Differences in Hypertension Risk Factors between Rural Maasai in Ngorongoro and Urban Maasai in Arusha Municipal: A Descriptive Study

Background: Many ethnic groups within Tanzania are migrating from rural to urban areas in search of jobs and better livelihoods. One such group is the Maasai, whose distinct ethnicity and lifestyle potentially offers significant learnings in hypertension-related population health. This project investigated potential risk factors for hypertension in two Maasai settings with contrasting lifestyles: rural Ngorongoro Conservation Area and urban Arusha Municipal.

Methods: A cross-sectional descriptive study in three rural villages (i.e., Olbalba, Misigiyo, Alelilayi) and urban Arusha Municipal, sampling 724 individuals aged 18 to 75 years, ( i . e. , 3 35 males; 389 females). Quantitative measurements included blood pressure, body mass index (BMI), waist to hip ratio (WHR), total cholesterol, alcohol consumption, cigarette/tobacco use, and level of physical activity. Qualitative measurements included self-reports of lifestyle related risk factors such as distance walked, daily meal frequencies, alcohol and cigarette/tobacco use.

Results: Prevalence of hypertension in urban Maasai 27.7% (n=97) was significantly higher (p<0.0001) than for rural Maasai 10.9% (n=41). Systolic blood pressure in urban Maasai was significantly positively correlated with obesity parameters including BMI, weight, waist- circumference, hip circumference and WHR while distance walked was significantly (p=0.004) negatively associated. In urban Maasai, hypertension prevalence increased with age being highest at 60 years and above. Gender differences were apparent between 40-59 years where prevalence in urban males was significantly higher than females. Compared to rural counterparts, urban Maasai were significantly higher (p<0.05) for overweight, number of daily meals consumed, alcohol use, and less physical activity. No difference occurred across sites with respect to WHR and total cholesterol. For rural Maasai, systolic blood pressure was only significantly (p<0.0033) positively associated with BMI. In contrast to urban Maasai, prevalence of hypertension amongst rural Maasai decreased with increasing age and, furthermore, there were no gender differences across age.

Conclusions: The unique lower hypertension pattern for rural Maasai may reflect a number of emerging environmental and life style factors. Amongst rural Maasai, a distinctive pattern emerged of underweight, low WHR, lower meal consumption frequency, and more physical activities. Urban Maasai showed higher prevalence of hypertension and it risk factors compared to their rural counterparts. Findings emphasized the need for hypertension prevention lifestyle programmes including ongoing monitoring of blood pressure trends within the Maasai, especially within the context of urbanization.