Background Hypertension is a leading cause of cardiovascular morbidity and mortality worldwide and represents a growing public health challenge in Ethiopia. Multiple demographic, metabolic, behavioral, and socioeconomic factors contribute to its development; however, the relative importance of these factors remains unclear. Objective To synthesize evidence on factors associated with hypertension in Ethiopia and compare the strength and consistency of these associations. Methods A systematic review was conducted following the PRISMA guidelines, with searches of PubMed/MEDLINE, Scopus, EMBASE, Web of Science, the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and African Journals Online (SABINET) from inception to March 2026. Observational studies reporting factors associated with hypertension in adults in Ethiopia were included. We performed a random‐effects meta‐analysis for factors with sufficient homogeneity, whereas other variables were synthesized narratively. A quantitative framework based on risk weight estimates was used to compare the strength and consistency of the associations and explore risk clustering; the findings were interpreted as indicative rather than causal. Results Forty‐one studies, predominantly cross‐sectional. Older age was strongly associated with hypertension (pooled OR 2.90, 95% CI: 2.07–4.07). Obesity and being overweight were consistently associated with increased odds (pooled OR ≈ 2.0–3.5). Diabetes showed a markedly elevated association (pooled OR = 11.47, 95% CI: 1.11–118.23), with wide confidence intervals. Behavioral factors, including alcohol use and physical inactivity, showed moderate but inconsistent associations, whereas socioeconomic factors were context‐dependent. Risk weight estimates indicated that diabetes (Rw = 2.5) and older age (Rw = 1.8) had the most consistent association with the outcome. Conclusion In Ethiopia, hypertension is strongly associated with metabolic factors, particularly age and diabetes, as well as with variable behavioral and socioeconomic influences. These findings support integrated prevention strategies that target high‐risk groups, defined here as groups with comparatively stronger observed associations with hypertension rather than prospectively established risk.
Background P‐wave terminal force in lead V1 (PTFV1) is an electrocardiographic marker of atrial electrical abnormality. We investigated whether β 1‐selective beta‐blocker use was associated with PTFV1 in hypertensive patients with echocardiographically confirmed left ventricular hypertrophy (LVH). Methods This retrospective study included 182 eligible patients with essential hypertension and LVH selected from 1372 screened patients. Patients were classified as β 1‐selective beta‐blocker users ( n = 82) or nonusers ( n = 100). Abnormal PTFV1 was defined as ≥ 0.04 mm s. Multivariable regression and sensitivity analyses were performed. Results PTFV1 was lower in beta‐blocker users than in nonusers (0.024 [0.015–0.036] vs. 0.030 [0.020–0.048] mm s, p = 0.005). In the primary adjusted model, beta‐blocker use was associated with lower PTFV1 ( B = −0.008, standardized β = −0.202, 95% CI −0.014 to −0.002, p = 0.009), although model explanatory capacity was limited ( R 2 = 0.064; adjusted R 2 = 0.021; overall p = 0.168). In an extended sensitivity analysis additionally adjusting for diabetes, renal function, and concomitant antihypertensive therapies, beta‐blocker group status remained associated with lnPTFV1 (standardized β = 0.294, p < 0.001; R 2 = 0.147; adjusted R 2 = 0.081; overall p = 0.011). Beta‐blocker use was also associated with lower odds of abnormal PTFV1 (OR = 0.43, 95% CI 0.22–0.84, p = 0.013). Conclusion β 1‐Selective beta‐blocker use was associated with lower PTFV1 and a lower likelihood of abnormal PTFV1. These findings suggest a more favorable atrial electrical profile but should be considered hypothesis‐generating given the retrospective design and modest model explanatory capacity.
Background Orthostatic blood pressure abnormalities are common in people with diabetes mellitus (DM) and are associated with adverse cardiovascular outcomes. Data on orthostatic hypotension (OH), exaggerated orthostatic pressor response (EOPR), and orthostatic hypertension (OHTN) in patients with diabetes from sub‐Saharan Africa are limited. Methods We conducted a multicenter cross‐sectional study among 339 ambulatory adults with DM attending three referral hospitals in Cameroon between November 2023 and April 2024. OH, EOPR, and OHTN were defined according to the 2023 American Autonomic Society/Japanese Society of Hypertension consensus statement. Prespecified multivariable logistic regression models identified factors independently associated with OH and OHTN. Results The mean age was 60.3 ± 11.3 years, and 66.1% of participants were female. The prevalence of OH was 13.3% (95% CI, 9.8–17.4), EOPR 8.9% (95% CI, 6.1–12.4), and OHTN 8.6% (95% CI, 5.8–12.1). A history of diabetes‐related complications (adjusted odds ratio [aOR] 2.47, 95% CI 1.05–5.81; p = 0.038) and ever smoking (aOR 2.85, 95% CI 1.09–7.44; p = 0.032) were independently associated with OH. Increasing age (aOR 1.08 per year, 95% CI 1.03–1.13; p = 0.002) and dyslipidemia (aOR 2.79, 95% CI 1.11–7.06; p = 0.030) were independently associated with OHTN. Sensitivity analyses using the previous diagnostic criteria increased the estimated prevalence of EOPR to 16.5% and OHTN to 15.0. Conclusions Orthostatic blood pressure abnormalities were common among adults with DM in this hospital‐based cohort in Cameroon. OH and OHTN were associated with different clinical factors, suggesting potentially distinct underlying mechanisms. Routine orthostatic blood pressure assessment may provide additional information for cardiovascular risk stratification in adults with diabetes, particularly in resource‐limited settings.
