afr. 2013;24(5):180–3. https://doi.org/10.5830/CVJA-2013-030.CrossRefPubMed

60.

Li R, Li WC, Lun ZJ, Zhang HP, Sun Z, Kanu JS, et al. Prevalence of metabolic syndrome in mainland china: a meta-analysis of published studies. BMC Public Health. 2016;16:296 10.1186/S12889-016-2870-Y.CrossRef

61.

Ong KL, Cheung BMY, Man YB, Lau CP, Lam KSL. Prevalence, awareness, treatment, and control of Hypertension among United States adults 1999–2004. Hypertension. 2007;49(1):69–75. https://doi.org/10.1161/01.HYP.0000252676.46043.18.CrossRefPubMed

62.

Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009;27(5):963–75. https://doi.org/10.1097/hjh.0b013e3283282f65.CrossRefPubMed

63.

Zimmerman MA, Sullivan JC. Hypertension: what’s sex got to do with its physiology? Physiology (Bethesda). 2013;28(4):234–44. https://doi.org/10.1152/physiol.00013.2013.CrossRef

64.

Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation. 2005;112(23):3562–8. https://doi.org/10.1161/CIRCULATIONAHA.105.539569.CrossRefPubMed

65.

Bachir Cherif A, Bouamra A, Taleb A, Nedjar R, Bouraghda A, Hamida F, et al. Differences in prevalence, treatment and control rates of hypertension between male and female in the area of Blida (Algeria). Ann Cardiol Angeiol (Paris). 2017;66:123–9. https://doi.org/10.1016/j.ancard.2017.04.009.CrossRef

66.

The ESHRE Capri Workshop Group. Hormones and cardiovascular health in women. Hum Reprod Update. 2006;12(5):483–97. https://doi.org/10.1093/humupd/dml028.CrossRef

67.

Boukli HL, Khelil MA, Chabane Sari D, Meguenni K, Meziane TA. Prevalence of cardiovascular risk factors in urban and rural communities in the Wilaya of Tlemcen (Algeria): a comparative study. Rev Epidemiol Sante Publique. 2017;65(4):277–84. https://doi.org/10.1016/j.respe.2017.01.121.CrossRef

68.

Sarki AM, Nduka CU, Stranges S, Kandala NB, Uthman OA. Prevalence of hypertension in low- and middle-income countries: A systematic review and meta-analysis. Medicine (Baltimore). 2015;94(50):e1959. https://doi.org/10.1097/MD.0000000000001959.CrossRef

69.

Ganguli MC, Grimm RH Jr, Svendsen KH, Flack JM, Grandits GA, Elmer PJ. Higher education and income are related to a better Na:K ratio in blacks: baseline results of the Treatment of Mild Hypertension Study (TOMHS) data. Am J Hypertens. 1997;10(9 Pt 1):979–84. https://doi.org/10.1016/s0895-7061(97)00162-3.CrossRefPubMed

70.

Tobe SW, Kiss A, Szalai JP, Perkins N, Tsigoulis M, Baker B. Impact of job and marital strain on ambulatory blood pressure results from the double exposure study. Am J Hypertens. 2005;18:1046–51. https://doi.org/10.1016/j.amjhyper.2005.03.734.CrossRefPubMed

71.

Rumball-Smith J, Nandi A, Kaufman JS. Working and hypertension: gaps in employment not associated with increased risk in 13 European countries, a retrospective cohort study. BMC Public Health. 2014;14:536. https://doi.org/10.1186/1471-2458-14-536.CrossRefPubMedPubMedCentral

72.

D'Elia L, De Palma D, Rossi G, Strazzullo V, Russo O, Iacone R, et al. Not smoking is associated with lower risk of hypertension: results of the Olivetti Heart Study. Eur J Pub Health. 2014;24(2):226–30. https://doi.org/10.1093/eurpub/ckt041.CrossRef

73.

Cleroux J, Feldman RD, Petrella RJ. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada. CMAJ. 1999;160(Suppl 9):S21–8 PMID: 10333850.PubMedPubMedCentral

74.

Vaidya A, Pokharel PK, Karki P, Nagesh S. Exploring the iceberg of hypertension: a community-based study in an eastern Nepal town. Kathmandu Univ Med J. 2007;5(3):349–59 PMID: 18604053.

75.

O’Connor LE, Hu EA, Steffen LM, Selvin E, Rebholz CM. Adherence to a Mediterranean-style eating pattern and risk of diabetes in a U.S. prospective cohort study. Nutr. Diabetes. 2020;10(1):8. https://doi.org/10.1038/s41387-020-0113-x.

76.

Eman S, Chaza A, Hala G, Carla M. Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature. BMC Public Health. 2018;18:639. https://doi.org/10.1186/s12889-018-5472-z.CrossRef

Title: Prevalence and risk factors of prehypertension and hypertension in Algeria
Authors: Abdellatif Moussouni
Adel Sidi-yakhlef
Houari Hamdaoui
Amaria Aouar
Djamel Belkhatir
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Hypercholesterolemia
Hypertension
Hypertension
Published in: BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-022-13942-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and risk factors of prehypertension and hypertension in Algeria

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2022

Association of public physical activity facilities and participation in community programs with leisure-time physical activity: does the association differ according to educational level and income?

Urban-rural differences in China’s crude death rate changes

Using health economic modelling to inform the design and development of an intervention: estimating the justifiable cost of weight loss maintenance in the UK

Infection preventive behaviors and its association with perceived threat and perceived social factors during the COVID-19 pandemic in South Korea: 2020 community health survey

SARS-CoV-2 cases reported from long-term residential facilities (care homes) in South Africa: a retrospective cohort study

Locked out during COVID-19 lockdown—an online survey of relatives of people with psychotic and bipolar disorders in Norway