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Gul R, Khan I, Alam I, Almajwal A, Hussain I, Sohail N, Hussain M, Cena H, Shafiq S, Aftab A. Ramadan-specific nutrition education improves cardio-metabolic health and inflammation-a prospective nutrition intervention study from Pakistan. Front Nutr 2023; 10:1204883. [PMID: 38249603 PMCID: PMC10798056 DOI: 10.3389/fnut.2023.1204883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/26/2023] [Indexed: 01/23/2024] Open
Abstract
There are recent reports that Ramadan fasting (RF) results in weight gain instead of weight loss. In addition, the data on the efficacy of brief nutrition education on healthy eating practices in Ramadan for better health are scarce. Therefore, a study was conducted to investigate the effects of brief nutrition education before the start of RF on healthy eating practices during RF. For this purpose, a prospective observational study focused on "Dietary Education and Awareness for Ramadan (DEAR)" as an intervention was carried out. The participants (n = 74) were recruited and divided into two groups, i.e., intervention and control groups (n = 37 each). As an intervention, nutrition education lessons were given before and during RF month. The control group did not attend these nutrition education lessons. Data on anthropometrics, dietary intake, and other parameters were collected at three time points: before, in the end, and 4 weeks after RF. Weight was measured in kg; height, waist circumference (WC), and hip circumference (HC) were measured in cm; and body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was calculated by dividing the waist value by the hip value. Body composition analysis was performed by the body composition analyzer (BF-907). Blood pressure (BP) was measured using a validated automated blood pressure. A 3-5 ml of venous blood was collected, and plasma and serum were separated. Serum and plasma samples were processed for general blood chemistry (blood lipid profile, glucose, and CRP) within 2 h. CRP was determined by the immunoturbidimetry method using an auto-analyzer. An enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine/chemokines. Adherence to nutrition education (intervention) was assessed. The results show that nutrition education has positive effects on overall nutrition. Significant improvement in dietary adherence to dietary advice in the intervention group was noted. Significant BW loss (mean loss: 1.21 kg) in the intervention group was observed. The majority (63.3%) had lost BW ≥ 1.0 kg. Other changes observed as a result of the intervention included improvements in blood glucose, cholesterol, CRP levels, and systolic and diastolic BP. There was a notable shift in pro- and anti-inflammatory cytokine concentrations: IL-7, IL-4, and TGF-α decreased, while IL-2, TNF-α and resistin, IL-1 RA, IL-17 A, and sCD40 increased. In conclusion, RF resulted in a loss in mean BW and an improvement in related blood chemistry and cytokine profiles. Furthermore, nutrition education before RF resulted in better nutrition practices during RF and a desirable healthy BW, blood lipid, and cytokine profiles.
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Affiliation(s)
- Rahmat Gul
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
- Department of Dietetics and Nutritional Science, Faculty of Pharmacy and Allied Health Sciences, University of Sialkot, Sialkot, Pakistan
| | - Imran Khan
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
| | - Iftikhar Alam
- Department of Human Nutrition and Dietetics, Bacha Khan University, Charsadda, Pakistan
| | - Ali Almajwal
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Imtiaz Hussain
- Department of Food Science and Technology, University of Poonch Rawalakot Azad Jammu and Kashmir, Poonch, Pakistan
| | - Namrah Sohail
- Department of Dietetics and Nutritional Science, Faculty of Pharmacy and Allied Health Sciences, University of Sialkot, Sialkot, Pakistan
| | - Muhammad Hussain
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
| | - Hellas Cena
- Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Sunara Shafiq
- Department of Dietetics and Nutritional Sciences, University of Sialkot, Sialkot, Pakistan
| | - Anam Aftab
- Department of Dietetics and Nutritional Sciences, University of Sialkot, Sialkot, Pakistan
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Jobe M, Mactaggart I, Hydara A, Kim MJ, Bell S, Badjie O, Bittaye M, Perel P, Prentice AM, Burton MJ. Evaluating the hypertension care cascade in middle-aged and older adults in The Gambia: findings from a nationwide survey. EClinicalMedicine 2023; 64:102226. [PMID: 37767194 PMCID: PMC10520336 DOI: 10.1016/j.eclinm.2023.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Background Hypertension is a major public health problem in sub-Saharan Africa with poor treatment coverage and high case-fatality rates. This requires assessment of healthcare performance to identify areas where intervention is most needed. To identify areas where health resources should be most efficiently targeted, we assessed the hypertension care cascade i.e., loss and retention across the various stages of care, in Gambian adults aged 35 years and above. Methods This study was embedded within the nationally representative 2019 Gambia National Eye Health Survey of adults ≥35 years. We constructed a hypertension care cascade with four categories: prevalence of hypertension (defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of medication prescribed for hypertension); those aware of their diagnosis; those treated; and those with a controlled blood pressure (defined as blood pressure <140/90 mmHg). Analyses were age- and sex-standardised to the population structure of The Gambia. Logistic regression was used to assess the socio-demographic factors associated with prevalence, awareness, treatment and control of hypertension. Findings Of 9171 participants with data for blood pressure, the prevalence of hypertension was 47.0%. Among people with hypertension, the prevalence of awareness was 54.7%, the prevalence of hypertension treatment was 32.5%, and prevalence of control was 10.0% with little difference between urban and rural residence. The cascade of care performance was better in women. However, there was no difference in achieving blood pressure control between men and women who were receiving treatment. Female sex, older age and higher body mass index were associated with higher hypertension awareness whilst having an occupation compared to being unemployed was associated with higher odds of being treated. Patients in the underweight category had higher odds of achieving blood pressure control. Interpretation There is a high prevalence of hypertension and low performance of the health care system that impact on the hypertension care cascade among middle-aged and older adults in The Gambia. Addressing the full cascade will be paramount especially in reducing the mounting prevalence and improving diagnosis of patients with hypertension, where the greatest dividends will be gained. Funding The Queen Elizabeth Diamond Jubilee Trust, Wellcome Trust.
