Hypertension Burden and its determinants among adults aged 18 to 69 years in Tanzania: Results from the 2023 National STEPS survey

Background: Hypertension is a major public health concern and a leading risk factor for non-communicable diseases (NCDs) globally. In Tanzania, up to date national level data on the prevalence and determinants of raised blood pressure (BP) are limited. This study analyzed data from the 2023 Tanzania STEPS survey to assess the prevalence and associated factors of raised BP among adults aged 18–69 years. Methods: A cross-sectional, household survey was conducted from September to November 2023 across all 31 regions of Tanzania. A three-stage stratified sampling approach was used to select 4,320 individuals from 288 enumeration areas. Data were collected through structured interviews, physical measurements, and biochemical sample collection. Raised BP was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or current use of antihypertensive medication. Multivariable analysis using Modified Poisson regression was performed to identify factors associated with raised BP. Results: The overall prevalence of raised BP was 23.1% (95% CI: 19.9–26.4). Prevalence increased significantly with age, from 12.6% (95% CI: 7.7–17.4) among individuals aged 18–30 years to 46.4% (95% CI: 40.7–52.1) among those aged 46–69 years (p < 0.001). Overweight/obese individuals had a higher prevalence of raised BP (36.4%, 95% CI: 31.0–42.2) compared to those with normal weight (19.2%, 95% CI: 16.0–22.7; p < 0.001). Geographic zones such as the Southern Highlands (aPR 1.07, 95% CI: 1.02–1.13, p = 0.003) and Unguja (aPR 1.09, 95% CI: 1.04–1.14, p = 0.001) were associated with higher prevalence. Conclusion: Hypertension is prevalent among Tanzanian adults, with older age, obesity, and geographic location identified as significant risk factors. Targeted interventions focusing on lifestyle modifications, improved healthcare access, and region-specific strategies are essential to reduce the burden of hypertension in Tanzania.