Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc
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Original Article

Volume 14, Number 2, December 2024, pages 74-85


Demographics and Clinical Correlates of Blood Pressure Among Ugandans at Risk for Stroke

Figures

Figure 1.
Figure 1. Distribution of SBPs (a) and DPBs (b) in a Ugandan screening sample. SBP: systolic blood pressure; DBP: diastolic blood pressure.
Figure 2.
Figure 2. Distribution of SBPs (a) and DBPs (b) in a Ugandan baseline sample. SBP: systolic blood pressure; DBP: diastolic blood pressure.

Tables

Table 1. Baseline Demographics and Clinical Characteristics of the TEAM Uganda Sample (N = 247 Randomized Sample)
 
VariablesN (%)Mean (SD), range
aIncludes self-employed work at home or farming. bObesity defined as BMI > 30. cESC-ESH grade 1: SBP 140 - 159 mm Hg and/or DBP 90 - 99 mm Hg; grade 2: SBP 160 - 179 mm Hg and/or DBP 100 - 109 mm Hg; grade 3: SBP ≥ 180 mm Hg and/or DBP ≥ 110 mm Hg. dHarmful drinking behaviors based on AUDIT score defined as total score > 8. eCurrent smoke based on baseline assessment using the Global Adult Tobacco Survey (GATS). SD: standard deviation; HTN: hypertension; BMI: body mass index; AUDIT: Alcohol Use Disorders Identification Test; TEAM: TargetEd manAgeMent Intervention; SBP: systolic blood pressure; DBP: diastolic blood pressure; HbA1c: glycosylated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; TIA: transient ischemic attack; ESC-ESH: the European Society of Cardiology and the European Society of Hypertension.
Age (years)55.4 (12.0), 20 - 90
Gender
  Male79 (32.0)
  Female168 (68.0)
Educational level
  None18 (7.3)
  Primary118 (47.8)
  Secondary87 (35.2)
  Tertiary24 (9.7)
Marital status
  Single15 (6.1)
  Married132 (53.4)
  Separated/divorced/widowed100 (40.5)
Currently employed/workinga162 (65.6)
Residency status
  Rural53 (21.5)
  Suburban83 (33.6)
  Urban111 (44.9)
Family stroke history50 (20.2)
Stroke risk factors at screening
  SBP ≥ 140 mm Hg247 (100)
  Diabetes72 (29.1)
  Hyperlipidemia199 (80.6)
  Obesityb98 (39.7)
  Current smoker3 (1.2)
  Sedentary lifestyle58 (23.5)
  Problem alcohol use26 (10.5)
  Personal history of stroke or TIA49 (19.8)
  Total number of stroke risk factors (including HTN) at screening3.0 (0.9), 2 - 6
SBP at screen158.1 (14.9), 140 - 216
DBP at screen95.4 (11.4), 71.5 - 132
SBP at baseline143.0 (19.8), 94.5 - 206
DBP at baseline89.3 (14.0), 61 - 136
ESC-ESH 2018 Guideline HTNc at baseline
  < Grade 1 (SBP < 140 and DBP < 90)93 (37.7)
  Grade 183 (33.6)
  Grade 247 (19.0)
  Grade 324 (9.7)
Serum cholesterol4.5 (1.1), 1.7 - 7.1
  Proportion with elevated value61 (24.7)
Serum HDL1.6 (2.8), 0.3 - 4.4
  Proportion with abnormal (low) value
    Men (n = 79)25 (31.6)
    Women (n = 166)90 (54.2)
Serum LDL3.0 (1.3), 0.4 - 8.3
  Proportion with elevated value82 (33.2)
Serum triglycerides1.6 (1.0), 0.3 - 7.7
  Proportion with elevated value84 (34.0)
HbA1c (total sample)6.1 (1.9), 2.0 - 15.0
  HBA1c (those with diabetes)8.4 (1.8), 6.5 - 15.0
BMI28.7 (5.8), 16.8 - 45.5
  Proportion with obesity98 (39.7)
AUDIT total score1.0 (3.5), 0 - 30
  Proportion with harmful drinking behaviord8 (4.9)
Current smokere, N (%)4 (1.6)
Receiving medication treatment for stroke/cardiovascular risk reduction
  No5 (2.0)
  Yes (at least 1 drug)242 (98.0)
Number of medication treatments, mean (SD)3.0 (1.2), 0 - 6
  Sample prescribed a single medication16 (6.6)
  Sample prescribed two treatments67 (27.7)
  Sample prescribed three or more treatments159 (65.7)

