The epidemiology of hypertension in the elderly is rarely reported in Africa and little is known about its specificities.

To study the prevalence of hypertension and associated factors in older people in Central Africa.

Individuals aged 65 years old and over living in two urban and two rural areas of the Republic of Congo (ROC) and the Central African Republic (CAR) were invited to participate into a comprehensive cross-sectional study assessing cognitive impairments and cardiovascular diseases. Demographic, clinical and biological data were collected. Hypertension was defined in case of self-reported on-going treatment and/or when averaged systolic blood pressure at rest was≥140mmHg and/or diastolic blood pressure was≥90mmHg.

Among 1990 participants (mean age=73 years; 62% females), the overall prevalence of hypertension was 61.1% (95% CI: 58.9-63.2), higher in ROC than in CAR (68.0% vs 53.7%, respectively; p<0.001) and higher in urban than in rural areas (64.7% vs 57.4%, respectively; p=0.001). Among hypertensive participants, 53.3% were unaware of their condition and only 17.3% received anti-hypertensive drug therapy. In multivariate analysis, increasing age and BMI, living in the ROC, the main lifetime occupation, presence of depressive symptoms and the number of meals per day remained significantly associated with an increased likelihood of hypertension. In contrast, smoking status, physical activity and an increasing number of stressful lifetime events were associated with a reduced likelihood for prevalent hypertension.

Hypertension is highly prevalent in elderly people of Central Africa, and presents some particularities in relation to specific conditions in this region.