High prevalence of hypertension in an agricultural village in Madagascar

PLoS One. 2018 Aug 16;13(8):e0201616. doi: 10.1371/journal.pone.0201616. eCollection 2018.


Elevated blood pressure presents a global health threat, with rates of hypertension increasing in low and middle-income countries. Lifestyle changes may be an important driver of these increases in blood pressure. Hypertension is particularly prevalent in African countries, though the majority of studies have focused on mainland Africa. We collected demographic and health data from 513 adults living in a community in rural Madagascar. We used generalized linear mixed models to assess body mass index (BMI), age, sex, and attributes related to household composition and lifestyle as predictors of blood pressure and hypertension. The prevalence of hypertension in this cohort was 49.1% (both sexes combined: N = 513; females: 50.3%, N = 290; males: 47.5%, N = 223). Blood pressure, as well as hypertensive state, was positively associated with age and BMI. Lifestyle and household factors had no significant relationships with blood pressure. The prevalence of hypertension was similar to that found in urban centers of other African countries, yet almost double what has been previously found in Madagascar. Future research should investigate the drivers of hypertension in rural communities worldwide, as well as the lifestyle, cultural, and genetic factors that underlie variation in hypertension across space and time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure Determination
  • Body Mass Index
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Madagascar
  • Male
  • Prevalence
  • Rural Population*

Grants and funding

This work was supported by Bass Connections at Duke University (https://bassconnections.duke.edu/): awarded to CLN; Duke Global Health Institute (https://globalhealth.duke.edu/): awarded to MBM. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.