 

Table 2. Comparison of Baseline Demographics and Clinical Characteristics of the TEAM Uganda Sample Classified Using ESC-ESH Cut-Points
 
VariablesESC-ESH HTN gradesaSignificant difference between groups
(A) < Grade 1 (n = 93, 37.7%), mean (SD) or N (%)(B) Grade 1 (n = 83, 33.6%), mean (SD) or N (%)(C) Grade 2 (n = 47, 19.0%), mean (SD) or N (%)(D) Grade 3 (n = 24, 9.7%), mean (SD) or N (%)
aESC-ESH grade 1: SBP 140 - 159 mm Hg and/or DBP 90 - 99 mm Hg; grade 2: SBP 160 - 179 mm Hg and/or DBP 100 - 109 mm Hg; grade 3: SBP ≥ 180 mm Hg and/or DBP ≥ 110 mm Hg. bIncludes self-employed work at home or farming. cCurrent smoker based on baseline assessment using the Global Adult Tobacco Survey (GATS). *P < 0.05; **P < 0.01; ***P < 0.001. SD: standard deviation; HTN: hypertension; BMI: body mass index; AUDIT: Alcohol Use Disorders Identification Test; TEAM: TargetEd manAgeMent Intervention; SBP: systolic blood pressure; DBP: diastolic blood pressure; HbA1c: glycosylated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; ESC-ESH: the European Society of Cardiology and the European Society of Hypertension.
Age (years), mean (SD)56.3 (12.0)55.8 (11.9)56.1 (13.5)49.6 (7.8)ns; A, B > D
Gender, n (%)
  Male27 (29.0)27 (32.5)17 (36.2)8 (33.3)
  Female66 (71.0)56 (67.5)30 (63.8)16 (66.7)ns
Educational level, n (%)
  None5 (5.4)9 (10.8)2 (4.3)2 (8.3)
  Primary42 (45.2)37 (44.6)27 (57.4)12 (50.0)
  Secondary37 (39.8)27 (32.5)13 (27.7)10 (41.7)
  Tertiary9 (9.7)10 (12.0)5 (10.6)0 (0.0)ns
Marital status, n (%)
  Single10 (10.8)3 (3.6)2 (4.3)0 (0.0)
  Married43 (46.2)43 (51.8)29 (61.7)17 (70.8)
  Separated/divorced/widow40 (43.0)37 (44.6)16 (34.0)7 (29.2)ns
Currently employed/workingb56 (60.2)58 (69.9)30 (63.8)18 (75.0)ns
Residency status, n (%)
  Rural14 (15.1)19 (22.9)15 (31.9)5 (20.8)
  Suburban37 (39.8)23 (27.7)12 (25.5)11 (45.8)
  Urban42 (45.2)41 (49.4)20 (42.6)8 (33.2)ns
Stroke family history, n (%)19 (20.4)16 (19.3)12 (25.5)3 (12.5)ns
Stroke risk factors at screening, n (%)
  Diabetes16 (17.2)30 (36.1)19 (40.4)7 (29.2)**; C, B > A
  Hyperlipidemia77 (82.8)68 (81.9)36 (76.6)18 (75.0)ns
  Obesity39 (41.9)34 (41.0)18 (38.3)7 (29.2)ns
  Current smoker2 (2.2)0 (0.0)0 (0.0)1 (4.2)ns
  Sedentary lifestyle27 (29.0)12 (14.5)10 (21.3)9 (37.5)*
  Problem alcohol use10 (10.8)6 (7.2)7 (14.9)3 (12.5)ns
  Personal stroke history29 (31.2)12 (14.55 (10.6)3 (12.5)**; A > C
Total number of risk factors at screening, mean (SD)3.0 (1.0)3.0 (0.8)2.9 (1.0)3.1 (1.1)ns
SBP at baseline, mean (SD)124.3 (10.4)145.4 (6.8)158.8 (10.9)176.0 (16.6)***; D > C > B > A
DBP at baseline, mean (SD)77.8 (7.4)88.6 (6.9)99.9 (7.7)115.9 (8.9)***; D > C > B > A
Serum cholesterol, mean (SD)4.8 (1.1)4.4 (1.2)4.4 (1.0)4.4 (1.2)ns
Serum HDL, mean (SD)1.3 (0.6)1.3 (0.6)1.4 (0.6)1.3 (0.5)ns
Serum LDL, mean (SD)3.1 (1.0)3.2 (1.7)2.6 (1.0)3.0 (1.6)*; A > C
Serum triglycerides1.6 (1.0)1.7 (0.8)1.8 (1.3)1.6 (1.0)ns
HbA1c, mean (SD)5.8 (1.7)6.2 (2.0)6.5 (1.9)6.2 (2.4)ns
BMI, mean (SD)29.4 (6.1)28.3 (5.5)28.8 (6.0)27.3 (5.0)ns
AUDIT, mean (SD)0.7 (1.9)0.8 (2.6)1.0 (3.4)3.0 (8.2)ns
Current smokerc, n (%)1 (1.1)1 (1.2)0 (0.0)2 (8.3)*
Receiving medication treatment for cardiovascular risk reduction, n (%) (at least 1 drug)92 (98.9)81 (97.6)47 (100.0)22 (91.7)ns
Number of medication treatments, mean (SD)3.0 (1.1)2.9 (1.2)3.0 (1.2)3.4 (1.5)ns
Number of individuals on a single treatment, n (%)5 (5.4)7 (8.6)4 (8.5)0 (0.0)ns
Number of individuals on two treatments, n (%)27 (29.3)21 (25.9)15 (31.9)4 (18.2)ns
Number of individuals on three or more treatments, n (%)60 (65.2)53 (65.4)28 (59.6)18 (81.8)ns

