Prevalence, Patterns and Factors Associated with Dyslipidemia Among Adult Hypertensive Patients in Uganda
DOI:
https://doi.org/10.59786/bmtj.224Keywords:
Prevalence, Hypertension, Lipid profile, Smoking, UgandaAbstract
Background
Dyslipidemia is a major risk factor for coronary heart disease and is responsible for an estimated 2.6 million deaths annually. Hypertensive patients often suffer from dyslipidemia, which can lead to complications such as ischemic heart disease and stroke.
Aim: This study examined the prevalence and factors associated with dyslipidemia among adult hypertensive patients admitted to Lira Regional Referral Hospital (LRRH) in Uganda.
Methods
This cross-sectional study, conducted over three months at Lira Regional Referral Hospital (LRRH), involved 431 patients. Medical examinations and histories were recorded, and blood samples were analyzed to measure high-density lipoprotein (HDL), low-density lipoprotein (LDL-c), total cholesterol (TC), and triglycerides (TG). Dyslipidemia was defined by any of the following: TC ≥200 mg/dL, TG ≥150 mg/dL, HDL-C < 40 mg/dL, or LDL-C ≥100 mg/dL. The data were analyzed using binary logistic regression in SPSS version 26 to identify associated factors.
Results
A total of 431 patients were included in the study, with the majority being females over 65 years of age (mean age = 64.7, SD = 8.8 years). The prevalence of dyslipidemia was 48.3% (208) (95% CI = 43.2-52.9%). High LDL levels were observed in 24.4% (105), high TC in 22.5% (97), high TG in 20.0% (86), and low HDL in 20.0% (86 patients). Multivariate analysis revealed that patients with elevated blood pressure, stage 1 hypertension, and stage 2 hypertension had 1.350 (aOR = 1.350, CI = 1.194-1.525, P < 0.001), 1.290 (aOR = 1.290, CI = 1.123-1.482, P < 0.001), and 1.302 (aOR = 1.302, CI = 1.077-1.576, P = 0.007) times higher odds of having dyslipidemia, respectively. Additionally, dyslipidemia was 1.414 times more common (aOR = 1.414, CI = 1.280-1.561, P < 0.001) among current or former smokers, and 1.493 times more common (aOR = 1.493, CI = 1.372-1.625, P < 0.001) in patients with diabetes mellitus.
Conclusion
The findings highlight a high prevalence of dyslipidemia, emphasizing the need for targeted interventions. Enhancing patient education on antihypertensive therapy adherence and increasing efforts to discourage smoking are crucial steps to reduce the burden of dyslipidemia in hypertensive populations.
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References
Adamu, U. G., Okuku, G. A., Oladele, C. O., Abdullahi, A., Oduh, J. I., & Fasae, A. J. (2013). Serum lipid profile and correlates in newly presenting Nigerians with arterial hypertension. Vascular Health and Risk Management, 9, 763.
Ahmmed, S., Shuvo, S. Das, Paul, D. K., Karim, M. R., Kamruzzaman, M., Mahmud, N., Ferdaus, M. J., & Elahi, M. T. (2021). Prevalence of dyslipidemia and associated risk factors among newly diagnosed Type-2 Diabetes Mellitus ( T2DM ) patients in Kushtia , Bangladesh. Plos Global Public Health, 1(12), 1–13. https://doi.org/10.1371/journal.pgph.0000003
Akintunde, A. A., Ayodele, E. O., Akinwusi, O. P., & Opadijo, G. O. (2010). Dyslipidemia among newly diagnosed hypertensives: pattern and clinical correlates. Journal of the National Medical Association, 102(5), 403–407.
Asiki, G., Murphy, G. A. V., Baisley, K., Nsubuga, R. N., Karabarinde, A., Newton, R., Seeley, J., Young, E. H., Kamali, A., & Sandhu, M. S. (2015). Prevalence of dyslipidaemia and associated risk factors in a rural population in South-Western Uganda: A community based survey. PLoS ONE, 10(5). https://doi.org/10.1371/journal.pone.0126166
Ataklte, F., Erqou, S., Kaptoge, S., Taye, B., Echouffo-Tcheugui, J. B., & Kengne, A. P. (2015). Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension, 65(2), 291–298.
