The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study

BMC Public Health

Research Article

Carien Laurence¹  Jimmy Volmink²  Francis Bajunirwe³  David Guwatudde⁴  Joan Nankya-Mutyoba⁴  Todd Reid⁵  Shona Dalal⁵  Michelle D. Holmes⁶  Hans-Olov Adami⁷  Robert Kalyesubula⁸  Faraja S. Chiwanga⁹  Marina Njelekela⁹  IkeOluwapo Ajayi^1,10  Clement Adebamowo^1,11 

[1] Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;The South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa;Department of Community Health, Mbarara University Of Science and Technology, Mbarara, Uganda;Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden;Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda;Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;Institute of Human Virology, Abuja, Nigeria;Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria;Institute of Human Virology, Abuja, Nigeria;Greenbaum Cancer Center and Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA;

关键词: Prevalence of hypertension;    Prevalence of pre-hypertension;    Sub-Saharan Africa;    Risk factors for hypertension;    Chronic disease epidemiology;   

DOI  :  10.1186/s12889-015-2546-z

 received in 2015-06-12, accepted in 2015-11-30,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHypertension, the leading single cause of morbidity and mortality worldwide, is a growing public health problem in sub-Saharan Africa (SSA). Few studies have estimated and compared the burden of hypertension across different SSA populations. We conducted a cross-sectional analysis of blood pressure data collected through a cohort study in four SSA countries, to estimate the prevalence of pre-hypertension, the prevalence of hypertension, and to identify the factors associated with hypertension.MethodsParticipants were from five different population groups defined by occupation and degree of urbanization, including rural and peri-urban residents in Uganda, school teachers in South Africa and Tanzania, and nurses in Nigeria. We used a standardized questionnaire to collect data on demographic and behavioral characteristics, injuries, and history of diagnoses of chronic diseases and mental health. We also made physical measurements (weight, height and blood pressure), as well as biochemical measurements; which followed standardized protocols across the country sites. Modified Poison regression modelling was used to estimate prevalence ratios (PR) as measures of association between potential risk factors and hypertension.ResultsThe overall age-standardized prevalence of hypertension among the 1216 participants was 25.9 %. Prevalence was highest among nurses with an age-standardized prevalence (ASP) of 25.8 %, followed by school teachers (ASP = 23.2 %), peri-urban residents (ASP = 20.5 %) and lowest among rural residents (ASP = 8.7 %). Only 50.0 % of participants with hypertension were aware of their raised blood pressure. The overall age-standardized prevalence of pre-hypertension was 21.0 %. Factors found to be associated with hypertension were: population group, older age, higher body mass index, higher fasting plasma glucose level, lower level of education, and tobacco use.ConclusionsThe prevalence of hypertension and pre-hypertension are high, and differ by population group defined by occupation and degree of urbanization. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

【 授权许可】

CC BY   
© Guwatudde et al. 2015