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Affiliation(s)
- Modou Jobe
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia
| | - Min J. Kim
- International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzannah Bell
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Omar Badjie
- Directorate of Health Promotion & Education, Ministry of Health, The Gambia
| | - Mustapha Bittaye
- Directorate of Health Services, Ministry of Health, The Gambia
- Department of Obstetrics and Gynaecology, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Pablo Perel
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
| | - Andrew M. Prentice
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Teshome DF, Balcha SA, Ayele TA, Atnafu A, Gelaye KA. Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis. BMC Health Serv Res 2023; 23:222. [PMID: 36882833 PMCID: PMC9990316 DOI: 10.1186/s12913-023-09212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Early detection of hypertension is associated with improved blood pressure control and a reduced risk of cardiovascular diseases. However, in rural areas of Ethiopia, evidence is scarce where access to healthcare services is low. This study aimed to estimate the proportion of undiagnosed hypertension and identify its determinants and mediators among patients with hypertension in rural northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from September to November 2020. A three-stage sampling technique was used to select a total of 2436 study participants. Blood pressure was measured using an aneroid sphygmomanometer two times, 30 min apart. A validated tool was used to assess participants' beliefs and knowledge of hypertension. The proportion, determinants, and mediators of undiagnosed hypertension were determined among patients with hypertension. The regression-based approach used to calculate the direct and indirect effects of determinants of undiagnosed hypertension. Joint significance testing was used to determine the significance of the indirect effect. RESULTS The proportion of undiagnosed hypertension was 84.0% (95% CI: 81.4-86.7%). Participants aged 25-34 years (AOR = 6.03; 95% CI: 2.11, 17.29), who drank alcohol (AOR = 2.40; 95% CI: 1.37, 4.20), were overweight (AOR = 0.41; 95% CI: 0.18, 0.98), had a family history of hypertension (AOR = 0.32; 95% CI: 0.20, 0.53), and had comorbidities (AOR = 0.28; 95% CI: 0.15, 0.54) were significantly associated with undiagnosed hypertension. The mediation analysis revealed that hypertension health information mediated 64.1% and 68.2% of the effect of family history of hypertension and comorbidities on undiagnosed hypertension, respectively. Perceived susceptibility to hypertensive disease mediated 33.3% of the total effect of age on undiagnosed hypertension. Health facility visits also mediated the effect of alcohol drinking (14.2%) and comorbidities (12.3%) on undiagnosed hypertension. CONCLUSION A higher proportion of hypertensive patients remain undiagnosed. Being young, drinking alcohol, being overweight, having a family history of hypertension, and having comorbidities were significant factors. Hypertension health information, knowledge of hypertensive symptoms, and perceived susceptibility to hypertension were identified as important mediators. Public health interventions aimed at providing adequate hypertension health information, particularly to young adults and drinkers, could improve knowledge and perceived susceptibility to hypertensive disease and reduce the burden of undiagnosed hypertension.
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Affiliation(s)
- Destaw Fetene Teshome
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Shitaye Alemu Balcha
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Uthman OA, Ayorinde A, Oyebode O, Sartori J, Gill P, Lilford RJ. Global prevalence and trends in hypertension and type 2 diabetes mellitus among slum residents: a systematic review and meta-analysis. BMJ Open 2022; 12:e052393. [PMID: 35210339 PMCID: PMC8883228 DOI: 10.1136/bmjopen-2021-052393] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE First, to obtain regional estimates of prevalence of hypertension and type 2 diabetes in urban slums; and second, to compare these with those in urban and rural areas. DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA Studies that reported hypertension prevalence using the definition of blood pressure ≥140/90 mm Hg and/or prevalence of type 2 diabetes. INFORMATION SOURCES Ovid MEDLINE, Cochrane CENTRAL and EMBASE from inception to December 2020. RISK OF BIAS Two authors extracted relevant data and assessed risk of bias independently using the Strengthening the Reporting of Observational Studies in Epidemiology guideline. SYNTHESIS OF RESULTS We used random-effects meta-analyses to pool prevalence estimates. We examined time trends in the prevalence estimates using meta-regression regression models with the prevalence estimates as the outcome variable and the calendar year of the publication as the predictor. RESULTS A total of 62 studies involving 108 110 participants met the inclusion criteria. Prevalence of hypertension and type 2 diabetes in slum populations ranged from 4.2% to 52.5% and 0.9% to 25.0%, respectively. In six studies presenting comparator data, all from the Indian subcontinent, slum residents were 35% more likely to be hypertensive than those living in comparator rural areas and 30% less likely to be hypertensive than those from comparator non-slum urban areas. LIMITATIONS OF EVIDENCE Of the included studies, only few studies from India compared the slum prevalence estimates with those living in non-slum urban and rural areas; this limits the generalisability of the finding. INTERPRETATION The burden of hypertension and type 2 diabetes varied widely between countries and regions and, to some degree, also within countries. PROSPERO REGISTRATION NUMBER CRD42017077381.
