Abstract : Background: Hypertension is an emerging public health challenge, particularly in low-resource urban settings, contributing to cardiovascular morbidity and mortality.
Objectives: To estimate the prevalence of hypertension and identify associated risk factors among adults living in urban slums.
Methods: A community-based cross-sectional study was conducted among 600 adults aged ?18 years residing in urban slums. Blood pressure (BP) was measured twice using a standardized protocol, and hypertension was defined according to JNC 8 criteria. A structured questionnaire collected data on sociodemographics, lifestyle factors, and anthropometrics. Multivariate logistic regression identified independent predictors of hypertension.
Results: The overall prevalence of hypertension was 32% (192/600). Prevalence increased with age: 18–29 years, 12%; 30–44 years, 28%; 45–59 years, 40%; ?60 years, 55%. Independent predictors included obesity (adjusted OR 3.1, 95% CI 2.1–4.6), current tobacco use (OR 1.8, 95% CI 1.2–2.8), low physical activity (OR 1.7, 95% CI 1.1–2.5), and advancing age (per 10-year increment: OR 1.5, 95% CI 1.3–1.8). Gender and alcohol consumption were not independently associated.
Conclusion: Nearly one-third of adults in urban slums are hypertensive. Obesity, tobacco use, low physical activity, and age are key modifiable risk factors. Community-level lifestyle interventions are urgently needed to reduce the burden of hypertension.
Introduction : Hypertension is a leading contributor to cardiovascular disease, stroke, and chronic kidney disease globally. The burden is rising in low-resource urban populations due to lifestyle transitions, dietary changes, and limited access to preventive healthcare. Urban slums are particularly vulnerable due to overcrowding, poor nutrition, and low health literacy. Despite its importance, population-based data on hypertension prevalence and risk factors in slum communities remain limited.
This study aimed to estimate the prevalence of hypertension and identify associated sociodemographic and lifestyle risk factors among adults living in urban slums, following the STROBE guidelines for reporting observational studies.
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Method : Study Design and Setting
A community-based cross-sectional study was conducted in [City, Country] between [Month Year] and [Month Year].
Participants
Adults aged ?18 years residing in selected urban slums for at least 6 months were included. Exclusion criteria were pregnancy and known secondary hypertension.
Sample Size
Based on an anticipated prevalence of 30%, 5% absolute precision, and 95% confidence level, the minimum sample size was 323. A total of 600 participants were enrolled to increase representativeness.
Data Collection
Trained field workers collected sociodemographic data (age, gender, education, occupation) and lifestyle factors (tobacco, alcohol, physical activity, diet) using a structured questionnaire. Height and weight were measured to calculate BMI (kg/m²).
Blood Pressure Measurement
BP was measured twice using a validated digital sphygmomanometer with a 5-minute interval, and the average value was used. Hypertension was defined as systolic BP ?140 mmHg, diastolic BP ?90 mmHg, or current antihypertensive use.
Statistical Analysis
Data were analyzed using SPSS v26. Continuous variables are reported as mean ± SD, categorical variables as frequency and percentage. Univariate analysis used chi-square tests. Variables with p<0.2 in univariate analysis were included in multivariate logistic regression to identify independent predictors. Statistical significance was set at p<0.05.
Result : Participant Characteristics
• Total participants: 600
• Mean age: 42.5 ± 13.8 years
• Female: 52%
• Education: no formal schooling 40%, primary 45%, secondary or higher 15%
• Occupation: daily wage laborers 38%, homemakers 32%, small business 15%, unemployed 15%
Prevalence of Hypertension
• Overall: 32% (192/600)
• Age-stratified prevalence:
o 18–29 years: 12%
o 30–44 years: 28%
o 45–59 years: 40%
o ?60 years: 55%
Lifestyle and Clinical Risk Factors
• Obesity (BMI ?30 kg/m²): 24%; prevalence among obese: 52%
• Current tobacco use: 28%; prevalence among tobacco users: 45%
• Low physical activity (<150 min/week): 46%; prevalence among sedentary: 41%
• Alcohol consumption: 35%; prevalence among drinkers: 34%
Multivariate Analysis
Risk Factor Adjusted OR 95% CI p-value
Obesity (BMI ?30) 3.1 2.1 – 4.6 <0.001
Current tobacco use 1.8 1.2 – 2.8 0.004
Low physical activity 1.7 1.1 – 2.5 0.015
Age (per 10-year increment) 1.5 1.3 – 1.8 <0.001
Gender and alcohol consumption were not independently associated with hypertension.
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Discussion : This study demonstrates that hypertension affects nearly one-third of adults in urban slums, confirming a substantial public health burden. Obesity, tobacco use, low physical activity, and age were independent predictors, consistent with previous research in low-resource urban populations [1–3].
The increasing prevalence in younger age groups highlights the need for early lifestyle interventions. Community-based health promotion focusing on physical activity, weight management, and tobacco cessation is essential.
Strengths
• Large, community-based sample
• Standardized BP measurements and validated questionnaires
• Multivariate analysis to adjust for confounders
Limitations
• Cross-sectional design limits causal inference
• Self-reported lifestyle data may be subject to recall bias
Conclusion : Hypertension is highly prevalent in urban slum populations. Modifiable risk factors including obesity, tobacco use, and low physical activity are key targets for intervention. Policymakers and public health practitioners should prioritize community-level strategies to promote healthy lifestyles and prevent cardiovascular disease.
References :
1. Anchala R, Kannuri NK, Pant H, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control. J Hypertens. 2014;32(6):1170–1177.
2. Gupta R, Xavier D. Hypertension: The most important non-communicable disease risk factor in India. Indian Heart J. 2018;70(4):565–572.
3. WHO. Global status report on noncommunicable diseases 2014. Geneva: World Health Organization; 2014.
4. World Health Organization. STEPwise approach to surveillance (STEPS). 2017. Available from: https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/steps