Association Between Hemoglobin Level, Anemia, and Hypertension Among Adults in Northern Sudan: A Community-Based Cross-Sectional Study

Background: Hypertension and anemia are major health problems globally. However, data regarding the association between hypertension and hemoglobin/anemia among adults are few and controversial. Therefore, the current study aimed to investigate the associations between hemoglobin/anemia and hypertension among Sudanese adults. Methods: A community-based cross-sectional study was conducted in Northern Sudan from September to December 2022. The participants' sociodemographic characteristics were assessed using a questionnaire. Standardized procedures measured participants' weight, height, body mass index (BMI), hemoglobin, and hypertension. Multivariate regression analysis was performed to determine the association between anemia and hypertension. Results: Three hundred eighty-four adults were enrolled; 195 (50.8%) and 189 (49.2%) were males and females, respectively. The median interquartile age of the enrolled adults of age, BMI, and hemoglobin level was 45.0 (33.0-55.8) years, 26.6 (22.6-30.6) kg/m 2 , and 13.4 (12.4-14.4) g/dl, respectively. Of 384 adults, 216 (56.3%) had hypertension, and 148 (38.5%) were newly diagnosed hypertensive. Eighty-six adults (22.4%) had anemia. In univariate analysis, while increasing age, being female, being unmarried, having a positive family history of hypertension, and increasing BMI were positively associated with hypertension, anemia was inversely associated with hypertension. Education, occupation, cigarette smoking, and alcohol consumption were not associated with hypertension. In multivariate analysis, age (adjusted odd ratio [AOR] = 1.05, 95% confidence interval [CI] = 1.03-1.07), BMI (AOR= 1.07, 95% CI = 1.03-1.12) were inversely associated with hypertension, being female (AOR = 2.92, 95% CI = 1.43-5.94), positive family history of hypertension (AOR= 1.73, 95% CI = 1.09-2.75), and hemoglobin level (AOR= 1.34, 95% CI = 1.12-1.61) were associated with hypertension. Anemia (AOR = 0.58, 95% CI = 0.34-0.99) was inversely associated with hypertension. Conclusion: Both anemia and hypertension are major public health problems in Northern Sudan. Anemia is associated with hypertension. Further research is needed to explore the complex association between hemoglobin/anemia and hypertension.