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Affiliation(s)
| | - Abimbola Ayorinde
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oyinlola Oyebode
- Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jo Sartori
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Paramjit Gill
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - R J Lilford
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Abariga SA, Al Kibria GM, Albrecht JS. Impact of the 2017 American College of Cardiology/American Heart Association Guidelines on Prevalence of Hypertension in Ghana. Am J Trop Med Hyg 2020; 102:1425-1431. [PMID: 32228784 PMCID: PMC7253088 DOI: 10.4269/ajtmh.19-0272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 02/20/2020] [Indexed: 12/21/2022] Open
Abstract
We investigated the prevalence of hypertension in Ghana using the 2017 American College of Cardiology/American Heart Association (ACC/AHA) criteria and compared with prevalence estimates using the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) criteria. Among 13,220 Ghanaians aged 15-49 years, the prevalence of hypertension was 30.4% (95% CI: 29.3-31.6) based on the 2017 ACC/AHA guideline compared with 12.8% (95% CI: 12.0-13.6) when using the JNC7 guideline. The overall increase in prevalence was 17.6% (95% CI: 16.8-18.6). The increment in prevalence was 19.0% (95% CI: 17.5-20.7) among men and 17.7% (95% CI: 16.1-18.2) among women. People aged 40-49 years had the highest prevalence (51.1%; 95% CI: 49.0-53.3). We used multiple logistic regressions to obtain odds ratios. Urban dwelling, tertiary education, or being in higher wealth status was significantly associated with the odds of hypertension. The 2017 ACC/AHA guideline resulted in a significant increase in the prevalence of hypertension in Ghana. Scaling up of existing prevention and control strategies for hypertension such as health education through already established community health implementation and planning programs as well as improved screening and diagnostic protocols for hypertension should be prioritized.
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Affiliation(s)
- Samuel A. Abariga
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gulam Muhammed Al Kibria
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jennifer S. Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
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Bosu WK, Aheto JMK, Zucchelli E, Reilly ST. Determinants of systemic hypertension in older adults in Africa: a systematic review. BMC Cardiovasc Disord 2019; 19:173. [PMID: 31331284 PMCID: PMC6647089 DOI: 10.1186/s12872-019-1147-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors. METHODS We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes. RESULTS From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke. CONCLUSION The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.
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Affiliation(s)
- William Kofi Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, 01 BP 153 Burkina Faso
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
| | - Justice Moses Kwaku Aheto
- Department of Biostatistics, School of Public Health, University of Ghana, PO Box LG 13, Legon, Accra Ghana
| | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
- Madrid Institute for Advanced Study (MIAS), Universidad Autonoma de Madrid, C/ Einstein, 13 Pabellón C 1a planta, E-28049 Madrid, Spain
| | - Siobhan Theresa Reilly
- Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG UK
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Bosu WK, Reilly ST, Aheto JMK, Zucchelli E. Hypertension in older adults in Africa: A systematic review and meta-analysis. PLoS One 2019; 14:e0214934. [PMID: 30951534 PMCID: PMC6450645 DOI: 10.1371/journal.pone.0214934] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/23/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypertension is the leading driver of cardiovascular disease deaths in Africa. Its prevalence is highest in older populations. Yet, this group has received little attention in many African countries. We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42017056474) to estimate the prevalence of hypertension in older adults living in Africa. METHODS We searched grey literature and major electronic databases including PubMed and Embase for population-based studies and published between 1 January 1980 to 28 May 2018 reporting the prevalence of hypertension for adults aged ≥50 years living in Africa. We employed a random effects model to estimate the pooled prevalence across included studies. FINDINGS We screened 10,719 articles and retrieved 103 full-text articles to evaluate for inclusion in the review. Thirty-four unique studies providing 37 data points on 43,025 individuals in 15 African countries were analyzed. The prevalence of hypertension ranged from 22.3% to 90.0% from the individual studies while the overall pooled prevalence was 57.0% (95% CI 52%-61%). The prevalence was not statistically significantly different by sex, residence, or African sub-region. In individual studies, older age and overweight/obesity were independently associated with hypertension. Twenty-nine (78%) data points were deemed to be of low- or moderate-risk of bias. Eliminating high-risk bias studies made little difference to the pooled estimate of hypertension. Sensitivity analyses, omitting one study at a time, identified three studies with significant but relatively small impact on the pooled estimate. We observed substantial heterogeneity (I2 = 98.9%) across the studies which was further explored by meta-regression analyses. Overall, the GRADE assessment suggested moderate quality evidence in the results. CONCLUSION The persistent high prevalence of hypertension among older adults in Africa, even in rural populations warrants more attention to the cardiovascular health of this group by public health authorities.
