Association of Chronic Khat Chewing with Blood Pressure and Predictors of Hypertension Among Adults in Gurage Zone, Southern Ethiopia: A Comparative Study

Abstract

Purpose

The leaves of the Khat plant contain amphetamine-like compounds which are implicated in the development of hypertension. The increase in blood pressure coincides with the plasma cathinone level. Other factors associated with hypertension are being overweight, obesity, cigarette smoking, alcohol use, physical inactivity, unhealthy diet, and stress. Thus, this study assessed the association of chronic khat chewing with hypertension and other factors associated with hypertension.

Patients and Methods

Acommunity based comparative cross-sectional study was undertaken from October 5, 2018 to February 15, 2019 in Gurage zone, southern Ethiopia. A total of 1200 adults (600 chewers and 600 non-chewers) aged 18 − 65 years were selected using a convenience sampling method. The data was collected by an interviewer-administered questionnaire plus physical measurements and were carried out at a fixed time of the day in the morning (7: 00 am–10:00 am). Linear regression and binary logistic regression analysis were performed to identify the determinant factors of blood pressure. The test of statistically significant association was declared by using 95% CI and p-value less than 0.05.

Results

A total of 1198 adults participated in the study giving a response rate of 99.8%. The mean age of Khat chewers were 34 (± 11.27) and non-chewers were 34.73 (± 11.48) years. The mean values of systolic blood pressure and diastolic blood pressure were higher in chewers than in non-chewers (p < 0.001). The prevalence of diastolic blood pressure > 80mmHg was significantly higher among Khat chewers than in non-chewers (17.4% versus 8.7%, p < 0.001). The duration of Khat chewing was significantly associated with systolic blood pressure (Beta coefficient = 0.83, p < 0.001) and diastolic blood pressure (Beta coefficient = 0.51, p < 0.001). The sex, age, BMI and alcohol were significantly associated with both systolic and diastolic blood pressure.

Conclusion

Chronic Khat chewing, male sex, BMI and alcohol were associated with increased systolic and diastolic blood pressure. To assess the cause and effect relationship between chronic Khat chewing and hypertension further studies with better defined cohorts and basic science studies need to be undertaken.

Keywords:

• chronic khat chewing
• systolic blood pressure
• diastolic blood pressure

Acknowledgments

The authors would like to thank local health extension workers, all data collectors, staff members of the Gurage Zone Health Bureau, Wolkite, Cheha, Ezha, Meskane, and Sodo District Health Office for their cooperation during data collection. Our heartfelt gratitude goes to all study participants who agreed to participate in the study. We also thank Wolkite University for sponsoring this research project.

Abbreviations

BP, Blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; SD, standard deviation; COR, crude odds ratio; AOR, Adjusted odds ratio; CI, confidence interval; SE, standard error.

Consent for Publication

Not applicable.

Ethics Approval and Informed Consent

The study was reviewed, ethically approved and written ethical clearance was obtained from the Institutional Review Board (IRB) of Wolkite University with ethical approval reference number IRB/56/8/2010. Then, the letter of permission to conduct the study was obtained from the district’s health office. The study participants were briefed about the study and written informed consent was obtained before the data collection. Confidentiality of the respondents’ information was kept throughout the study.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author Contributions

TGG and GGW conceived and designed the study, supervised the data collection. Then all authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Funding

This study was funded by Wolkite University. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

Disclosure

The authors declare that they have no competing interests.