Socioeconomic and Behavioral Risk Factors for Cardiovascular Complications Among Hypertensive Adults in Lusaka, Zambia: A Cross‐Sectional Study

ABSTRACT Background and Aims Hypertension is a leading cause of cardiovascular complications (CVCs), yet the contribution of socioeconomic and behavioral risk factors to CVC development in Zambia is poorly understood. This study aimed to assess the association between socioeconomic status (SES), lifestyle behaviors, and CVCs among hypertensive patients at the University Teaching Hospital (UTH) in Lusaka, Zambia. Methods A hospital‐based cross‐sectional study was conducted using secondary data from 384 medical records of hypertensive adults aged ≥ 18 years at UTH. Data on sociodemographic characteristics, SES, behavioral factors (salt intake, smoking, alcohol use, physical activity), and presence of CVCs (e.g., heart failure, left ventricular hypertrophy) were extracted. Multivariable logistic regression analysis was performed, and due to evidence of quasi‐complete separation, Firth's penalized logistic regression was applied to improve estimate stability. Results Increasing age was significantly associated with higher odds of CVCs (aOR = 1.097, p  < 0.001). Male sex was not significantly associated with CVCs after adjustment (aOR = 1.76, p  = 0.24). Low SES was associated with higher odds of CVCs (aOR = 4.09, p  = 0.05), although this was borderline significant. Smoking (aOR = 3.09, p  = 0.04) and alcohol intake (aOR = 1.13, p  = 0.002) were significantly associated with increased odds, while physical activity was strongly protective (aOR = 0.08, p  < 0.001). Conclusion Socioeconomic and behavioral factors were associated with the manifestation of CVCs in hypertensive patients. Older age was associated with increased odds of CVCs. Smoking and alcohol use were significant behavioral risk factors, while low SES showed a borderline association. Higher education and physical activity were protective. Public health interventions must integrate targeted lifestyle modification and address socioeconomic disparities to mitigate cardiovascular risk.