Magnitude of hypertension and its association with obesity among employees of Wallaga University, Ethiopia: a cross-sectional study

Abstract

Objective

To determine the magnitude of hypertension, its association with obesity and the associated factors among employees of Wallaga University, Ethiopia.

Design, setting and participants

This institution-based cross-sectional study was employed among 588 employees of the university. Respondents were selected by stratified random sampling technique and interviewed with the aid of a structured questionnaire.

The main outcome measured

Hypertension and obesity were measured using WHO Stepwise approach and recommendations. We used a stratified random sampling technique to select 588 employees of the university from 3 August 2021 to 15 October 2021. A structured questionnaire and anthropometric measurements were used for data collection. Multivariable logistic regression analysis was used to determine factors independently associated with hypertension. A p value less than or equal to 0.05 and its 95% confidence level was used to declare the statistical significance.

Results

A total of 578 participants consented and completed the study, giving a response rate of 98.3%. The mean age of the respondents was 31.78 years with SD of 5.4. The overall prevalence of hypertension, general obesity and central obesity was 14.4% (95% CI 11.6% to 17.5%), 31.3% (95% CI 27.6% to 35.3%) and 37% (95% CI 33.1% to 41.1%), respectively. Obesity was significantly associated with hypertension (adjusted OR (AOR): 6.3; 95% CI 2.60 to 8.19). Age range from 35 to 46 (AOR 7.01; 95% CI 1.56 to 31.74), age ≥46 years (AOR 8.45; 95% CI 1.14 to 62.04), being non-academic staff (AOR 2.74; 95% CI 1.56 to 4.81), having additional income (AOR 2.48; 95% CI 1.08 to 5.70), physical inactivity (AOR 2.36; 95% CI 1.44 to 3.88) and poor practice of dietary salt consumption (AOR 1.65; 95% CI 1.01 to 2.87) were factors associated with hypertension.

Conclusion

One in seven, more than two in seven and nearly two in six of the employees of Wallaga University were hypertensive, centrally obese and generally obese, respectively. There was a positive association between obesity and hypertension. Comprehensive awareness creation and devising workplace intervention strategies are highly recommended to reduce the hypertension burden and associated obesity.

STRENGTHS AND LIMITATIONS OF THIS STUDY.

• To the best of the authors’ knowledge, this study was the first of its kind to explore the magnitude of hypertension and obesity in higher education settings in Ethiopia.

• We used an established tool with good anthropometric indices.

• The study was a cross-sectional design that could make it difficult to establish causation.

• Majority of the study participants were from the same ethnic group that could make it difficult to generalise for the universities in Ethiopia.

Introduction

Hypertension is a major global public health problem. It is the most common cardiovascular disorder affecting approximately 1.39 billion people globally, of these approximately three-quarters of individuals with hypertension lived in low-income and middle income countries.^{1 2} In Africa, 46% of adults 25 years and above had hypertension as of 2008.³ Sub-Saharan Africa had the highest burden of raised blood pressure compared with high-income countries.² The prevalence of hypertension in sub-Saharan Africa estimated in 2014 was 30%; only 27% of people with hypertension were aware of their hypertensive status and only 18% of them were receiving treatment.⁴

In Ethiopia, according to the results of systematic review and meta-analysis done in 2020, the pooled prevalence of hypertension was 21.81%, and the prevalence of hypertension is higher among males (23.21%) than females (19.62%).⁵ Community-based cross-sectional studies from different parts of the country reported that the prevalence of hypertension ranged from 9.3% to 34.9%.^6–10

Hypertension is the leading preventable cause of cardiovascular disease (CVD), premature death and disability worldwide.^{11 12} The WHO estimated that around 62% of CVDs and 49% of ischaemic heart diseases are attributable to high blood pressure in the world.¹³ According to the global report on the epidemiology of hypertension, the largest proportion of non-communicable diseases (NCDs) deaths is caused by CVDs (48%), and raised blood pressure is one of the leading behavioural and physiological risk factor to which 13% of global deaths are attributed.¹⁴

Hypertension is a multifactorial condition influenced by many risk factors including genetic, sociodemographic and behavioural factors.^{15 16} Advanced age, family history of hypertension, being overweight or obese, diabetes mellitus (DM), stress^17–19 and behavioural factors, such as alcohol consumption, cigarette smoking, consumption of excess salt, being physically inactive or following sedentary lifestyle, contribute to the development of hypertension.^{17 20–22}

