Relationship of anthropometric indicators with blood pressure levels and the risk of hypertension in Nigerian adults

Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey

OBJECTIVE

To investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage (TOD) and its associated factors among adults in Freetown, Sierra Leone.

DESIGN

This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants.

SETTING

The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Sierra Leone.

PARTICIPANTS

A total of 2394 adult Sierra Leoneans aged 20 years or older were enrolled.

OUTCOME MEASURE

Anthropometric data, fasting lipid profiles, fasting plasma glucose, TOD, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to TOD.

RESULTS

The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidaemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by two-dimensional echo and 11.4% had chronic kidney disease (CKD). The odds of developing ECG-LVH were higher with diabetes (OR=1.255, 95% CI (0.822 to 1.916) and dyslipidaemia (OR=1.449, 95% CI (0.834 to 2.518). Associated factors for higher odds of Left Ventricular Mass Index by echo were dyslipidaemia (OR=1.844, 95% CI (1.006 to 3.380)) and diabetes mellitus (OR=1.176, 95% CI (0.759 to 1.823)). The odds of having CKD were associated with diabetes mellitus (OR=1.212, 95% CI (0.741 to 1.983)) and hypertension (OR=1.163, 95% CI (0.887 to 1.525)). A low optimal cut-off point for ECG-LVH (male 24.5 mm vs female 27.5 mm) was required to maximise sensitivity and specificity by a receiver operating characteristics curve since the odds for LVH by ECG were low.

CONCLUSIONS

This study provides novel data-driven information on the burden of CMRF and its association with preclinical TOD in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management in Sierra Leonean.

High rates of undiagnosed and uncontrolled hypertension upon a screening campaign in rural Rwanda: a cross-sectional study

BACKGROUND

Hypertension remains the major risk factor for cardiovascular diseases (CVDs) worldwide with a prevalence and mortality in low- and middle-income countries (LMICs) among the highest. The early detection of hypertension risk factors is a crucial pillar for CVD prevention.

DESIGN AND METHOD

This cross-sectional study included 4284 subjects, mean age 46 ± 16SD, 56.4% females and mean BMI 26.6 ± 3.7 SD. Data were collected through a screening campaign in rural area of Kirehe District, Eastern of Rwanda, with the objective to characterize and examine the prevalence of elevated blood pressure (BP) and other CVD risk factors. An adapted tool from the World Health Organization STEPwise Approach was used for data collection. Elevated BP was defined as ≥ 140/90 mm/Hg and elevated blood glucose as blood glucose ≥ 100 mg/dL after a 6-h fast.

RESULTS

Of the sampled population, 21.2% (n = 910) had an elevated BP at screening; BP was elevated among individuals not previously known to have HTN in 18.7% (n = 752). Among individuals with a prior diagnosis of HTN, 62.2% (n = 158 of 254) BP was uncontrolled. Age, weight, smoking, alcohol history and waist circumference were associated with BP in both univariate analyses and multivariate analysis.

CONCLUSION

High rates of elevated BP identified through a health screening campaign in this Rwandan district were surprising given the rural characteristics of the district and relatively low population age. These data highlight the need to implement an adequate strategy for the prevention, diagnosis, and control of HTN that includes rural areas of Rwanda as part of a multicomponent strategy for CVD prevention.

Predictive capacity of obesity indices for high blood pressure among southern Ethiopian adult population: a WHO STEPS survey

BACKGROUND

World Health Organization (WHO) consultation experts recommend countries to have guidance to identify public health action points suitable for their country. The objective of the study was to evaluate different obesity indices to predict high blood pressure and its optimal cutoff values among the adult population.

METHOD

A total of 3368 individuals age from 25 to 64 years were included in this study. Data was collected based on the WHO Stepwise approach. Body mass index (BMI), waist circumference (WstC), waist to hip ratio (WHpR) and waist to height ratio (WHtR) were measured and calculated. High blood pressure was considered for those with systolic blood pressure above 135 mmHg, diastolic blood pressure above 85 mmHg or taking antihypertensive medications. To generate cutoff values, the receiver operator characteristic curve was generated with the maximum Youden index.

RESULT

Women had a significantly higher hip circumference (P = 0.003), BMI (P = 0.036) and WHtR (P < 0.001) than men. Men had significantly higher WHpR (P = 0.027) than women. There were significantly higher BMI, WstC, WHpR, and WHtR among those with high blood pressure. The cutoff values for BMI, WstC, WHpR and WHtR were 22.86 kg/m2, 84.05 cm, 0.91 and 0.50 for men and 24.02 kg/m2, 79.50 cm, 0.91 and 0.51 for women, respectively.

