Prevalence and socio-demographic factors associated with hypertension among rural and urban population of Kisii County, Kenya

Alex O. Ondieki, Harun M. Kimani, Titus M. Kahiga


Background: Hypertension (HTN) is a major cause of morbidity and mortality worldwide. 9.4 out of the 20 million cardiovascular deaths are due to HTN. HTN has often been described to be more prevalent in urban areas. However, there has been an epidemiologic transition from urban to rural areas which often go unreported or underreported. This gap therefore called for a study to compare the prevalence of HTN burden and assess how socio-demographic factors contribute to HTN development among the rural and urban population.

Methods: This study methodology focused on HTN among residents aged 30-69 years, from urban and rural population of Nyaribari Chache sub county, Kisii County, Kenya using a descriptive cross sectional study in which 490 respondents were interviewed. Sampling involved a random sampling technique which entailed household selection. Data was analysed using statistical package for social scientists (SPSS) version 21.

Results: The prevalence of HTN for the sampled population was 44.668%. The prevalence of HTN was 44.134% in rural and 43.598% in urban areas. Rural population were more at risk of developing HTN than urban (OR=1.135 and RR=1.072). On general health, those who had ever been told that they had hypertension (p<0.000), ever been told that they had hypertension for the past 12 months (p=0.000) and those who were currently taking hypertension medication (p=0.026) were statistically significant variables.

Conclusions: The study concludes that residents in rural population have higher prevalence of hypertension. Further, female respondents, those who are currently married, completed primary school education and were self-employed reported to have a higher prevalence of hypertension.


Hypertension, Prevalence, Urban, Rural, Socio-demographic, Kisii

Full Text:



WHO. Fact sheet: A global brief on hypertension: silent killer, global public health crisis, 2013. Available at: Accessed on 14 June 2020.

Whelton P, Carey R, Aronow S, Casey E, Collins K, Himmelfarb D, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American college of cardiology/American heart association taskforce on clinical practice guidelines. Hypertension. 2018;71(6):1269-324.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya A, Aboyans B, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2095-128.

Hendriks E, Wit W, Roos T, Brewster M, Akande M, DeBeer H, et al. Hypertension in sub-Saharan Africa: cross-sectional surveys in four rural and urban communities. PLoS One. 2012;7(3):32638.

Mensah A. Tackling non-communicable diseases in Africa. Caveat Lector. Health Edu Behavior. 2016;43(1):7-13.

Rush L, Goma M, Barker A, Ollivier A, Ferrier S, Sangini D. Hypertension prevalence and risk factors in rural and urban Zambian adults in western province: a cross-sectional study. Pan Afr Med J. 2018;30:97.

Bhansali A, Dhandania K, Deepa M, Anjana M, Joshi R, Joshi P, et al. Prevalence of and risk factors for hypertension in urban and rural India: the ICMR–INDIAB study. J Hum Hypertens. 2015;29(3):204-9.

Reynolds K, Chen J, He J. Global Disparities of hypertension Prevalence and control. Circulation. 2016;2016(134):441-50.

Gupta R, Gaur K, Ram S. Emerging trends in hypertension epidemiology in India. J Hum Hypertension. 2019;33:575-87.

Anchala R, Kannuri K, Pant H, Khan F, Franco H, DiAngelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32(6):1170-7.

Ministry of Health (MOH), Kenya STEPwise survey for non-communicable risk factors report. Ministry of Health, Division of Non Communicable Diseases. 2015. Accessed on 14 June 2021.

Mathenge W, Foster A, Kuper H. Urbanization, Ethnicity and cardiovascular risk in a population in transition in Nakuru Kenya, a population based survey. BMC Public Health. 2010;10:569.

African Population Health Research Centre (APHRC). African Population Health Research Centre, Nairobi Uran Health Demographic Surveillance System Indicators 2003-2015. African Population Health Research Centre, Nairobi. 2017. Accessed on 14 June 2021.

Oomen M, Abraham J, George K, Jose J. Prevalence of risk factors for non-communicable diseases in rural and urban Tamil. Indian J Med Res. 2016;144(3):460-71.

WHO. Fact sheet: Cardiovascular diseases fact sheet web site, 2021. Available at: Accessed on 14 June 2021.

Dalal S, Beunza J, Volmink J, Adebamowo C, Bajunirwe F, Njelekela M, et al. Non-communicable diseases in Sub Sharan Africa: what we know. Int J Epidemiol. 2011;40(4):885-901.

