Cardiovascular sex differences and associated factors among adult population in Somaliland using insights from Somaliland demography and health survey.
To examine sex differences and identify associated risk factors for cardiovascular disease (CVD) among adults in Somaliland, in order to inform targeted public health interventions.
A cross-sectional analysis of nationally representative survey data.
Community-based, covering all regions of Somaliland.
A sample of 20,669 adults from the 2020 Somaliland Demographic and Health Survey (SLDHS).
Not applicable (observational study).
The primary outcome was the prevalence of self-reported, doctor-diagnosed CVD (including coronary heart disease, hypertensive heart disease, and stroke). Key determinants were assessed via adjusted odds ratios (AOR) from multivariable logistic regression.
The overall CVD prevalence was 0.94%, with significant sex and geographic disparities. Hypertension was the strongest predictor overall (AOR = 4.68, 95% CI: 3.26-6.71), with a greater effect in females (AOR = 5.10, 95% CI: 3.23-8.04). Diabetes was a significant risk factor for males only (AOR = 2.59, 95% CI: 1.11-6.07). Widowhood and rural residence increased CVD risk for females, while nomadic residence was protective for males.
This study reveals significant, sex-specific disparities in CVD determinants in Somaliland. Public health strategies must prioritize hypertension and diabetes control, improve healthcare access for women-particularly widowed and rural residents-and develop regionally tailored interventions to mitigate the growing CVD burden.
A cross-sectional analysis of nationally representative survey data.
Community-based, covering all regions of Somaliland.
A sample of 20,669 adults from the 2020 Somaliland Demographic and Health Survey (SLDHS).
Not applicable (observational study).
The primary outcome was the prevalence of self-reported, doctor-diagnosed CVD (including coronary heart disease, hypertensive heart disease, and stroke). Key determinants were assessed via adjusted odds ratios (AOR) from multivariable logistic regression.
The overall CVD prevalence was 0.94%, with significant sex and geographic disparities. Hypertension was the strongest predictor overall (AOR = 4.68, 95% CI: 3.26-6.71), with a greater effect in females (AOR = 5.10, 95% CI: 3.23-8.04). Diabetes was a significant risk factor for males only (AOR = 2.59, 95% CI: 1.11-6.07). Widowhood and rural residence increased CVD risk for females, while nomadic residence was protective for males.
This study reveals significant, sex-specific disparities in CVD determinants in Somaliland. Public health strategies must prioritize hypertension and diabetes control, improve healthcare access for women-particularly widowed and rural residents-and develop regionally tailored interventions to mitigate the growing CVD burden.
Authors
Mohamed Mohamed, Abdikarim Abdikarim, Ali Ali, Mohamed Mohamed, Abdillahi Abdillahi, Mohamed Mohamed, Muse Muse
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