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Affiliation(s)
- William Kofi Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Burkina Faso
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | - Siobhan Theresa Reilly
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
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Peltzer K, Pengpid S. The Prevalence and Social Determinants of Hypertension among Adults in Indonesia: A Cross-Sectional Population-Based National Survey. Int J Hypertens 2018; 2018:5610725. [PMID: 30174948 PMCID: PMC6106720 DOI: 10.1155/2018/5610725] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 08/02/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hypertension is the most significant avoidable cause of morbidity and mortality, yet nationally representative adult data on Indonesia have not been available. The study aimed at assessing the prevalence and determinants of hypertension, including sociodemographic variables, weight status, health behaviour, and psychosocial stress and support risk factors. METHODS The Indonesia Family Life Survey (IFLS-5) interviewed and examined in a national population-based cross-sectional study 29965 individuals aged 18 years and older, mean age 43.3 years (SD=15.3). Blood pressure, body height and weight, dietary behaviour, physical activity, tobacco use, and psychosocial variables were measured. Logistic regression analyses were used to estimate determinants of hypertension by gender. RESULTS The prevalence of hypertension among study participants was 33.4 % (95 % CI: 32.7-34.0), among males 31.0% (95% CI: 30.2, 31.9), and among females 35.4% (95% CI: 34.6, 36.3). Among hypertensives, 42.9% were aware, 11.5% were treated, and 14.3% were controlled. In fully adjusted analyses, in both men and women, older age, no or elementary education, being overweight or obese, and having visited an outpatients health facility in the past 4 weeks were positively associated hypertension. Significant linear relationships of hypertension were found with age (P for trend <0.001) and body mass index (BMI) (P for trend < 0.001). In addition, among men having quit tobacco use and depressive symptoms were positively associated with hypertension, while current tobacco use was negatively associated with hypertension. Moreover, among women lower subjective economic status was associated with hypertension. CONCLUSIONS The prevalence of hypertension was high and awareness was low, and treatment and control were very low. Significant multilevel public health interventions are urgently needed to improve the diagnosis, treatment, and control of hypertension in Indonesia.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria 0001, South Africa
- Department of Research and Innovation, University of Limpopo, Sovenga 0727, South Africa
| | - Supa Pengpid
- Department of Research and Innovation, University of Limpopo, Sovenga 0727, South Africa
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
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Tianyi FL, Agbor VN, Njamnshi AK. Prevalence, awareness, treatment, and control of hypertension in Cameroonians aged 50 years and older: A community-based study. Health Sci Rep 2018; 1:e44. [PMID: 30623073 PMCID: PMC6266375 DOI: 10.1002/hsr2.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/18/2018] [Accepted: 04/02/2018] [Indexed: 01/11/2023] Open
Abstract
AIMS To assess the prevalence of hypertension (HTN) in a rural elderly population (50 y and older) in Cameroon; evaluate the rates of awareness, treatment, and control of HTN in this population; and describe factors associated with HTN in this population. METHODS AND RESULTS A total of 501 participants aged 50 years and older were randomly recruited from May to July 2013 in a house-to-house survey of the Batibo Health District. Data were measured using standardized methods modelled after the World Health Organization STEPwise approach to Surveillance. The Statistical Package for the Social Sciences version 20.0 was used for statistical analysis. Chi-square, Fisher's exact or Student T test were used to compare variables. A multivariable logistic regression analysis was used to identify factors associated with HTN in this population. In our study population, 31% of the participants were men, with a mean age of 65.4 ± 8 years; women had a mean age of 61.4 ± 9 years. The prevalence of HTN was 57.3% (95% CI, 52.9-61.6). The awareness rate was 63.4%, treatment rate 96.7%, and control rate 32.4%. Being overweight/obese was independently associated with HTN in this group (odds ratio = 3.46; 95% CI, 2.38-5.03; P < .001). CONCLUSION The prevalence of HTN amongst the elderly in the Batibo Health District is high. Emphasis should be on patient education to improve the rates of blood pressure control amongst patients on treatment for HTN. Healthy lifestyle measures such as reduction in salt intake and increase in physical exercise should be encouraged amongst the elderly.