Obesity is one of the causative factors of high blood pressure. Several studies conducted support the theory that primary hypertension at early age is associated with overweight and excessive salt intake.²³ This is due to the fact that excess weight gain puts pressure on the heart. There is direct evidence that shows the left ventricular muscle mass increases because of large body size, obesity and high blood pressure.²⁴ There is a decrease rate of hypertension when individuals lose weight.²⁵ The significance of both obesity and hypertension, as important public health challenges, is increasing worldwide. Compared with the year, 2000, the number of adults with hypertension is predicted to reach 1.56 billion by the year 2025. The growing prevalence of obesity is also increasingly recognised as one of the most important risk factors for the development of hypertension. Other NCDs including DM and chronic kidney diseases are also paralleled by the alarming increase of the twin diseases.²⁶

Evidences showed the association between the increased risk of hypertension and job. Job stress resulting from lack of balance between the job demand and job control, shift work, occupational lead exposure, noise exposure and high workload were among the risk factors identified so far.^{27 28} WHO recommends workplace wellness programme with a focus on health promotion through the reduction of individual risk-related behaviours like; tobacco use, excessive alcohol use and physical inactivity.²⁹ To develop target-specific hypertension preventive strategies, information on the magnitude and the factors associated with hypertension among various work types is needed. Yet in Ethiopia, neither the magnitude of hypertension nor the associated risk factors among university employees were studied. To this effect, this study aimed to determine the prevalence of hypertension, and its association with obesity in employees of Wallaga University, Ethiopia.

Research design and methods

Study design and settings

This institutional-based, cross-sectional study was conducted from 3 August 2021 to 15 October 2021 at Wallaga University, main campus, which is one of the Ethiopian governmental higher institutions established by ministry of education in 2007. There were a total of 5573 employees in the university; 1231 academic staff (998 males and 238 females), 2030 administrative staff (1000 males and 1030 females) and 1730 other workers (daily labourers and contracts (1097 males and 633 females). The university has one referral hospital containing 582 total employees (347 males and 235 females), 73 doctors of different specialty (65 males and 8 females), 238 other health professionals (163 males and 75 females) and 271 supportive staffs (119 males and 152 females), one students’ clinic and four model pharmacies.

Study population

All employees of Wallaga University were the target population. All the employees whose age greater than or equal to 18 years who fulfil the inclusion criteria and who were on duty during data collection period were included in the study. Pregnant women and those who were critically ill during the data collection were excluded from the study.

Sample size determination

The sample size was determined using single population proportion formula based on the prevalence of hypertension among university employees to be 50%, 95% CI and 5% margin of error.

Adding 10% of nonresponse rate, the sample size became 422. Since the total target population is less than 10 000, a correction formula was applied and the final sample size, 392 was calculated.

Because, two stage stratified random sampling technique was applied, we used design effect of 1.5. As such, the final sample size was (392×1.5=588).

Sampling procedure

A two-stage stratified random sampling technique was used to select the study participants. First, the employees were stratified into four as academic, administrative, supportive staff and Wallaga University Referral Hospital health professionals of different specialty. Each stratum is believed to be homogenous so that the sample size was calculated based on the total sample of each stratum, taken from the human resource directorate office of the university.

Study variables

Prevalence of hypertension was the outcome variable. Sociodemographics, behavioural and clinical related were considered as the independent variables.

Data collection tool and procedure

The data collection tool was adapted from WHO Stepwise approach for NCDs survey³⁰ (online supplemental Annex 1). Ten experienced health professionals of different expertise were recruited for the data collection. Moreover, the four-part data collection tool was used based on the objective of the study. The first part of the questionnaire focused on sociodemographic information including age, sex, marital status, religion, level of education, main type of work in the campus (academics/non-academic), place of birth, source of monthly income (only salary or salary and additional income source), and average monthly income. The second part assessed the behavioural factors that include tobacco and alcohol use practice, dietary practices, dietary salt consumption status, oil use practices, physical activity, sedentary behaviour. The third part contained the clinical related characteristics including history of medical illness. The fourth part contains the physical measurements which include blood pressure, heart rate and anthropometric (height, weight, waist circumference (WC), hip circumference) measurements.