The present study aimed at investigating the association between serum heavy metals, anthropometric characteristics, and hypertension among different occupations and analyzing the prediction between heavy metals, anthropometrics, and hypertension among male and female miners, artisans, laborers, and farmers. Body weight, height, and circumferences were measured via the direct standard anthropometric approach. Blood pressure (BP) was measured using a standardized mercury sphygmomanometer with an appropriate cuff size. Blood samples were analyzed using an atomic absorption spectrophotometer. Chi-square and binary logistic regression analysis were conducted at a significance level of p < 0.05 (∗). For miners, there was no significant association between serum heavy metals, anthropometric characteristics, and hypertension (p > 0.05). Among artisans, age and anthropometric circumferences showed significant association with hypertension (χ2 = 5.266 – 21.206, p < 0.05∗). Among laborers, age was significantly associated with hypertension (χ2 = 62.548, p < 0.05∗). For farmers, age showed significant association with hypertension (χ2 = 3.925, p < 0.05∗). The derived regression model, which included age as a predictor, showed that increasing age was significantly associated with higher odds of hypertension among miners (aOR: 1.076, 95% CI: 1.029–1.125) and artisans (aOR: 11.938, 95% CI: 3.349–38.621). Furthermore, anthropometric circumferences were significant predictors of hypertension among artisans (aOR: 3,427, 95% CI: 1.205–9.747) and laborers (aOR: 2.50, 95% CI: 1.130–3.207). The study contributes to the understanding of relevant of heavy metals and specific anthropometrics to BP. Understanding the effects of heavy metals and age have implications in occupational health and contribute to the development of public health interventions.
Objective Although the association between obesity and left ventricular diastolic dysfunction (LVDD) is well established, the concurrent associations of epicardial adipose tissue (EAT), sleep‐trough (prewaking) morning blood pressure surge (MBPS), and autonomic imbalance with LVDD have not been fully elucidated. This study aimed to evaluate the associations of EAT thickness, MBPS, and heart rate variability (HRV) parameters with LVDD in obese adults and to assess the cross‐sectional discriminatory performance of these multimodal markers. Methods This cross‐sectional study included 240 individuals, comprising 120 obese participants (body mass index ≥ 30 kg/m 2 ) and 120 age‐ and sex‐matched normal‐weight controls (body mass index 18.5–24.9 kg/m 2 ). All participants underwent transthoracic echocardiography, 24‐h ambulatory blood pressure monitoring, and 24‐h Holter electrocardiographic analysis, with HRV data available for the entire cohort ( n = 240). EAT thickness was measured echocardiographically, and LVDD was classified using contemporary guideline‐based echocardiographic criteria. SDNN was predefined as the primary autonomic marker, while RMSSD and the LF/HF ratio were reported as supportive indices. Associations with LVDD (≥ Grade I) were evaluated using correlation analysis, multivariable logistic regression, and receiver operating characteristic analyses. Cross‐sectional discrimination analysis and performance assessment were performed within the obese subgroup ( n = 120). Results Compared with controls, obese participants exhibited greater EAT thickness (6.5 ± 1.7 vs. 4.0 ± 1.2 mm), higher MBPS (33 ± 10 vs. 21 ± 7 mmHg), increased LF/HF ratio, and lower SDNN and RMSSD values (all p < 0.001). The prevalence of LVDD was significantly higher in obese individuals than in controls (45% vs. 15%, p < 0.001). In multivariable analysis, EAT thickness (odds ratio [OR] = 1.20 per 1 mm; 95% confidence interval [CI] 1.08–1.34), MBPS (OR = 1.35 per 10 mmHg; 95% CI 1.10–1.65), and SDNN (OR = 0.88 per 10 ms; 95% CI 0.80–0.97) were independently associated with LVDD. The parsimonious model demonstrated discrimination and calibration comparable to or superior to the full clinical model (AUC: 0.89 vs. 0.85). Conclusion In obese adults, increased epicardial adiposity, exaggerated MBPS, and autonomic dysfunction coexist with LVDD. Integrated assessment of structural (EAT), hemodynamic (MBPS), and autonomic (SDNN) markers may facilitate cross‐sectional identification of LVDD and improve phenotypic characterization in obesity.
