Causal relationships in risk factors associated with cardio vascular disease in Uganda: An assessment by rural-urban residence

Abstract

The main objective of the study was to assess causal relationships in risk factors associated with Cardio Vascular Disease (CVD) in Uganda. A secondary analysis of data collected by the Uganda Ministry of Health during the 2014 Uganda Non-communicable Diseases Risk Factor Survey was conducted (MoH, 2014). The analysis was clustered by rural-urban residence and the causal relationship was determined using Generalized Structural Equations Modeling (SEM) with a logit link function. In the results, one-in-every ten individuals (9.6%) had CVD. In the multivariate analysis, exogenous factors that indicated increased odds of having CVD were; Tobacco users with OR=1.67 CI (1.26, 2.22) in rural and urban areas, OR=1.68, CI(1.10,2.55), the elderly in rural with OR= 1.72, CI(1.16,2.55) and urban areas OR=2.27, CI(1.10,4.67), females in rural areas OR=1.57, CI(1.18,2.10) and overweight individuals in rural areas OR=1.65, CI (1.16,2.34). Indirect significant associations with increased odds of having CVD through tobacco use were noted by; Adults with OR=1.42, CI(1.18,1.72) and elderly OR=1.64, CI (1.23,2.18) in rural areas. Females with OR=0.5, CI(0.35,0.71) in rural and physically inactive individuals in rural OR=0.71, CI(0.57,0.87) and urban OR=0.46, CI(0.33,0.64) areas both had reduced odds of having CVD. Indirect significant relationships that increased the odds of having CVD through BMI included; adults OR=1.32, CI(1.01,1.72) in rural areas, High income earners OR=2.33, CI (1.14,4.76) High BP in rural OR=1.51, CI(1.14,2.00) and urban areas OR=1.63, CI(1.08,2.47), High WHR OR=3.25, CI(1.53,6.88) in urban areas and females in rural OR=2.23,CI(1.25,3.99) and urban areas OR=4.07, CI(1.97,8.39) had increased odds of being obese. The findings establish significant causal relationships in risk factors associated with CVD and further reveal significance of direct and indirect relationships and rural urban differences in the prevalence of CVD. Therefore the Country’s Ministry of Health should gear emphasis geared towards reducing the increasing prevalence of CVD and the CVD residence differentials