Blood pressure was measured after at least 5 min of rest using an adult size digital BP apparatus and expressed in mm Hg. It was taken three times, and the average of the value determined the blood pressure status. Hypertension was defined based on WHO criteria, systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. Diagnosis of hypertension was based on the standardised definition for hypertension.^31–33

General obesity was measured using height and weight of the respondents. Using anthropometric measuring device, weight was recorded to the nearest 0.1 kg using an electronic portable scale (Seca). It was measured without shoes or with socks and with minimum clothes. To ensure measurement accuracy the scale was checked for zero readings before each weighing. It was calibrated with a metal every morning before data collection. Height was measured in the standing position, to the nearest 0.5 cm using a portable stadiometer. Participants were asked to stand without shoes or just with only socks back against the scale, heels together and head in the upright position. The movable headboard was lowered until it touches the upper part of the subjects’ head firmly. According to the American Diabetes Association guideline³⁴ and Canadian clinical practice guideline on obesity,²⁵ body mass index (BMI)<18.0 kg/m² was taken as underweight, 18.0–24.9 kg/m² as normal weight, 25.0–29.9 as overweight and ≥30 kg/m² as obese.

Central obesity was measured using WC measured in centimetre (cm) by placing a non-elastic tape metre horizontally, midway between the 12th rib and the iliac crest on the mid-axillary line. Male and female participants with WC of ≥94 cm and ≥80 cm were considered as having central obesity respectively. The cut-off was used from the recommendation of WHO for the Europeans.³⁵

Data quality control

Data quality was maintained through having a pretesting of the questionnaires on 5% of the sample size calculated among Shambu campus of Wallaga University employees. Modifications on the use of words and sequence of questions were made after the pretest. The questionnaire was prepared in English language and translated to Afaan Oromo and then back to English language version to avoid inconsistencies. All the measurements were done according to the standards. During data collection, there was a random supervision by the investigators.

Data processing and analysis

The collected data were checked for its completeness, coded and entered to EpiData software V.3.1 and exported to SPSS software V.26 for cleaning and analysis. Descriptive statistics were performed using means, medians, SD and IQRs and the results were explained using frequency distribution tables and figures. Bivariable logistic regression was employed among the dependent variable and independent variable; variables with p<0.25 were considered as the candidate variables for the multivariable regression. Multivariable logistic regression analysis was used as the final model and variables with p≤0.05 were considered as statistically significant. The model was checked for fitness using Hosmer and Lemeshow goodness of fit.

Patient and public involvement

No patients nor the public were involved in the design, analysis and interpretation of this study and will not be involved in the dissemination of the results.

Results

Sociodemographic characteristics of the study participants

A total of 578 (98.3%) employees of Wallaga University were included in the analysis. The mean age of the respondents was 31.78 with the SD of ±5.4 years. Two hundred and sixty-three (45.5%) of them were females and about three-fourth of them were married. More than half (56.1%) of the study participants were first degree holders. Majority (92.7%) of them got their monthly income from salary only (table 1).

Table 1.

Sociodemographic characteristics of employees of Wallaga University, Ethiopia, 2021 (n=578)

S.no	Variables and categories	Frequency	Percentage
1	Sex
	Male	315	54.5
	Female	263	45.5
2	Mean age	32.05 (SD±5.95)
3	Age category
	≤25	66	11.4
	26–35	361	62.5
	36–45	138	23.9
	≥46	13	2.2
3	Ethnic group
	Oromo	557	96.4
	Amhara	15	2.6
	Others*	6	1
4	Religion
	Orthodox	147	25.4
	Protestant	374	64.7
	Muslim	32	5.5
	Waaqeffataa	18	3.1
	Others†	7	1.2
5	Marital status
	Married	415	71.8
	Single	149	25.8
	Others‡	14	2.4
6	Highest level of education achieved
	College (diploma and level)	93	16.1
	First degree (BSc/BA/MD, DVM)	324	56.1
	Masters (second degree/specialist)	124	21.5
	Terminal degree (PhD/subspecialist)	9	1.6
	Others§	28	4.8
7	Main job status in the University
	Administration staff	277	47.9
	Academic staff	251	43.4
	Other¶	50	8.7
8	Region of birth
	Oromia	558	96.5
	Amhara	15	2.6
	Other**	5	0.9
9	Source of monthly income
	Only salary	536	92.7
	Salary and additional income	42	7.3
10	Median monthly income	4952.50 (IQR 6700.00)

*Guraghe, Tigre, Expatriate.

†Catholic, adventist.

‡Divorced, widowed.

§Informal education, primary education, secondary education.

¶Daily labourers, contract personnel.