CONCLUSION

BMI, WstC, WHpR, and WHtR are a useful predictor of high blood pressure among adults' rural residents of southern Ethiopia. As the sensitivity for the cutoff values of most of indices were low, further surveys in different settings may need to be done before a conclusion can be drawn on whether or not to review the anthropometric cut offs for high blood pressure in Ethiopia.

Predictors of Hypertension among Adult Female Population in Kpone-Katamanso District, Ghana

Background. Hypertension is an independent risk factor of cardiovascular disease, which is one of the biggest health challenges today. The objective of this study was to estimate the prevalence of the problem and other factors related to hypertension among women who are 25 years and above. Methods. A community-based cross-sectional study was conducted from September and November 2017. A multistage cluster sampling technique was used to select the study participants. The data was collected using a structured questionnaire and physical measurements adapted from "WHO STEPwise approach to chronic disease risk factor surveillance (STEPS)." Data were examined using the SPSS program IBM version 20. Descriptive statistics, including proportions, frequencies, and cross-tabulations, were used to summarize the study variables. A binary logistic regression was fitted variable with a p value of < 0.7. The bivariable analyses were entered in the multivariable analysis to control the possible effect of confounders. Multivariable logistic regression analysis was used to identify factors associated with hypertension. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the level of certainty. A p value of <0.05 was considered statistically significant. Results. The study indicated that the prevalence of hypertension (BP ≥ 140/90 mmHg) was 33.8% (95% CI 27.4-40.2) which increased with age. At the time of the study, women aged 45-64 years [AOR =2.19, (95% CI: 1.11-4.34, p<0.02)] and 65+ years [AOR =5.13, (95% CI: 2.20-11.99), p<0.001] were two to five times as likely as those with age of 25-44 years to be hypertensive. Women who had a higher body mass index (BMI) ≥30 kg/m²were two times as likely as those with normal weight to be hypertensive [AOR 2.38, (95% CI; 1.14-4.95, p<0.02)]. Women who did not consume fresh fruit daily were three times as likely as those women who consume fresh fruit daily to be hypertensive [AOR 3.17 (95% CI; 1.05-9.55, p<0.04)]. Conclusion. Increasing age, obesity, and women who did not consume fresh fruits daily were associated with hypertension, indicating opportunities for health education and other prevention measures.

Not a ‘Straitjacket Affair’: Anthropometrically Derived Obesity Index Correlates of Elevated Blood Pressure among University Undergraduates

Obesity is known to correlate with measures of blood pressure (BP). The nature of the correlations has, however, remained a subject of scientific enquiry, especially when BP phenotypes are disaggregated and obesity is determined by a variety of methods. This study examined the relationship between obesity and BP in young-adult Nigerians. A total of 1610 subjects (53.9% females) were recruited from five universities in the Igbo-speaking part of Nigeria. Relevant BP and anthropometric data were obtained following standard protocols. Appropriate statistical tools were used for data analyses. The results show that 42.2% (49.5% males, 36.1% females) and 13.3% (15.2% males, 11.6% females) of the population had point prehypertension and hypertension, respectively. By body mass index (BMI) standards, 20.6% (12.4% males, 27.5% females) of the population were overweight/obese. Despite the weak positive and significant correlations between BP and the measures of obesity in both males and females in the general population (r = +0.110 to +0.261; p < 0.05), the correlations were found to exist essentially in normotensives, taper in the prehypertensives, and disappear (or became negative) among hypertensives. When analysed along weight status lines, a discordant relationship was found between the sexes. Overall, the relationship between blood pressure and measures of obesity is not linear throughout the BP spectrum. Clearly the said relationship is not a ‘straitjacket affair’.

The misuse of Cyproheptadine: a non-communicable disease risk behaviour in Kinshasa population, Democratic Republic of Congo

Background

Obesity is one of the main risk factors of non-communicable diseases (NCDs) worldwide, especially in sub-Saharan Africa. The use of Cyproheptadine increases body weight and the risk of becoming obese. The aim of this study is to determine the prevalence of Cyproheptadine misuse in the Kinshasa population and to describe its characteristics.

Methods

A cross-sectional study was conducted in two town sectors of Kinshasa, Democratic Republic of Congo (DRC), over a 4 month period (May 2011 to August 2011). Data from 499 participants, aged between 13 and 55 years were collected and analyzed. Mean and standard deviation were used for quantitative variables and frequency and percentage for categorical variables. In order to determine the relationship between socio-demographic status and Cyproheptadine use the Chi-square test was conducted. Student’s t-test was used to compare means age of Cyproheptadine users and non-users. Logistic regression was used to determine predictors of Cyproheptadine use. A p-value of <0.05 was considered statistically significant.

