Hypertension in a rural community in Sri Lanka: prevalence, associated factors and its effect on the renal profile

Introduction: Chronic kidney disease (CKD) in which the disease cannot be attributed to any known cause is named CKD of uncertain aetiology (CKDu). The main aims of this analysis were to estimate the prevalence of hypertension and to identify the associated factors in a rural community vulnerable to CKDu and to identify the effect of hypertension on the renal profile among this community. Methods: We conducted a cross-sectional representative population survey in five study areas in Anuradhapura district, a rural district in Sri Lanka. Blood pressure, blood glucose, bioimpedance measurements and renal profile were measured using standard instruments and protocols. Results: A total of 4803 participants (88.7%) took part in the study. The overall prevalence of hypertension in the study population was 26.3% (95% confidence interval 25.0-27.5). Among those who were previously diagnosed, only 17.3% had normal blood pressure. Increasing age, family history of hypertension, presence of diabetes mellitus, estimated glomerular filtration rate (eGFR) less than 60 ml/min per 1.7 m(2) and increasing BMI were independently associated with having hypertension. High prevalence of hypertension was observed among those who had eGFR less than 60 ml/min per 1.7 m(2). Hypertension was significantly associated with having eGFR less than 60 ml/min per 1.7 m(2) (adjusted odds ratio 2.931). Conclusion: One in four individuals in the rural district of Anuradhapura is a hypertensive. Hypertension poses a significant burden to CKD even in populations affected by CKDu. Hence, public health initiatives should be implemented parallelly to control both CKDu and hypertension in these rural communities.