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Affiliation(s)
- Frank L. Tianyi
- Mayo‐Darlé Sub‐divisional HospitalBanyoAdamawa RegionCameroon
| | | | - Alfred K. Njamnshi
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
- Brain Research Africa Initiative (BRAIN)YaoundeCameroon
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Sarfo FS, Mobula LM, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O, Ofori-Adjei D. Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study. PLoS One 2018; 13:e0193494. [PMID: 29554106 PMCID: PMC5858765 DOI: 10.1371/journal.pone.0193494] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/12/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The burden of uncontrolled hypertension in Low-and-Middle Income Countries (LMICs) is high, with an increased risk of cardiovascular diseases and chronic renal failure in these settings. OBJECTIVE To assess the factors associated with uncontrolled blood pressure control in a cross-section of Ghanaian hypertensive subjects involved in an on-going multicenter epidemiological study aimed at improving access to hypertension treatment. METHODS A cross-sectional study involving 2,870 participants with hypertension with or without diabetes who were enrolled at 5 hospitals in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-hypertensive medications and treatment adherence were collected. The 14-item version of the Hill-Bone compliance to high blood pressure therapy scale was used to assess adherence to treatment in 3 domains namely adherence to medications, salt intake and clinic appointments. Questionnaires on knowledge, attitudes and practices on hypertension, sources of antihypertensive medications and challenges with accessing these medications were also administered. Blood pressure, weight and height were measured for each subject at enrollment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model. RESULTS The mean ± SD age of study participants was 58.9 ± 16.6 years, with a female preponderance (76.8%). Among study participants, 1,213 (42.3%) study participants had blood pressure measurements under control. Factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95% CI) included receiving therapy at a tertiary level of care: 2.47 (1.57-3.87), longer duration of hypertension diagnosis: 1.01 (1.00-1.03), poor adherence to therapy: 1.21 (1.09-1.35) for each 5 points higher score on the Hill-Bone scale, reported difficulties in obtaining antihypertensive medications: 1.24 (1.02-1.49) and number of antihypertensive medications prescribed: 1.32 (1.21-1.44). CONCLUSION We have found high rates of uncontrolled blood pressure among Ghanaian patients with hypertension accessing healthcare in public institutions. The system-level and individual-level factors associated with poor blood pressure control should be addressed to improve hypertension management among Ghanaians.
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Affiliation(s)
- Fred Stephen Sarfo
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - Linda M. Mobula
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Gilbert Burnham
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Daniel Ansong
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Osei Sarfo-Kantanka
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ofori-Adjei
- Department of Medicine & Therapeutics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
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Bosu WK, Aheto JMK, Zucchelli E, Reilly S. Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol. Syst Rev 2017; 6:192. [PMID: 28978358 PMCID: PMC5628476 DOI: 10.1186/s13643-017-0585-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The health of older persons has not been a major priority in many African countries. Hypertension is one of the common health problems of older persons. However, there is little information on the prevalence of hypertension in older adults in Africa. This is in spite of the fact that Africa has the highest age-standardized prevalence of hypertension in the world. We therefore present this protocol to conduct a systematic review and meta-analysis on the prevalence of hypertension and the level of its awareness among older persons living in Africa. METHODS Major databases (EMBASE, MEDLINE, Academic Search Complete, CINAHL, PsycINFO) and unpublished literature will be searched to identify population-based studies on hypertension in adults aged 50 years and older living in Africa. Eligible articles are those which use the 140/90-mmHg cutoff to diagnose hypertension and were published from 1980 to present. We will exclude subjects in restricted environments such as patients and refugees. Articles will be independently evaluated by two reviewers to determine if they meet the inclusion criteria. They will also evaluate the quality of included studies using a validated tool by Hoy and colleagues for prevalence studies. The main outcome is the prevalence of hypertension while the explanatory variables include demographic, socio-economic, dietary, lifestyle and behavioural factors. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the prevalence of hypertension in this population. DISCUSSION The estimates of the prevalence, the risk factors and the level of awareness of hypertension could help in galvanizing efforts at prioritizing the cardiovascular health of older persons in Africa. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017056474.
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Affiliation(s)
- William K Bosu
- West African Health Organisation (WAHO), 175 Avenue Ouezzin Coulibaly, 01 BP 153, Bobo-Dioulasso, Burkina Faso. .,Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK.
| | - Justice M K Aheto
- School of Public Health, University of Ghana, LG 13, Legon, Accra, Ghana
| | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK
| | - Siobhan Reilly
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK
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박지은, 김홍수, Sung-il Cho, 류연희. Factors Associated with Controlled Hypertension by Sex and Macro Level: A Systematic Review. ACTA ACUST UNITED AC 2016. [DOI: 10.15709/hswr.2016.36.2.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Otitoola O, Oldewage-Theron W, Egal A. Trends in the development of obesity in elderly day care attendees in Sharpeville, South Africa, from 2007-2011. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2015.11734520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Olamoyegun MA, Oluyombo R, Iwuala SO, Asaolu SO. Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria. Cardiovasc J Afr 2016; 27:356-360. [PMID: 27171978 PMCID: PMC5408398 DOI: 10.5830/cvja-2016-037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 03/22/2016] [Indexed: 12/17/2022] Open
Abstract
Objective To determine the prevalence and subtypes of hypertension among semi-urban residents in south-western Nigeria. Methods All adults aged 18 years or older in 10 semi-urban communities were recruited for the study. The blood pressure (BP) reading taken with a validated electronic BP monitor after at least 10 minutes of rest was used in the analysis. Hypertension was defined as BP ≥ 140/90 mmHg. Results Seven hundred and fifty subjects with a mean age of 61.7 ± 18.2 years participated in the study. The prevalence of hypertension was 55.5%. Stage 2 hypertension was the most common, present among 225 (54.1%) of the participants with hypertension, and 191 (45.9%) had stage 1 hypertension. Of those with hypertension, systolic–diastolic hypertension (SDH) was present among 198/416 (47.6%), while isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) were present among 181/416 (43.6%) and 37/416 (8.9%), respectively. The prevalence of hypertension increased significantly with age. Conclusion The prevalence of hypertension was high in these semi-urban communities. Hence, increased awareness and integrating hypertension care into primary healthcare and other community health services in these areas may prove beneficial in ameliorating its adverse effects.
