BACKGROUND Non-communicable diseases are increasing in sub-Saharan Africa and are estimated to account for 32% of adult deaths in The Gambia. Worldwide, prevalence of hypertension is highest in the African region (46%) and a very high proportion is undiagnosed. This study examined diagnosed and undiagnosed hypertension in The Gambian adult population. METHODS Data were collected in 2010 from a nationally representative random sample of 4111 adults aged 25-64 years, using the World Health Organization STEPwise cross-sectional survey methods. Analyses were restricted to non-pregnant participants with three valid blood pressure measurements (n = 3573). We conducted gender-stratified univariate and multivariate regression analyses to identify the strongest sociodemographic, behavioural and biological risk factors associated with hypertension. RESULTS Almost one-third of adults were hypertensive; a high proportion were undiagnosed, particularly among men (86% of men vs 71% of women with hypertension, P < 0.001). Rural and semi-urban residents and overweight/obese persons had increased odds of hypertension. Compared with urban residents, participants from one of the most rural regions had higher odds of hypertension among both men [adjusted odds ratio (AOR) 3.2; 95% CI: 1.6-6.4] and women (AOR 2.5; 95% CI: 1.3-4.6). Other factors strongly associated with hypertension in multivariate analyses were age, smoking, physical inactivity and ethnicity. CONCLUSIONS Rural and semi-urban residence were strongly associated with hypertension, contrary to what has been found in similar studies in sub-Saharan Africa. Intervention to reduce the burden of hypertension in The Gambia could be further targeted towards rural areas.

中文翻译：

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冈比亚的高血压负担：来自世界卫生组织（WHO）国家STEP调查的证据。

背景技术在撒哈拉以南非洲，非传染性疾病正在增加，据估计占冈比亚成年人死亡的32％。在世界范围内，高血压的患病率在非洲地区最高（46％），并且未确诊的比例很高。这项研究检查了冈比亚成年人口中已诊断和未诊断的高血压。方法：采用世界卫生组织阶梯式横断面调查方法，于2010年从全国代表性的4111名25-64岁成年人中随机抽取数据。分析仅限于具有三个有效血压测量值（n = 3573）的非孕妇。我们进行了按性别分层的单因素和多元回归分析，以确定与高血压相关的最强的社会人口统计学，行为和生物学危险因素。结果几乎三分之一的成年人患有高血压。未诊断的比例很高，尤其是在男性中（高血压的男性比例为86％，女性的比例为71％，P <0.001）。农村和半城市居民以及超重/肥胖者患高血压的几率增加。与城市居民相比，来自农村地区最远的地区之一的参与者在男性中患高血压的几率更高[调整后的优势比（AOR）为3.2；95％CI：1.6-6.4]和女性（AOR 2.5； 95％CI：1.3-4.6）。在多变量分析中与高血压密切相关的其他因素是年龄，吸烟，缺乏运动和种族。结论农村居民和半城市居民与高血压密切相关，这与撒哈拉以南非洲地区类似研究的结果相反。