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This study analyzed data from 3,842 overweight and obese Ethiopian adults and found that 24.8% had hypertension. Individual risk factors included older age, male sex, higher education, and greater wealth, while community-level factors such as urban residence and concentrated community wealth also significantly increased hypertension risk. The multilevel analysis revealed that both personal characteristics and environmental context contribute substantially to hypertension prevalence among overweight individuals.
Why it matters
The findings demonstrate that addressing hypertension in Sub-Saharan Africa requires strategies beyond individual clinical care, including urban planning that promotes physical activity and consideration of socioeconomic clustering effects. This is particularly important as Ethiopia and similar countries undergo epidemiological transitions with rising rates of obesity and cardiovascular disease.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Abstract Background: Sub Saharan Africa is experiencing an accelerating epidemiological transition characterized by a growing burden of non-communicable diseases. Although excess body weight is an established risk factor for cardiovascular disease significant variations in hypertension status exist among overweight and obese adults due to individual traits and community environments. This study aimed to identify individual and community level determinants of hypertension among overweight and obese adults in Ethiopia using nationally representative Demographic and Health Survey data. Methods: We analyzed nationally representative data from non pregnant adults aged eighteen years and older with a Body Mass Index of 25 kilograms per meter squared or higher from the two stage cluster sampled 2024-25 Ethiopia Demographic and Health Survey across 797 enumeration areas. The primary outcome was hypertension, defined by elevated blood pressure or current antihypertensive medication use. Two level multivariable logistic regression evaluated fixed effect Adjusted Odds Ratios with 95% Confidence Intervals, alongside cluster random effects and model performance using Intra Class Correlation, Median Odds Ratio, Proportional Change in Variance and the Akaike Information Criterion. Results: Among a total weighted sample of three thousand eight hundred forty-two overweight and obese adults across six hundred twelve clusters, the weighted national prevalence of hypertension was 24.8%. In the final multivariable multilevel model, advancing age, male sex, higher educational status and upper wealth index categories were significant individual level risk factors. At the community level, residing in urban clusters and high community level wealth concentration significantly elevated hypertension odds. The null model revealed substantial clustering, which dropped substantially in the final model, demonstrating that contextual factors account for much of the cluster variations. Conclusions: Both individual metabolic and demographic drivers alongside community level economic and urban environments influence hypertension risk among overweight and obese Ethiopian adults. Cardiovascular health strategies should combine clinical targeted screening with urban structural modifications that facilitate active living environments.