Prevalence of hypertension and associated factors among slum residents in Mbarara City, Uganda, 2024

Introduction: Hypertension, a primary cause of cardiovascular diseases and premature death, is highly prevalent in urban slums due to poverty, limited healthcare access, and unhealthy lifestyles. Data on hypertension from Ugandan slums remain limited. We estimated the prevalence of hypertension and examined associated factors among adult slum residents in Mbarara City, southwestern Uganda. Methods: We conducted a cross-sectional study in two densely populated slums during November–December 2024. Adults aged ≥18 years were selected using systematic random sampling. Blood pressure (BP) was measured using automated sphygmomanometers, and sociodemographic and lifestyle data were collected via structured questionnaires. Hypertension was classified per American College of Cardiology/American Heart Association guidelines: stage 1 for systolic BP 130-139 mmHg or diastolic BP 80-89 mmHg, and stage 2 for systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg. Multivariable modified Poisson regression identified factors associated with hypertension. Results: Of 411 participants, 64% (263/411; 95% CI: 59.2-68.5%) had hypertension, and among those classified as hypertensive, 32/263 (12.2%) reported a prior diagnosis. Prevalence was higher among adults aged 40-60 years (aPR: 1.29, 95% CI:1.11–1.50) and >60 years (aPR: 1.50, 95% CI:1.25–1.85) compared to those <40 years. Alcohol consumption (aPR: 1.23, 95% CI:1.06-1.42) and resting heart rate above 100 beats per minute (aPR: 1.36, 95% CI:1.15-1.60) were associated with higher hypertension prevalence, whereas regular vegetable intake was associated with lower prevalence (aPR: 0.78, 95% CI:0.65-0.94). Conclusion: Hypertension prevalence was high in Mbarara City slums, and few participants classified as hypertensive reported a prior diagnosis. Older age, alcohol consumption, and elevated resting heart rate were associated with higher hypertension prevalence, whereas weekly vegetable consumption was associated with lower prevalence. Public health strategies should strengthen hypertension detection, linkage to care, and evidence-based cardiovascular risk-reduction interventions in urban slum populations.