Results

Overall, 499 participants were enrolled (352 females, 147 males, mean age ± standard deviation 24.9 ± 9.7 years) in the study. The majority of the study participants (72.9 %) had used Cyproheptadine as an appetite stimulant. Females were 11 times more likely to use Cryproheptadine (OR = 11.9; 95 % CI: 7.1–20.1) than males. People aged between 36 and 55 were three times less likely to use Cryproheptadine (OR = 0.3; 95 % CI: 0.2–0.8) compared to teenagers. More than half of the participants (69.0 %) declared to take daily Cyproheptadine. Half of the study participants (50.0 %) used Cyproheptadine for more than a year and also declared to combine it with Dexamethasone (87.6 %).

Conclusion

This study shows that the Kinshasa population is significantly misusing Cyproheptadine and is highly exposed to its risk, including obesity.

Population-based survey of overweight and obesity and the associated factors in peri-urban and rural Eastern Uganda

Background

In sub-Saharan Africa (SSA), the rising prevalence of overweight, obesity and non-communicable diseases co-exists with the high burden of under-nutrition. The paucity of data on adulthood overweight and obesity, disaggregated by socio-demographic characteristics and in rural settings in SSA calls for research. We determined the prevalence of underweight, overweight/obesity and associated factors among adults in peri-urban and rural Uganda.

Methods

A cross-sectional study of 1210 randomly selected adults aged ≥ 18 years was conducted in Iganga-Mayuge Health and Demographic Surveillance Site in eastern Uganda in 2013. Height, weight and socio-demographic variables were assessed. Overweight was defined as BMI = 25.0-29.99 kg/m², obesity ≥ 30 kg/m² and overweight/obesity ≥ 25 kg/m². Logistic regression was used to identify factors associated with overweight/obesity.

Results

Of the participants, 7 % were underweight (8.1 % of men; 5.9 % of women, p = 0.99); 17.8 % were overweight (12.4 % of men; 23.1 % of women, p < 0.001); and 7 % were obese (2.0 % of men; 12.7 % of women, p < 0.001). Overweight prevalence was 15.8 % and 23.8 % among rural and peri-urban adults, respectively (p < 0.001). Obesity prevalence was 3.9 % and 17.8 % among rural and peri-urban adults, respectively (p < 0.001). Factors associated with overweight/obesity were: being female, adjusted odds ratio (AOR) 4.3 (95 % confidence interval (PloS one 8:e75640, 20013) 3.2–5.9); peri-urban residence AOR 2.6 (1.9–3.6); being in age group 35–44, AOR 3.1 (1.8–5.3); 45–54 AOR 4.1 (2.3–7.3); 55–64 AOR 2.6 (1.4–5.0); ≥ 65 years AOR 3.1 (1.6–6.0); and having socio-economic status (SES) in the third AOR 2.8 (1.7–4.6), fourth 2.5 (1.5–4.2) and fifth 2.7 (1.6–4.4) quintile.

Conclusions

Overweight/obesity was prevalent among adults. Overweight/obese was associated with being female, being aged 35 years and older, residing in a peri-urban area and having a higher SES. The time has come to develop interventions to prevent and control overweight/obesity.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2506-7) contains supplementary material, which is available to authorized users.

Prevalence and pattern of overweight and obesity in three rural communities in southwest Nigeria

BACKGROUND

Limited data exist on the prevalence of overweight and obesity in the Nigerian adult rural population. This study therefore assessed the prevalence and pattern of overweight and obesity in adults in three rural communities of the Ife North Local Government Area, Nigeria.

MATERIALS AND METHODS

A total of 777 adults between 20 and 90 years of age were recruited into this cross-sectional study, which was performed over a 6-month period using a multistage proportional stratified random sampling technique. Sociodemographic data and anthropometric variables were obtained.

RESULTS

A total of 385 (49.5%) men and 395 (50.5%) women participated in the study. The mean age and body mass index of the participants were 36.3±14.3 years and 23.53±4.6 kg/m(2), respectively. The overall crude prevalence of overweight and obesity in the total population were 20.8% and 8.4%, respectively. Obesity increased across the age gradient, peaking in the 51- to 60-year age-group in men and women. Among the overweight and obese subjects (n=227), 70.9% of them were overweight and the remaining 29.1% were obese, with class I obesity accounting for 20.7% of these overweight and obese subjects.

CONCLUSION

The prevalence of overweight and obesity in these communities was 20.8% and 8.4% respectively, indicating a trend towards increased prevalence. Class I obesity is the most common obesity pattern, and obesity increased across the age gradient, peaking in the 51- to 60-year age-group. There is a need for regular community education on healthy lifestyles, and regular health screening to control the rising prevalence of overweight and obesity, as well as to prevent or reduce the risk of obesity comorbidities in these communities.