Bartelt, A., Bruns, O. T., Reimer, R., Hohenberg, H., Ittrich, H., Peldschus, K., Kaul, M. G., Tromsdorf, U. I., Weller, H., & Waurisch, C. (2011). Brown adipose tissue activity controls triglyceride clearance. Nature Medicine, 17(2), 200–205.
Bekele, S., Yohannes, T., & Mohammed, A. E. (2017). Dyslipidemia and associated factors among diabetic patients attending Durame General Hospital in Southern Nations , Nationalities , and People ’ s Region. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 10, 265–271.
Bromfield, S., & Muntner, P. (2013). High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Current Hypertension Reports, 15(3), 134–136.
Demelash, Z., Alemu, A., Adugna, M., & Bayleyegn, B. (2021). Prevalence and predictors of dyslipidemia among hypertensive patients in Lumame Primary Hospital , Amhara , Ethiopia : A cross-sectional study. Metabolism Open, 11, 100108. https://doi.org/10.1016/j.metop.2021.100108
Dixit, A. K., Dey, R., Suresh, A., Chaudhuri, S., Panda, A. K., & Mitra, A. (2014). The prevalence of dyslipidemia in patients with diabetes mellitus of ayurveda Hospital. Journal of Diabetes & Metabolic Disorders, 13(58), 2–7. https://doi.org/http://www.jdmdonline.com/content/13/1/58
Guwatudde, D., Mutungi, G., Wesonga, R., Kajjura, R., Kasule, H., Muwonge, J., Ssenono, V., & Bahendeka, S. K. (2015). The epidemiology of hypertension in Uganda: findings from the national non-communicable diseases risk factor survey. PloS One, 10(9), e0138991.
Haj Mouhamed, D., Ezzaher, A., Neffati, F., Gaha, L., Douki, W., & Najjar, M. F. (2013). Association between cigarette smoking and dyslipidemia. Immuno-Analyse et Biologie Specialisee, 28(4), 195–200. https://doi.org/10.1016/j.immbio.2013.03.004
Jain, R. B., & Ducatman, A. (2018). Associations between smoking and lipid/lipoprotein concentrations among US adults aged≥ 20 years. Journal of Circulating Biomarkers, 7, 1849454418779310.
Jeenduang, N., Whanmasae, S., Seepawin, P., & Kullabootr, S. (2013). The prevalence of dyslipidemia among a rural Thai population in the Nakhon Si Thammarat province. Journal of the Medical Association of Thailand= Chotmaihet Thangphaet, 96(8), 992–1000.
Kaddumukasa, M., Kayima, J., Nakibuuka, J., Blixen, C., Welter, E., Katabira, E., & Sajatovic, M. (2017). Modifiable lifestyle risk factors for stroke among a high risk hypertensive population in Greater Kampala, Uganda; A cross-sectional study. BMC Research Notes, 10(1), 1–6. https://doi.org/10.1186/s13104-017-3009-7
Kiplagat, S. V., Lydia, K., Jemimah, K., & Drusilla, M. (2017). Prevalence of Dyslipidemia and The Associated Factors Among Type 2 Diabetes Patients in Turbo Sub-County kenya. Journal of Endocrinology and Diabetes, 4(5), 1–9. https://doi.org/10.15226/2374-6890/4/5/00190
Kotwani, P., Kwarisiima, D., Clark, T. D., Kabami, J., Geng, E. H., Jain, V., Chamie, G., Petersen, M. L., Thirumurthy, H., & Kamya, M. R. (2013). Epidemiology and awareness of hypertension in a rural Ugandan community: a cross-sectional study. BMC Public Health, 13(1), 1–10.
Liu, W., Yang, C., Chen, Z., Lei, F., Qin, J.-J., Liu, H., Ji, Y.-X., Zhang, P., Cai, J., & Liu, Y.-M. (2022). Global death burden and attributable risk factors of peripheral artery disease by age, sex, SDI regions, and countries from 1990 to 2030: Results from the Global Burden of Disease study 2019. Atherosclerosis, 347, 17–27.
