Background: Prehypertension (PHTN) is an emerging cardiovascular risk factor in sub-Saharan Africa. The aim of this study was to assess the overall cardiovascular risk in prehypertensive subjects in the city of Kisangani. Methods: An analytical cross-sectional study was conducted on 344 prehypertensive adults recruited by stratified random sampling. The 10-year cardiovascular risk was assessed using the ISH/WHO score. Descriptive and inferential analyses were performed to identify factors associated with elevated cardiovascular risk. Results: The prevalence of high cardiovascular risk (≥20%) was 32.7%. Older age (AOR = 4.27; CI 95%: 2.59 - 7.06; p < 0.001), male sex (AOR = 1.86; CI: 1.14 - 3.02; p = 0.013), smoking (AOR = 2.41; CI 95%: 1.44 - 4.08; p = 0.001), low physical activity (AOR = 1.75; CI: 1.08 - 2.86; p = 0.025), diabetes mellitus (AOR = 3.92; CI: 1.78 - 8.77; p = 0.001), dyslipidaemia (AOR = 2.15; CI 95%: 1.32 - 3.50; p = 0.002) and obesity (AOR = 2.76; CI 95%: 0.93 - 2.53; p = 0.005) have been independently associated with this elevated risk. Conclusion: A significant proportion of prehypertensives in Kisangani have a high cardiovascular risk, which underlines the need of adding global risk assessment into the management of prehypertensives and to develop targeted prevention strategies.
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