 

Table 3. Pearson Correlations for Baseline Demographics and Clinical Characteristics of the TEAM Uganda Sample (N = 247)
 
VariablesSBPDBPESC-ESH HTN severity gradea
aESC-ESH grade 1: SBP 140 - 159 mm Hg and/or DBP 90 - 99 mm Hg; grade 2: SBP 160 - 179 mm Hg and/or DBP 100 - 109 mm Hg; grade 3: SBP ≥ 180 mm Hg and/or DBP ≥ 110 mm Hg. bIncludes self-employed work at home or farming. cCurrent smoker based on baseline assessment using the Global Adult Tobacco Survey (GATS). *P < 0.05, **P < 0.01, ***P < 0.001. SD: standard deviation; HTN: hypertension; BMI: body mass index; AUDIT: alcohol use disorders identification test; SBP: systolic blood pressure; DBP: diastolic blood pressure; HbA1c: glycosylated hemoglobin; HDL: high-density lipoprotein; LDL: low-density lipoprotein; ESC-ESH: the European Society of Cardiology and the European Society of Hypertension; TEAM: TargetEd manAgeMent Intervention.
Age (years)-0.01-0.24***-0.11
Female-0.040.03-0.05
Educational level-0.08-0.06-0.08
Married0.13*0.17**0.16*
Currently employed/workingb0.070.14*0.08
Residency status (n = 129)
  Rural0.160.130.16
Stroke history
  Family (yes)0.020.02-0.01
Stroke risk factors at baseline
  Diabetes0.19**0.100.15*
  Hyperlipidemia-0.04-0.05-0.07
  Obesity-0.03-0.06-0.07
  Current smoker-0.01-0.02-0.00
  Sedentary life style-0.04-0.010.01
  Personal stroke history-0.19**-0.18**-0.19**
Total number of risk factors at screening (including HTN)-0.000.060.02
SBP1.00***0.76***0.85***
DBP0.76***1.00***0.84***
ESC-ESH 2018 Guideline HTN European grade0.85***0.84***1.00***
Serum cholesterol-0.05-0.11-0.12
Serum HDL0.02-0.040.00
Serum LDL-0.09-0.07-0.09
Serum triglycerides0.09-0.050.04
HbA1c0.18**0.050.10
BMI-0.07-0.07-0.09
AUDIT total score0.14*0.14*0.15*
Current smokerc, N (%)0.070.130.10
Receiving medication treatment for cardiovascular risk-0.03-0.10-0.09
Number of medication treatments0.13*0.070.07