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Affiliation(s)
- M A Olamoyegun
- Ladoke Akintola University of Technology (LAUTECH), LAUTECH Teaching Hospital, Ogbomoso, Nigeria. ,
| | - R Oluyombo
- Department of Medicine, Federal Teaching Hospital, Ido Ekiti, Nigeria
| | - S O Iwuala
- Department of Medicine, Endocrinology, Diabetes and Metabolism Unit, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
| | - S O Asaolu
- Department of Internal Medicine, LAUTECH Teaching Hospital, Ogbomoso, Nigeria
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Abstract
Studies on correlates of subjective well-being of older adults are virtually non-existent in sub-Saharan Africa. Yet, understanding and improving the well-being of older adults should be a focal point of research and policy directed at this fast growing population. The aim of this study was to assess the links between socio-demographic factors, economic conditions, health, social relations, and the life satisfaction of older adults in Dakar. To this end, a survey was conducted on a sample of 500 dwellers of the Senegalese capital, aged 50 to 100, using the quota method for greater representativeness. Results revealed that with advancing age older adults expressed greater life satisfaction, and that older women were more satisfied than older men. As well, economic conditions were a main predictor of life satisfaction, along with good social relations. In contrast to findings with Western populations, neither self-rated health nor physical disabilities were associated with aging adults' life satisfaction. Findings suggest a number of avenues for future research.
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Banerjee S, Mukherjee TK, Basu S. Prevalence, awareness, and control of hypertension in the slums of Kolkata. Indian Heart J 2016; 68:286-94. [PMID: 27316479 PMCID: PMC4912028 DOI: 10.1016/j.ihj.2015.09.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 08/26/2015] [Accepted: 09/27/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Slum dwellers have poor socio-environmental conditions and less access to medical care, which make them susceptible to illnesses. Studies on urban slums have primarily focused on communicable diseases and less on lifestyle diseases, such as hypertension. Consequently, there is a paucity of prevalence studies of hypertension in slums in different parts of the country. The aim of the study was to provide estimates of the prevalence, awareness, and control of hypertension in an adult population sample of the slums of Kolkata. METHODS A population-based cross-sectional study was conducted in the slums of Kolkata in collaboration with Kolkata Municipality Corporation. Door-to-door survey was conducted by trained healthcare workers using a structured questionnaire. Age, sex, religion, housing conditions (house/hut), average monthly household income, education status, current use of tobacco, history of hypertension, and whether on antihypertensive treatment were recorded. Blood pressure (BP) was recorded as per standard guidelines. Hypertension was diagnosed by JNC-VII criteria. A total of 10,175 adults aged ≥20 years were enrolled in the study. RESULTS Overall prevalence of hypertension was 42%. Hypertension was newly detected in 19% of the population. Fifty-four percent of the hypertensive subjects were aware of their hypertension status, 38% were on antihypertensive treatment, and 12% had their BP controlled to target level. Subgroup analysis showed that the prevalence of hypertension was higher in men, above 60 years age, in the minority community, in those with a higher household income, and among the tobacco users. CONCLUSION There is a high prevalence of hypertension in the slums of Kolkata. Although the awareness of the condition is high, the control of hypertension is poor.
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Affiliation(s)
- Suvro Banerjee
- Consultant Cardiologist, Department of Cardiology, Apollo Gleneagles Hospital, Kolkata, India.
| | - Tapan Kumar Mukherjee
- Advisor, Department of Health, Ex-Chief Municipal Health Officer, Kolkata Municipal Corporation, Kolkata, India
| | - Srabashi Basu
- Program Chair, Predictive Business Analytics, Bridge School of Management, NCR, India
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A Concept Mapping Study of Physicians' Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa. Int J Hypertens 2015; 2015:412804. [PMID: 26550488 PMCID: PMC4621343 DOI: 10.1155/2015/412804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/20/2015] [Indexed: 11/17/2022] Open
Abstract
Hypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians' perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management.
