Observational studyBulletin of the World Health Organization2025
Measured and self-reported hypertension among women of reproductive age, Gambia, Kenya, Mozambique.
Observational study in Bulletin of the World Health Organization, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Problem: In sub-Saharan Africa, hypertension prevalence is usually estimated from participant recall. We assessed the accuracy of self-reported hypertension in women of reproductive age. Approach: In PRECISE (PREgnancy Care Integrating translational Science, Everywhere), an observational prospective cohort study, we recruited 1825 non-pregnant women of reproductive age, 610 in the Gambia, 609 in Kenya and 606 in Mozambique. We compared self-reported and measured hypertension (systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg). We adjusted hypertension prevalence for age, body mass index, education, parity, and antihypertensive medicine and oral contraceptive use. Local setting: PRECISE was conducted in both urban and rural hospitals or clinics. Relevant changes: The women were generally in their late twenties and parous. Adjusted measured hypertension prevalence was higher in Mozambique (10.4%; 95% confidence interval, CI: 7.9-12.7) and the Gambia (9.3%; 95% CI: 6.6-12.6) than in Kenya (4.6%; 95% CI: 3.0-6.6). Self-reported hypertension prevalence was highest in the Gambia (12.9%; 95% CI: 10.2-15.9) versus Mozambique (4.2%; 95% CI: 2.8-5.7) or Kenya (6.7%; 95% CI: 5.0-8.6). Sensitivity of self-reported (versus measured) hypertension was less than 45% in all countries, with specificities more than 89%. Positive likelihood ratios were fair in the Gambia (3.70; 95% CI: 2.47-5.54), and good in Kenya (5.79; 95% CI: 3.36-9.98) and Mozambique (5.18; 95% CI: 2.56-10.46). All negative likelihood ratios were poor (≥ 0.20). Lessons learnt: Self-reported hypertension is unsuitable for population hypertension estimates among women of reproductive age in these countries.
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