Kenya National Bureau of Statistics (KNBS). Fact sheet: Global adult tobacco survey (GATS), Kenya, 2014. Available at: Accessed on 14 June 2021.

Kengne A, Echouffo-Tcheugui J, Yaya S, Joshi R. Population surveillance and chronic non-communicable diseases in low- and middle-income countries. Wallingford: CAB International; 2016.

Kenya National Bureau of Statistics (KNBS). Fact sheet: Kenya Demographic and Health Survey, 2015. Available at: Accessed on 14 June 2021.

Fisher A, Laing J, Stroker J. Operation research design in sampling. Washington, DC: Population Council; 2003.

Bosu K, Bosu D. Prevalence, awareness and control of hypertension in Ghana: a systematic review and meta-analysis. PloS One. 2021;16(3):0248137.

Abebe M, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in Northwest Ethiopia. PloS One. 2015;10(4).

Tabrizi S, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and associated factors of prehypertension and hypertension in Iranian population: the lifestyle promotion project (LPP). PloS One. 2016;11(10).

Prabakaran J, Vijayalakshmi N, VenkataRao E. Prevalence of hypertension among urban adult population (25-64 years) of Nellore, India. Int J Res Dev Health. 2013;1(2):42-9.

Solomon I, Adjuik M, Takramah W, Axame K, Owusu R, AttaParbey P, et al. Prevalence and awareness of hypertension among urban and rural adults in Hohoe Municipality, Ghana. J Market Res. 2017;3(3):136-45.

Boateng D, Wekesah F, Browne L, Agyemang C, Agyei-Baffour P, Aikins D, et al. Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: a systematic review. PloS One. 2017;12(12):0189264.

Dhungana R, Pandey R, Bista B, Joshi S, Devkota S. Prevalence and associated factors of hypertension: a community-based cross-sectional study in municipalities of Kathmandu, Nepal. Int J Hypertension. 2016:1656938.

Singh S, Shankar R, Singh P. Prevalence and associated risk factors of hypertension: a cross-sectional study in urban Varanasi. Int J Hypertens. 2017;2017:5491838.

Kushitor K, Boatemaa S. The double burden of disease and the challenge of health access: Evidence from access, bottlenecks, cost and equity facility survey in Ghana. PLoS One. 2018;13(3):0194677.

Sanuade A, Boatemaa S, Kushitor K. Hypertension prevalence, awareness, treatment and control in Ghanaian population: evidence from the Ghana demographic and health survey. PLoS One. 2018;13(11):0205985.

Bâ O, Menta I, Camara Y, Sangaré I, Landoure G, Millogo R, et al. Cardiovascular risk factors (CVrf) in rural and urban areas Mali: data from the step 2013 survey. World J Cardiovascul Dis. 2018;8(1):3

Thankappan R, Mini K, Daivadanam M, Vijayakumar G, Sarma S, Nichter M. Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India. BMC Public Health. 2013;13:47.

Bhagyalaxmi A, Atul T, Shikha J. Prevalence of risk factors of non-communicable diseases in a District of Gujarat, India. J Health Popul Nutr. 2013;31(1):78-85.

Noubani A, Nasreddine L, Sibai M, Tamim H, Ismaeel H. Prevalence, awareness, and control of hypertension in Greater Beirut area, Lebanon. Int J Hypertension. 2018.

Akpan E, Ekrikpo E, Udo I, Bassey E. Prevalence of hypertension in Akwa Ibom State, South-South Nigeria: rural versus urban communities study. Int J Hypertens. 2015;2015:975819.

Sola O, Chinyere I, Stephen O, Kayode A. Hypertension prevalence in an urban and rural area of Nigeria. J Med Science. 2013;4(4):149-54.

Priya M, Mishra C. Prevalence of hypertension in an area of urban Varanasi, India and its association with selected demographic factors. Int J Commun Med Pub Health. 2016;3(6):1600.

Awoke A, Awoke T, Alemu S, Megabiaw B. Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study. BMC Cardiovasc Disord. 2012;12(1):113.

Gao Y, Chen G, Tian H, Lin L, Lu J, Weng J, et al. Prevalence of hypertension in China: a cross-sectional study. PloS One. 2013;8(6):65938.

Katchunga B, Mirindi P, Baleke A, Ntaburhe T, Twagirumukiza M, M’buyamba-Kabangu R. The trend in blood pressure and hypertension prevalence in the general population of South Kivu between 2012 and 2016: results from two representative cross-sectional surveys-the Bukavu observational study. PloS One. 2019;14(8).