# Prevalence of Comorbidity and Associated Factors Among Patients With Hypertension in Health Facilities of Southern Ethiopia

## TL;DR

This study finds that over half of hypertension patients in Southern Ethiopia have comorbid conditions, with age, urban residence, and unhealthy behaviors being key risk factors.

## Contribution

The study provides the first detailed analysis of comorbidity prevalence and associated factors among hypertension patients in Southern Ethiopia.

## Key findings

- The prevalence of comorbidity among hypertension patients was 56.8%.
- Patients aged 55+ and urban residents had significantly higher odds of comorbidity.
- Alcohol use, smoking, and high BMI were linked to comorbidity, while physical activity reduced it.

## Abstract

Comorbidity in patients with hypertension presents a significant challenge to effective disease management, leading to worsened health outcomes due to increased complications, higher healthcare costs, and elevated mortality rates. In resource‐limited settings like Ethiopia, the prevalence of comorbid disorders among patients with hypertension remains poorly understood. This lack of understanding is particularly alarming as noncommunicable diseases are on the rise, and the health systems in these areas are often inadequate. While different studies have assessed the prevalence and risk factors of hypertension, there is limited knowledge regarding the prevalence of comorbidity and related factors among patients with hypertension, particularly in Southern Ethiopia. To effectively develop integrated methods for the prevention, early diagnosis, and management of hypertension, a thorough understanding of the associated comorbidities and related factors is essential. Therefore, this study is aimed at determining the prevalence of comorbidity and its associated factors among patients with hypertension in healthcare facilities of Southern Ethiopia.

An institution‐based cross‐sectional study was conducted among patients with hypertension aged ≥ 18 years attending follow‐up at Dilla University Teaching Hospital from November 30, 2022, to January 30, 2023. A systematic random sampling technique was used to recruit 190 hypertensive patients from a hypertension registration logbook, collected using a pretested, structured‐administered questionnaire and supplemented by a medical record review. The data collection tool was translated into the Amharic language and back‐translated to ensure consistency. The data was analyzed using STATA Version 14. To characterize the data, descriptive statistics were applied. To determine the factors that are associated with comorbidity among patients with hypertension, a logistic regression model was fitted. Model fitness was checked using the Hosmer–Lemeshow goodness‐of‐fit test (p‐value = 0.633), indicating an adequate model fit. In the end, an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated and interpreted, and a p‐value of less than 0.05 was used to declare statistical significance.

The prevalence of comorbidity among patients with hypertension was 56.8% (95% CI: 49.7%–63.7%). Several factors were found to be significantly associated with comorbidity. Patients aged 55 years and above were over four times more likely to have comorbid conditions (AOR = 4.42, 95% CI: 2.65–7.68), while those residing in urban areas had nearly seven times higher odds of comorbidity (AOR = 6.67, 95% CI: 2.73–8.72). Likewise, alcohol consumption (AOR = 3.50, 95% CI: 2.94–11.31), cigarette smoking (AOR = 4.87, 95% CI: 1.23–6.53), and having a body mass index (BMI) ≥ 25 kg/m2 (AOR = 4.55, 95% CI: 2.78–10.91) were independently associated with a higher likelihood of comorbidity. Conversely, being physically active was inversely associated with comorbidity, reducing the odds by nearly half (AOR = 0.52, 95% CI: 0.24–0.89).

More than half of the patients with hypertension had at least one comorbid condition. Sociodemographic, behavioral, and clinical factors were significantly associated with these comorbidities. Based on our findings, we recommend routine screening for comorbid conditions, the implementation of educational programs to increase patient awareness about the risks of alcohol consumption and smoking, the promotion of healthy lifestyle practices, and improved access to healthcare services to ensure early detection and comprehensive management of hypertension and its related comorbidities.