**SNNP, Tigray, non-Ethiopians.

Magnitude of hypertension and obesity among employees of Wallaga University

Eighty-three (14.4%) of the study participants had raised blood pressure both by systolic and diastolic, among whom about two-thirds of them (67.5%) were not aware of their blood pressure status before the study was conducted with no significant difference between sex. Sixty-five (11.2%) and 52 (9.0%) of them had systolic and diastolic blood pressure, respectively.

Based on BMI measurement, 167 (28.9%) and 14 (2.4%) of the study participants were overweight and obese, respectively, with significant difference between sex (figure 1). Based on the WC, 214 (37%) were centrally obese with significant gender difference. Females were more centrally obese (27.7%) compared with their male (9.3%) correspondents (p<0.001).

Figure 1.

Proportion of body mass index of employees working at Wallaga University, Ethiopia, 2021.

In this study, 38 (6.6%) of obese participants were hypertensive while 45 (7.8%) of non-obese were found to be hypertensive (p<0.002). Contrary to the general obesity, there is no significant association between central obesity and hypertension (p<0.196) (figure 2).

Figure 2.

Hypertension and obesity status among employees of Wallaga University, Ethiopia, 2021.

Associated risk factors of hypertension among Wallaga University employees

Multivariable logistic regression analysis showed older age (age range above 35 years), being non-academic staff, having additional income, poor dietary salt consumption practice, being physically inactive and obesity were the variables associated with hypertension.

Individuals whose age ranged from 35 to 46 years were seven times (OR 7.01, 95 % CI 1.56 to 31.47) and those above 46 years were 8.4 times (OR 8.41, 95% CI 1.14 to 62.04) more likely to develop hypertension when compared with their younger counterparts, respectively. Employees who were mainly involved in non-academic work in the university were 2.74 times more likely to develop hypertension when compared with the academicians (OR 2.74, 95% CI 1.56 to 4.81). The odd of hypertension was 2.48 times higher in those who had other source of income in addition to their salary when compared with those whose monthly income was only monthly salary (OR 2.48, 95% CI 1.08 to 5.70).

Employees who had poor practice towards dietary salt consumption were about two times more likely to develop hypertension when compared with their counter parts (OR 1.65, 95% CI 1.01 to 2.87). The odd of developing hypertension among physically inactive employees was 1.62 times higher (OR 1.62, 95% CI 1.02 to 2.82) when compared with those who were physically active.

Obese individuals were 6.3 times more likely to develop hypertension when compared with those who were underweight when compared by using their BMI (OR 6.3, 95% CI 1.03 to 44.15) (table 2).

Table 2.

Bivariable and multivariable logistic regression analysis of factors associated with hypertension (HTN) in employees of Wallaga University, Ethiopia, 2021

