Prevalence, Awareness, and Factors Associated with Hypertension Among Adults in Rural Southwestern Uganda: A Baseline Survey.

Background: Hypertension is the leading cause of preventable deaths globally. However, reports on its prevalence and risk factors in rural sub-Saharan Africa have been inconsistent, making targeted interventions challenging. This study examines the prevalence, awareness, and associated factors of hypertension among adults in a rural community in southwestern Uganda. Methods: We conducted a baseline survey in Ngango, Mbarara district, enrolling adults aged 18-79 years from eleven villages. Research assistants and community health workers recruited participants from their homes using the WHO STEPS questionnaire, collecting data on demographics, lifestyle behaviors (tobacco and alcohol use, diet, and physical activity), and other risk factors. Blood pressure (BP) was measured three times, with hypertension defined as BP ≥140/90 mmHg or self-reported antihypertensive use. Logistic regression was applied to identify factors associated with hypertension. Results: A total of 953 adults were enrolled, with a median age of 43 years (IQR: 30-57). Women accounted for 61.5%, and only 43.5% recalled ever having their blood pressure measured. Hypertension prevalence was 27.3%, with 61.5% of cases undiagnosed. Among those receiving treatment (27.7%), 65.3% had controlled blood pressure. Despite 66.8% of participants reporting regular physical activity, 63.7% were overweight. The key factors associated with hypertension included age over 40 years (OR: 2.26), consuming fewer than three servings of fruits or vegetables per week (OR: 1.62), and being overweight (OR: 1.57) or obese (OR: 2.73). Conclusion: Hypertension is highly prevalent in rural southwestern Uganda, underscoring the need for targeted interventions-especially within a relatively young and physically active population.