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Ikama SM, Nsitou BM, Makani J, Ellenga-Mbolla B, Ondze-Kafata LI, Mongo-Ngamami SF, Nkalla-Lambi M, Gombet TR, Kimbally-Kaky G. [Practice of ambulatory measurement of arterial pressure in Brazzaville (Congo): preliminary data]. Pan Afr Med J 2015; 20:353. [PMID: 26175841 PMCID: PMC4491458 DOI: 10.11604/pamj.2015.20.353.6591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/31/2015] [Indexed: 11/11/2022] Open
Abstract
Introduction Méthodes Résultats Conclusion
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Affiliation(s)
- Stéphane Méo Ikama
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo,Corresponding author: Ikama Méo Stéphane, Service de cardiologie, CHU de Brazzaville, Congo
| | | | - Jospin Makani
- Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Bertrand Ellenga-Mbolla
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Louis Igor Ondze-Kafata
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Solange Flore Mongo-Ngamami
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Mûnka Nkalla-Lambi
- Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Thierry Raoul Gombet
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service des urgences, Centre Hospitalier Universitaire de Brazzaville, Congo
| | - Gisèle Kimbally-Kaky
- Département de Médecine, Faculté des Sciences de la Santé de l'Université Marien Ngouabi de Brazzaville, Congo,Service de Cardiologie, Centre Hospitalier Universitaire de Brazzaville, Congo
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Ikama MS, Nsitou BM, Makani J, Nkalla-Lambi M, Passi-Louamba C. [Arterial hypertension and control in Brazzaville (Congo): role of ambulatory blood pressure monitoring (ABPM)]. Ann Cardiol Angeiol (Paris) 2015; 64:76-80. [PMID: 25702238 DOI: 10.1016/j.ancard.2015.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 01/05/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the rate control in the hypertensive patients and to identify the predictive factors of non-control. METHODS It was about a cross-sectional study with prospective collection of data over a period of 36 months. It has been held in Brazzaville, and included a consecutive series of 620 hypertensive patients known and treated for at least 6 weeks, having profited from an ambulatory blood pressure monitoring (ABPM) with therapeutic aiming. We used the TONOPORT V and the software Cardiosoft 6.51 of GE Health Care, respectively for the recording and the data analysis. The threshold fixed on the average of 24-hour was BP<130/80 mmHg, and the patients divided into two groups according to whether they were or not controlled. RESULTS They were 352 men (56.8%) and 268 women (43.2%), old on average of 53.8 ± 9.7 years (ranges: 29 and 89 years). The standard of living of the patients was average in 330 cases (53.2%), weak in 132 cases (21.3%), and high in 71 cases (11.5%). The other associated risk factors were sedentariness in 275 cases (44.4%), overweight/obesity in 134 cases (21.6%), dyslipidemia in 121 cases (19.5%), diabetes mellitus in 90 cases (14.5%), and tobacco addiction in 25 cases (4%). The hypertension, old of 5.8 ± 5.7 years on average, was controlled among 215 patients (34.7%). The 24- hour BP average was 139 ± 14 mmHg for the SBP and 88.2 ± 10.2 mmHg for the DBP. The awake and asleep BP averages were respectively 141 ± 14 mmHg and 133 ± 16.2 mmHg for the SBP, 90.5 ± 10.5 and 81.2 ± 11.1 mmHg for the DBP. The antihypertensive protocol used was a monotherapy in 130 cases (21%), bitherapy in 287 cases (46.3%), tritherapy in 154 cases (24.8%), quadritherapy or more in 27 cases (4.3%). Prevalence of non-dipping was 43%. Age and male gender were the significant predictors of poor control. CONCLUSION The rate control of hypertension in our study population remains low. Its improvement passes by the education of the hypertensive patients and the improvement of their living conditions.
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Affiliation(s)
- M S Ikama
- Service de cardiologie, CHU de Brazzaville, BP 2234 Brazzaville, Congo.
| | - B M Nsitou
- Service de cardiologie, CHU de Brazzaville, BP 2234 Brazzaville, Congo
| | - J Makani
- Service de cardiologie, CHU de Brazzaville, BP 2234 Brazzaville, Congo
| | - M Nkalla-Lambi
- Service de cardiologie, CHU de Brazzaville, BP 2234 Brazzaville, Congo
| | - C Passi-Louamba
- Service de cardiologie, CHU de Brazzaville, BP 2234 Brazzaville, Congo
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Duboz P, Touré M, Hane F, Macia E, Coumé M, Bâ A, Boëtsch G, Guèye L, Chapuis-Lucciani N. [Ageing and chronic diseases in Senegal. A comparison between rural (Ferlo) and urban (Dakar) populations]. ACTA ACUST UNITED AC 2014; 108:25-31. [PMID: 25256252 DOI: 10.1007/s13149-014-0397-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 07/22/2014] [Indexed: 11/25/2022]
Abstract
The objectives of this study were: to compare the prevalence of hypertension, overweight and obesity in rural (Ferlo) and urban (Dakar) Senegalese populations aged 50 and over. The survey was conducted on individuals aged 50 and older living in the rural area (N=478) and in the urban area (N=220). We have collected data about age, gender, marital status, education level, and knowledge, treatment of hypertension, height, weight and blood pressure. We have observed that overweight and obesity were more prevalent in the urban area (Dakar) than in the rural one (Ferlo). The risk of overweight or obesity decreased when age increased, and women had weight problems more often than men. The prevalence of arterial hypertension was lower in rural area (55.86%) than in Dakar (66.36%), but increased at an older age. However, the logistic regression showed that these increased proportion of hypertension in Dakar is linked to the more important proportion of overweight and obese people in this area. Moreover, rates of knowledge, treatment and control of hypertension are particularly low in the rural area of Senegal. In conclusion, age-associated diseases should be better managed in Senegal, particularly in rural areas.