Variables	HTN status		95% confidence level
	Yes N (%)	No N (%)	COR	AOR
Sex
Male	46 (8.0)	269 (46.5)	1.04 (0.65 to 1.67)	0.92 (0.49 to 1.74)
Female	37 (6.4)	226 (39.1)	1	1
Age category
≤25	2 (0.3)	63 (10.9)	1	1
26–35	49 (8.5)	317 (54.8)	4.87 (1.15 to 20.54)	4.22 (0.97 to 18.24)
36–45	28 (4.8)	106 (18.3)	8.32 (1.92 to 36.12)	7.01 (1.56 to 31.47)**
≥46	4 (0.7)	9 (1.6)	14 (2.23 to 87.75)	8.41 (1.14 to 62.04)*
Marital status
Married	95 (16.4)	320 (55.4)	1.78 (0.39 to 8.1)	1.04 (0.21 to 5.23)
Single	19 (3.3)	130 (22.5)	0.88 (0.18 to 4.22)	0.63 (0.11 to 3.51)
Others	2 (0.3)	12 (2.1)	1	1
Main work
Non-academic*	61 (10.6)	255 (44.1)	2.6 (1.55 to 4.38)	2.74 (1.56 to 4.81)***
Academic	22 (3.8)	240 (41.5)	1	1
Source of monthly income
Only salary	71 (12.3)	465 (80.4)	1	1
Salary and other	12 (2.1)	30 (5.2)	2.62 (1.28 to 5.35)	2.48 (1.08 to 5.70)*
Current smoking
Yes	2 (0.3)	6 (1)	1.33 (0.27 to 6.70)	1.23 (0.20 to1.17)
No	114 (19.7)	456 (78.9)	1	1
Alcohol drinking
Yes	19 (3.3)	53 (9.2)	1.51 (0.86 to 2.67)	0.67 (0.31 to 8.36)
No	97 (16.8)	409 (70.8)	1	1
Coffee drinking
Yes	105 (20.3)	2 (0.4)	1.72 (0.38 to 7.76)	0.86 (0.15 to 4.90)
No	396 (76.7)	13 (2.5)	1	1
Dietary salt consumption status
Knowledge
Good	42 (7.3)	249 (43.1)	1	1
Poor	41 (7.1)	246 (42.6)	0.99 (0.62 to 1.57)	0.83 (0.47 to 1.46)
Attitude
Favourable	38 (6.6)	262 (45.3)	1	1
Unfavourable	45 (7.8)	233 (40.3)	1.33 (0.84 to 2.12)	1.32 (0.78 to 2.25)
Practice
Good	44 (7.6)	323 (55.9)	1	1
Poor	39 (6.7)	172 (29.8)	1.67 (1.04 to 2.66)	1.65 (1.01 to 2.87)*
Physical activity status
Active	52 (9)	362 (62.6)	1	1
In-active	31 (5.4)	133 (23)	1.62 (1.01 to 2.64)	1.63 (1.02 to 2.82)*
Central obesity status
Non-obese	47 (8.1)	317 (54.8)	1	1
Obese	36 (6.2)	178 (30.8)	1.36 (0.85 to 2.19)	1.16 (0.64 to 2.09)
BMI
Underweight	2 0.3)	19 (3.3)	1	1
Overweight	48 (8.3)	119 (20.6)	3.83 (0.86 to 17.09)	12 (0.25 to 5.83)
Obese	7 (1.2)	7 (1.2)	9.50 (1.58 to 57.16)	6.3 (1.03 to 44.15)*

*p<0.05, **p<0.01, ***p<0.001.

*Administration, supporting staffs, contracts and daily laborerslabourers.

AOR, adjusted OR; BMI, body mass index; COR, crude OR.

Discussion

This study has examined the association between hypertension and obesity among Wallaga University employees. Our findings revealed a considerable magnitude of hypertension. We also found a high prevalence of overweight and obesity. We found older age, being non-academic staff, having additional income, poor dietary salt consumption practice, being physically inactive and obesity were significantly associated with hypertension.

This study found that 14.4% of Wallaga University employees suffer from hypertension. The finding is lower with the national systematic review and meta-analysis report 21.81%, 7%–37% and 20.63%,^36–38 Hawassa University (19.7%)³⁹ and lower-income countries’ report.⁴⁰ But slightly comparable to the study result reported from university of Gondar academic employees (13.9%),⁴¹ public servants in Tigray region (16%)⁴² and governmental school staffs in Dessie town, Amhara (13.8%).⁴³ The discrepancy might be due to the difference in sample size, study settings and populations. For instance, the systematic review and meta-analysis results included both the community and institution-based studies. It included many pocket studies and contains larger sample size. However, in the current study, and the other comparative three studies fewer sample sizes and limited study area were used. Moreover, this might be because of the difference in the age ranges and dietary exposure levels. For instance, in Hawassa University study, 41.3% of individual’s age is greater than 35 which is higher than our current finding (26.1% are greater than 35 years).

In this study, majority of hypertensive employees were not aware of their blood pressure status. This is supported by other large scale studies in lower-income countries in general.³⁶ The reason could be attributed to absence of symptoms in most of those whose blood pressure is high until complications arise and low screening practice in general and in the work-places in particular. This finding calls for the urgency of establishing and/or strengthening suitable mechanisms/strategies for early detection and preventive strategies at work-place.

The findings of this study showed that the magnitude of hypertension is higher among older adults than younger adults, which is in agreement with other studies.^44–48 According to the recent systematic review and meta-analysis conducted in Ethiopia, the pooled effect of age greater than 35 years was 3.6 times higher than age less than 35 years to develop hypertension. The observed rise in blood pressure with an individual’s age can be explained by the structural and functional changes in the arteries and decreased elasticity due to age-related gene expression.⁴⁹

Our findings revealed that hypertension was significantly associated with job category. We could not find a significant association between hypertension and being non-academic employee in other similar studies. This might be related to the difference in their routine activities which is less likely to be physically active during the working hours. The administrative staffs are more prone to sit for a long period of time compared with the academicians which contributed to use less energy to burn fat accumulated in their body.

