Abstract
Objectives: We compared the prevalence of hypertension and cardiovascular risk factors in two post- conflict Sri Lankan communities affected by mass emigration and environment/life-style changes.
Methods: Cross-sectional analytic study and Focus group discussions.
Results: 234 randomly selected consenting adults took part from 2 regions (117/region) in Northern Sri Lanka. Age, height, sex, ethnicity, religion and numbers/household were comparable. Educational and employment levels were significantly lower in the Karainagar (KN) group. This poorer and marginalised group had significantly lower body weight, waist circumference and BMI. Prevalence of hypertension was significantly greater in the more urban/affluent Nallur (NR) cohort (50.4%; 95% CI: 41.1 - 59.7) Vs 36.4%; 95% CI 28.2-46.2; P<0.05). Measured systolic, diastolic and mean arterial pressures were also significantly greater in the NR group (130 Vs 125; 84 Vs 81 and 99 Vs 95 mm Hg respectively; P<0.05). Waist circumference and diabetes had significant association with hypertension [OR 1.04 ;95% CI 1.00-1.08) and 6.98; 95% CI 3.15-17.19 respectively]. Odds ratio for diabetes to co-exist with hypertension was more than double (Median OR 11.62 Vs 4.73); subjective measures of QOL were significantly lower (P<0.001) and moderate/severe mobility disorders were significantly greater (P<0.05) in the KN group. Cost burdens, time pressures, seasonal variability
and the lack of social justice in access to water was evident.
Conclusions: Urbanisation and sedentary lifestyle are translating into greater
prevalence of cardio-vascular risk factors in sections of the community. Stronger
association between diabetes and hypertension in the poorer and more marginalised group raises the hypothesis that poverty/deprivation induced inflammation may play a role in pathophysiology.
Methods: Cross-sectional analytic study and Focus group discussions.
Results: 234 randomly selected consenting adults took part from 2 regions (117/region) in Northern Sri Lanka. Age, height, sex, ethnicity, religion and numbers/household were comparable. Educational and employment levels were significantly lower in the Karainagar (KN) group. This poorer and marginalised group had significantly lower body weight, waist circumference and BMI. Prevalence of hypertension was significantly greater in the more urban/affluent Nallur (NR) cohort (50.4%; 95% CI: 41.1 - 59.7) Vs 36.4%; 95% CI 28.2-46.2; P<0.05). Measured systolic, diastolic and mean arterial pressures were also significantly greater in the NR group (130 Vs 125; 84 Vs 81 and 99 Vs 95 mm Hg respectively; P<0.05). Waist circumference and diabetes had significant association with hypertension [OR 1.04 ;95% CI 1.00-1.08) and 6.98; 95% CI 3.15-17.19 respectively]. Odds ratio for diabetes to co-exist with hypertension was more than double (Median OR 11.62 Vs 4.73); subjective measures of QOL were significantly lower (P<0.001) and moderate/severe mobility disorders were significantly greater (P<0.05) in the KN group. Cost burdens, time pressures, seasonal variability
and the lack of social justice in access to water was evident.
Conclusions: Urbanisation and sedentary lifestyle are translating into greater
prevalence of cardio-vascular risk factors in sections of the community. Stronger
association between diabetes and hypertension in the poorer and more marginalised group raises the hypothesis that poverty/deprivation induced inflammation may play a role in pathophysiology.
Original language | English |
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Journal | Journal of hypertension |
Publication status | Accepted/In press - 24 Jul 2025 |