Luo, J., Ma, Y.-T., Yu, Z., Yang, Y.-N., Xie, X., Ma, X., Liu, F., Li, X., & Chen, B. (2014). Prevalence, awareness, treatment and control of dyslipidemia among adults in northwestern China: the cardiovascular risk survey. Lipids in Health and Disease, 13(1), 1–6.
Marcus, M. E., Ebert, C., Geldsetzer, P., Theilmann, M., Bicaba, B. W., Andall-Brereton, G., Bovet, P., Farzadfar, F., Singh Gurung, M., & Houehanou, C. (2021). Unmet need for hypercholesterolemia care in 35 low-and middle-income countries: A cross-sectional study of nationally representative surveys. PLoS Medicine, 18(10), e1003841.
Meetei, M. M., & Devi, R. K. V. (2019). Prevalence and Pattern of Dyslipidemia in a Tertiary Care Center of Manipur. IOSR Journal of Dental and Medical Sciences, 18(8), 30–35. https://doi.org/10.9790/0853-1808113035
Mondo, C. K., Otim, M. A., Musoke, R., Orem, J., & Akol, G. (2016). The prevalence and distribution of non-communicable diseases and their risk factors in Kasese district, Uganda. South African Journal of Diabetes and Vascular Disease, 13(1), 31–36.
Moradinazar, M., Pasdar, Y., Najafi, F., Shahsavari, S., Shakiba, E., Hamzeh, B., & Fakhri, N. (2020). Association between dyslipidemia and blood lipids concentration with smoking habits in the Kurdish population of Iran. BMC Public Health, 20(1), 1–10.
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., De Ferranti, S., Després, J.-P., & Fullerton, H. J. (2016). Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation, 133(4), e38–e360.
Obsa, M. S., Ataro, G., Awoke, N., Jemal, B., Tilahun, T., Ayalew, N., Woldegeorgis, B. Z., Azeze, G. A., & Haji, Y. (2022). Determinants of Dyslipidemia in Africa: A Systematic Review and Meta-Analysis. Frontiers in Cardiovascular Medicine, 8(February), 1–13. https://doi.org/10.3389/fcvm.2021.778891
Pan, L., Yang, Z., Wu, Y., Yin, R. X., Liao, Y., Wang, J., Gao, B., & Zhang, L. (2016). China National Survey of Chronic Kidney Disease Working, G. The prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis, 248, 2–9.
Peng, J., Zhao, F., Yang, X., Pan, X., Xin, J., & Wu, M. (2021). Association between dyslipidemia and risk of type 2 diabetes mellitus in aged and older Chinese adults : a secondary analysis of a nationwide cohort. BMJ Open, 11, 1–8. https://doi.org/10.1136/bmjopen-2020-042821
Poulter, N. R., & Prabhakaran, D. (2015). Caulfield M. Hypertension. Lancet (London, England), 386(9995), 801–812.
WHO. (2018). Progress on the prevention and control of noncommunicable diseases in the Western Pacific Region: country capacity survey 2017. World Health Organisation.
WHO. (2021). Hypertension. World Health Organization.
WHO, W. H. O. (2019). Global Health Observatory (GHO) data. Geneva: World Health Organization; 2019. World Health Organization.
Woudberg, N. J., Goedecke, J. H., Blackhurst, D., Frias, M., James, R., Opie, L. H., & Lecour, S. (2016). Association between ethnicity and obesity with high-density lipoprotein (HDL) function and subclass distribution. Lipids in Health and Disease, 15(1), 1–11.
Yan-Ling, Z., Dong-Qing, Z., Chang-Quan, H., & Bi-Rong, D. (2012). Cigarette smoking and its association with serum lipid/lipoprotein among Chinese nonagenarians/centenarians. Lipids in Health and Disease, 11(1), 1–6.
Yu, S., Yang, H., Guo, X., Zhang, X., Zheng, L., & Sun, Y. (2015). Prevalence of dyslipidemia and associated factors among the hypertensive population from rural Northeast China Chronic Disease epidemiology. BMC Public Health, 15(1), 1–9. https://doi.org/10.1186/s12889-015-2486-7
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