Prevalence of hypertension in three rural communities of Ife North Local Government Area of Osun State, South West Nigeria

BACKGROUND

The prevalence of hypertension is increasing rapidly in sub-Saharan Africa, but data are limited on hypertension prevalence. In addition, few population-based studies have been conducted recently in Nigeria on the prevalence and correlates of hypertension in both urban and rural communities. Therefore, we determined the prevalence of hypertension in adults in the three rural communities of Ipetumodu, Edunabon, and Moro, in South West Nigeria.

MATERIALS AND METHODS

One thousand adults between 15 and 90 years of age were recruited into this cross-sectional study, over a 6-month period, using a multistage proportional stratified random sampling technique. Sociodemographic data and anthropometric variables were obtained, and resting blood pressure (BP) was measured using an electronic sphygmomanometer. Diagnosis of hypertension was based on the JNC VII guidelines, the WHO/ISH 1999 guidelines, and the BP threshold of 160/95 mmHg.

RESULTS

Four hundred and eighty-six men (48.6%) men and 514 women (51.4%) participated in the study. Their mean age, weight, height, and body mass index were 32.3±14.7 years, 62±13 kg, 1.5±0.1 m, and 23.02 kg/m(2), respectively. The prevalence of hypertension, based on the 140/90 mmHg definition, was 26.4% (Male: 27.3%; Female: 25.4%). The prevalence of hypertension, based on the 160/95 mmHg definition, was 11.8% (Male: 13.5%; Female: 10.1%). There were significant positive correlations between BP and some anthropometric indicators of obesity.

CONCLUSION

The prevalence of hypertension in the three rural communities was 26.4%, indicating a trend towards increasing prevalence of hypertension. There was also a significant positive correlation between anthropometric indicators of obesity and BP in this population.

The Use of Obesity Indicators for the Prediction of Hypertension Risk among Youth in the United Arab Emirates

BACKGROUND

Obesity is a significant risk factor for metabolic disorders including increase in blood pressure. Body mass index (BMI), waist circumference (WC) and Waist/Hip ratio (WHR) are simple and effective indicators of obesity. The objectives of this study were to examine the relationships between obesity anthropometric indicators and hypertension and to identify the best anthropometric indicator/s that can predict hypertension risk among youth in the UAE.

METHODS

A 110 first year students in a Medical University in Ajman, UAE, during the year 2009-2010 were included in a cross-sectional study. The height, weight, WC, hip circumference and blood pressure were measured and the BMI and WHR were calculated for each student and used in the analyses.

RESULTS

The mean values for BMI, WC, hip circumference and WHR, were significantly higher in the Pre/Hypertensive group compared to normal blood pressure group. The risk of Pre/ hypertension was significantly increased by 4.3 times for participants who had general obesity (BMI≥ 30) or abdominal obesity (identified from high WC). Highly significant correlations were noticed between systolic and diastolic blood pressure and all anthropometric indicators except that for Hip circumference and systolic blood pressure. Step-wise linear regression model showed that when all obesity indicators were studied together, the waist circumference was the only indicator which showed significant relationship with both systolic and diastolic blood pressure.

CONCLUSION

Waist circumference is the best anthropometric indicator that can predict hypertension risk among youth in the UAE.

The association of anthropometric measurements and lipid profiles in Turkish hypertensive adults

BACKGROUND

Few studies have associated anthropometric measurements and lipid profile with hypertension in adult populations and to the best of our knowledge none has been done in Turkey

OBJECTIVES

To relate anthropometric derivatives of overweight/obesity with hyperlipidemia status in a group of Turkish hypertensive adults.

METHODS

Six hundred forty nine (307 male, 342 female) hypertensive adults aged between 20 and 64 years were included in the study.

RESULTS

The mean systolic and diastolic blood pressure (BP) of participants were measured as 147.6 ± 17.2 and 91.4 ± 10.4 mmHg for males and 149.9 ± 16.3 and 91.1 ± 9.4 mmHg for females, respectively. With respect to BMI classification systolic BP was significantly higher in obese males and females, and diastolic BP was only higher in obese females (p<0.05). According to BMIs for lipid profile, high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) levels were found to be lower in normal females than other BMI groups. Age and waist circumference (WC) in particular was the most related factor for systolic and diastolic BP in both genders (p<0.05).

CONCLUSIONS

This study indicates most hypertensive adults surveyed were overweight and obese. Furthermore, age and WC were the important factors that affects the systolic and diastolic BP in both genders.