Date of Award

5-2021

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Ahmed Sokwala

Second Supervisor/Advisor

Dr. Jasmit Shah

Third Supervisor/Advisor

Dr. Anders Barasa

Department

Internal Medicine (East Africa)

Abstract

Background: Hypertension is the world’s most significant risk factor for morbidity and mortality. Sub-Saharan Africa has the highest prevalence of hypertension worldwide. In Kenya, the estimated overall prevalence of hypertension is at 24.5%. Young adult hypertensive patients have a lower proportion of controlled blood pressure compared to older adults. Uncontrolled hypertension, irrespective of age, increases cardiovascular risk.

Methods: A total of 401 patients aged between 18 and 40 years were identified from the records department based on the ICD-10 codes for hypertension. Using their hospital identification numbers, files were sorted and analyzed including laboratory data on the hospital information management system to obtain all the data variables. Demographic and clinical characteristics were summarized using descriptive statistics which include frequencies, percentages, medians, and interquartile ranges.

Results: The median age at diagnosis was 33.0 years, males were 49.1% and females were 50.9%. Those with a history of alcohol consumption and smoking were 42.4% and 8.2% respectively. Most patients were either overweight or obese accounting for 77.8% of the total. Only 19.8% of patients were diagnosed with diabetes based on HBA1c levels. Echocardiography was done on 21.4% of the patients, 7.2% had features of LVH and the average left ventricular ejection fraction was 62.0%. The most common medication prescribed was calcium channel blockers at 57.6%. The most common adverse outcome was chronic kidney disease at 6.0%, followed by stroke, coronary artery disease, and heart failure at 1.8%, 1.3%, and 0.8% respectively.

Conclusion: There exist heterogeneous characteristics among both demographic and clinical characteristics among young hypertensive patients with hypertension. Most are overweight and obese. Alcohol consumption is high among this population. Most patients with adverse outcomes were of the male gender, had abnormal ECG, and impaired kidney function.

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