Prevalence of hypertension and peripheral arterial disease in adults in Léogâne, Haiti

Abstract

# Background The prevalence of hypertension under different treatment guidelines and peripheral arterial disease are unknown in many low and middle-income populations. # Methods A community sample of adults ≥18 years in Léogâne, Haiti, had blood pressure and ankle-brachial index (ABI) measurements in the Summers of 2014 and 2015 in addition to surveys to ascertain knowledge related to awareness and consequences of hypertension. Descriptive statistics for prevalence of hypertension and peripheral artery disease were performed. Sensitivity analyses were performed for hypertension prevalence under the Eighth Joint National Committee (JNC) and 2017 guidelines. # Results Overall, 1039 adults participated, with 43.6% (453/1039) having hypertension, per JNC 7 guidelines. Under JNC 8, 13 fewer participants would be considered hypertensive (42.3%, or 440/1039 participants). Defining stage I hypertension under 2017 guidelines would lead to an additional 231 participants meeting criteria (66.3%, or 702/1059 participants) but only 10 needing additional pharmacotherapy. Of 409 participants with ABIs, 31 (7.6%) had an ABI ≤ 0.9, 11 (2.7%) had an ABI \<0.8, and none had an ABI \<0.5. On surveys, 98.9% of participants (1,024/1,035) endorsed awareness of hypertension and 84.7% (856/1,027) that hypertension could lead to general health problems. Overall, 71.5% (449/628) cited hypertension as a risk factor for heart attacks and 96.0% (603/628) for strokes. However, few participants were aware hypertension could be asymptomatic (8.0%, or 82/1,028). # Conclusions Hypertension is highly prevalent in a community sample of Haitian adults. Adopting newer guidelines would substantially increase the proportion of adults meeting the definition without substantially increasing those requiring treatment. The population has relatively low rates of peripheral artery disease, further indicating chronic risk factor modification may limit cardiovascular morbidity in this low-income population.