Furthermore, physically inactive employees were at higher risk to develop hypertension compared with those who were physically active. This finding is supported by other studies.⁵⁰ This is due to the fact that physical inactivity has direct link with overweight/obesity which in turns leads to raised blood pressure. The imbalance between energy intake and expenditure is the main cause of excessive overweight and obesity which in turn leads to the exacerbation of hypertension.⁵¹

Moreover, the magnitude of general obesity and central obesity as measured by BMI and WC were also considerably high (31.3% and 37%), respectively, compared with other study in Ethiopia.⁵² The magnitude of the general obesity in this study was much higher when compared with the previous study (13.1%) and slightly similar for abdominal obesity (33.6%) compared with the previous study in Ethiopia.⁴¹ This difference might also be due to the difference in the study population. In the present study, the non-academicians were more likely to develop hypertension compared with the academicians, while this population was missed from the previous study. The increasing pattern of the central obesity in both studies sought the attention of the policy-makers, the university management, all the university population and other concerned bodies.

Previous studies also revealed that there is a strong association between obesity and hypertension.⁴¹ This is due to that fact that obesity is associated with activation of both sympathetic nervous system and the rennin–angiotensin system contributing to emergence of hypertension.⁵¹ A putative role of leptin in the causation of hypertension through an activation of sympathetic nervous system, and direct effect on the kidneys, resulting in increased sodium reabsorption leading to hypertension. Obesity per se may have structural effect on the kidney that might perpetuate hypertension, leading to increased risk of end-stage renal diseases resulting in further hypertension.^{41 53}

Additional source of income than monthly salary was found to be positively associated with the odds of developing hypertension among the university employees. This is controversial with the other study, which indicated that low socioeconomic status is associated with high blood pressure.⁵⁴ The findings reported that it is related with their educational level. The same is reported from Jamaica⁵⁵ where unlike women, mean blood pressure were highest in poor men with limited education. But the finding was not in agreement with the current findings. There is no significant association between the education level of the participants and the blood pressure level and their income level.

Our finding of positive association between dietary salt consumption practice and hypertension was consistent with results from epidemiological studies.^56–58 High levels of dietary sodium (consumed as common salt, sodium chloride) are associated with hypertension and adverse cardiovascular health.⁵⁸ One of the proposed mechanisms linking salt consumption to hypertension is related to the altered sodium homeostasis. Salt ingestion induces sodium and water retention as well as extracellular volume expansion in salt-sensitive people, resulting in higher cardiac output and tissue perfusion that exceeds metabolic demands. The peripheral tissue vasculature responds by increasing peripheral resistance by activating auto regulatory vasoconstriction.⁵⁹

The study has reported well-powered insights on the magnitude of self-reported and measured hypertension and its associations with anthropometric indices along with the independently associated factors in employees of higher education institutions. Central obesity was measured using Europid cut-off, which was recommended by WHO, which is still might have slight difference with Ethiopians, thus need attention when reporting or using for further study. The study population were both the academicians and non-academicians unlike the previous study in Ethiopian. For the betterment of future research, few limitations sought attention when interpreted and used for policy intervention. Majority of the study participants were Oromo ethnic groups. This might affect the generalisability for the Ethiopian higher institutions and needs caution on interpretation. Due to the cross-sectional nature of the study, temporal relations could not be established between the association of measured obesity and raised blood pressure. Due to the design, the association of the cause-and-effect evaluation was also limited. Despite these limitations, the findings from this study may contribute to the existing body of knowledge and also fill the gaps in the already limited data on the burden of hypertension and obesity in Ethiopian higher education institutions and the study area.

In conclusion, the prevalence of hypertension, central obesity and general obesity was increasing among employees of Wallaga university. Majority of the hypertensive employees were unware of their blood pressure status. This is an alarming for the need of work-place awareness creation and designing preventive strategies. There was a positive association between obesity and hypertension. Age, job category, income, obesity, physical inactivity and dietary practice were the factors independently associated with hypertension.

Data availability statement

Data are available on reasonable request. Data are available on reasonable request through the email address of the corresponding author.

Ethics statements

Patient consent for publication

Not applicable.

Ethics approval

This study involves human participants and the study received a letter of approval from the Research Ethics Review Committee (RERC) of Wallaga University, WU-25-5-2013. Written informed consent was taken from the study participants. All procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human involving research and with the Helsinki Declaration of 1975, as revised in 2008. Participants gave informed consent to participate in the study before taking part.