Relationship between psychological distress, health behaviours and future reports of hypertension among adults in East Zimbabwe: a cohort study.

Journal: Open heart

Volume: 10

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  Department of Health and Social Care, UK Government, London, UK. MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK k.davis@imperial.ac.uk. MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK. Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe.

Abstract summary 

Extensive cross-sectional evidence has demonstrated an association between psychological distress (PD) and hypertension. However, evidence on the temporal relationship is limited, especially in low-income and middle-income countries. The role of health risk behaviours including smoking and alcohol consumption in this relationship is also largely unknown. The aim of this study was to investigate the association between PD and later development of hypertension, and how this association may have been influenced by health risk behaviours, among adults in east Zimbabwe.The analysis included 742 adults (aged 15-54 years) recruited by the Manicaland general population cohort study, who did not have hypertension at baseline in 2012-2013, and who were followed until 2018-2019. In 2012-2013, PD was measured using the Shona Symptom Questionnaire, a screening tool validated for use in Shona-speaking countries including Zimbabwe (cut-off point: 7). Smoking, alcohol consumption and use of drugs (health risk behaviours) were also self-reported. In 2018-2019, participants reported if they had diagnosed with hypertension by a doctor or nurse. Logistic regression was used to assess the association between PD and hypertension.In 2012, 10.4% of the participants had PD. The odds of new reports of hypertension were 2.04 times greater (95% CI 1.16 to 3.59) among those with PD at baseline, after adjusting for sociodemographic and health risk behaviour variables. Female gender (adjusted odds ratio, AOR 6.89, 95% CI 2.71 to 17.53), older age (AOR 2.67, 95% CI 1.63 to 4.42), and greater wealth (AOR 2.10, 95% CI 1.04 to 4.24 more wealthy, 2.88, 95% CI 1.24 to 6.67 most wealthy) were significant risk factors for hypertension. The AOR for the relationship between PD and hypertension did not differ substantially between models with and without health risk behaviours.PD was associated with an increased risk of later reports of hypertension in the Manicaland cohort. Integrating mental health and hypertension services within primary healthcare may reduce the dual burden of these non-communicable diseases.

Authors & Co-authors:  Shamsuddin Shehla S Davis Katherine K Moorhouse Louisa L Mandizvidza Phyllis P Maswera Rufurwokuda R Dadirai Tawanda T Nyamukapa Constance C Gregson Simon S Chigogora Sungano S

Study Outcome 

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Statistics
Citations :  Forouzanfar MH, Afshin A, Alexander LT, et al. . Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016;388:1659–724. 10.1016/S0140-6736(16)31679-8
Authors :  9
Identifiers
Doi : e002346
SSN : 2053-3624
Study Population
Female
Mesh Terms
Humans
Other Terms
biostatistics;epidemiology;global health;hypertension;public health
Study Design
Cross Sectional Study,Cohort Study
Study Approach
Country of Study
Zimbabwe
Publication Country
England