Hypertension burden and associated risk factors among people from the slums in a developing country: evidence from the COMBAT-CVD study

Hypertension remains a public health problem worldwide, particularly in Africa, where the burden is disproportionately high. However, little is known about the burden and factors associated with hypertension among populations living in slums, particularly in Sub-Saharan African countries like Nigeria, where a significant proportion of the population in Africa lives. This study assessed the hypertension burden and risk factors among individuals residing in the slums compared to the overall sample and those from the non-slum areas in Ibadan, Nigeria. In this study, 3635 participants from the door-to-door Community-based Investigation of the Risk Factors for Cardiovascular Diseases study provided information on sociodemographic and lifestyle factors. Blood pressure and anthropometric measurements were carried out using standard procedures. Hypertension was defined as one of the following conditions: systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, self-reported diagnosis of hypertension by a certified health professional, and current use of anti-hypertensive or blood pressure-lowering medications. Overall, 903 (24.8%) were hypertensive in the entire sample, but 29.4% (170 of 579) of the participants from the slums and 23.9% (733 of 3056) of those living in non-slum areas presented with hypertension. Generally, the odds of hypertension (using "no formal education" as reference) decreased with increasing education in the overall population and those from non-slum areas, with generally suggestive lower odds among those from the slum areas; OR: 0.45; 95% CI: 0.16, 1.25). Lifestyle modification interventions targeting older people who are married and less educated should lessen the burden of hypertension in these slums.