Study title: Significance of Hypertension in Early Adulthood Research in Zimbabwe (SHEAR Zim)
Lead Researcher(s)
Kalpana Sabapathy, Trevor Chivandire
Funder(s)
Wellcome Trust
Partner(s)
Ministry of Health and Child Care, Harare City Health, Chitungwiza City Health, University of Zimbabwe, Newlands Laboratory, London School of Hygiene and Tropical Medicine, International Statistics and Epidemiology Group
Background
Hypertension is a growing public health concern in sub-Saharan Africa (SSA), with rising prevalence among young adults, unlike in most other global regions. International guidelines for hypertension management are based largely on older adults in high-income settings, leaving a gap in understanding and management for young adults in SSA. Emerging evidence from Zimbabwe suggests that nearly half (48%) of young adults exhibit elevated blood pressure (BP) and 7% meet the World Health Organisation criteria for a diagnosis of hypertension, yet the clinical significance and long-term effects remain unclear. The SHEAR Zim study aims to address these gaps by investigating BP profiles, early vascular aging (EVA), and hypertension-mediated organ damage (HMOD) among young Zimbabwean adults aged 20-29years.
Study Aim(s)
Determine the prevalence of elevated central and brachial BP in young Zimbabwean adults.
Assess the prevalence of EVA and HMOD and their association with elevated BP.
Identify clinical, behavioral, and biological risk factors influencing hypertension, EVA, and HMOD.
Improve understanding of the aetiology and clinical significance of hypertension in young adults in SSA.
Provide evidence-based recommendations for screening, treatment, and prevention.
Study Design
The study is a cross-sectional observational study aiming to recruit a random sample of approximately 1,000 participants aged 20–29 years.
· Participants will be recruited from selected urban and peri-urban communities in Greater Harare (Highfields, Mufakose, Budiriro, and Sunngdale) and Chitungwiza (St Mary’s, Zengeza, and Seke).
Measurements will include routine BP, ambulatory BP, central BP, EVA (pulse wave velocity), and HMOD (cardiac and renal damage, retinal vessel changes, and cognitive function tests).
Additional data collection will include sociodemographic characteristics, lifestyle factors, sleep patterns, and inflammatory biomarkers.
A subset of participants will have household environmental monitoring (air quality and air temperature) to assess external influences on BP.
The findings from SHEAR Zim will guide future interventions and policy recommendations for hypertension management in young adults in SSA.
Study dates
February 2025 - July 2026