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Affiliation(s)
- P Duboz
- Faculté de médecine secteur Nord, UMR 7268 ADES, CNRS/Aix-Marseille Université/EFS, Boulevard Pierre Dramard, Marseille, France.
- Observatoire hommes-milieux international Téssékéré, Dakar, Sénégal.
| | - M Touré
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - F Hane
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - E Macia
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - M Coumé
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - A Bâ
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - G Boëtsch
- Observatoire hommes-milieux international Téssékéré, Dakar, Sénégal
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - L Guèye
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - N Chapuis-Lucciani
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
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Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. PLoS One 2014; 9:e104300. [PMID: 25090232 PMCID: PMC4121276 DOI: 10.1371/journal.pone.0104300] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 07/10/2014] [Indexed: 12/14/2022] Open
Abstract
Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.
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Affiliation(s)
- Davies Adeloye
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
- * E-mail:
| | - Catriona Basquill
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
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Minicuci N, Biritwum RB, Mensah G, Yawson AE, Naidoo N, Chatterji S, Kowal P. Sociodemographic and socioeconomic patterns of chronic non-communicable disease among the older adult population in Ghana. Glob Health Action 2014; 7:21292. [PMID: 24746141 PMCID: PMC3991840 DOI: 10.3402/gha.v7.21292] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 02/26/2014] [Accepted: 03/13/2014] [Indexed: 11/14/2022] Open
Abstract
Background In Ghana, the older adult population is projected to increase from 5.3% of the total population in 2015 to 8.9% by 2050. National and local governments will need information about non-communicable diseases (NCDs) in this population in order to allocate health system resources and respond to the health needs of older adults. Design The 2007/08 Study on global AGEing and adult health (SAGE) Wave 1 in Ghana used face-to-face interviews in a nationally representative sample of persons aged 50-plus years. Individual respondents were asked about their overall health, diagnosis of 10 chronic non-communicable conditions, and common health risk factors. A number of anthropometric and health measurements were also taken in all respondents, including height, weight, waist and hip circumferences, and blood pressure (BP). Results This paper includes 4,724 adults aged 50-plus years. The highest prevalence of self-reported chronic conditions was for hypertension [14.2% (95% CI 12.8–15.6)] and osteoarthritis [13.8%, (95% CI 11.7–15.9)]. The figure for hypertension reached 51.1% (95% CI 48.9–53.4) when based on BP measurement. The prevalence of current smokers was 8.1% (95% CI 7.0–9.2), while 2.0 (95% CI 1.5–2.5) were infrequent/frequent heavy drinkers, 67.9% (95% CI 65.2–70.5) consume insufficient fruits and vegetables, and 25.7% (95% CI 23.1–28.3) had a low level of physical activity. Almost 10% (95% CI 8.3–11.1) of adults were obese and 77.6% (95% CI 76.0–79.2) had a high-risk waist-to-hip ratio (WHR). Risks from tobacco and alcohol consumption continued into older age, while insufficient fruit and vegetable intake, low physical activity and obesity increased with increasing age. The patterns of risk factors varied by income quintile, with higher prevalence of obesity and low physical activity in wealthier respondents, and higher prevalence of insufficient fruit and vegetable intake and smoking in lower-income respondents. The multivariate analysis showed that only urban/rural residence and body mass index (BMI) were common determinates of both self-reported and measured hypertension, while all other determinants have differing patterns. Conclusions The findings show a high burden of chronic diseases in the older Ghanaian population, as well as high rates of modifiable health risk factors. The government could consider targeting these health behaviors in conjunction with work to improve enrolment rates in the National Health Insurance Scheme.
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Affiliation(s)
- Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy; Department of Community Health, University of Ghana, Accra, Ghana;
| | | | - George Mensah
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Alfred E Yawson
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Nirmala Naidoo
- Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland
| | - Paul Kowal
- Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland; Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, Australia
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Peltzer K, Phaswana-Mafuya N. Hypertension and associated factors in older adults in South Africa. Cardiovasc J Afr 2014; 24:67-71. [PMID: 23736129 PMCID: PMC3721893 DOI: 10.5830/cvja-2013-002] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 01/11/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Little attention has been focused on hypertension and associated factors among older adults in Africa. Therefore, this study aimed to investigate the prevalence and associated factors of hypertension in a national sample of older South Africans who participated in the Study of Global Ageing and Adults' Health (SAGE) in 2008. METHODS In 2008 we conducted a national, population-based, cross-sectional study of a sample of 3 840 subjects aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. RESULTS The prevalence of hypertension in the sample population was 77.3% (male 74.4%, female 79.6%). The rates of awareness, treatment and control among the hypertensive participants were 38.1, 32.7 and 17.1%, respectively. The results of multivariate logistic regression analysis revealed that the prevalence of hypertension was associated with being in the Coloured population group, having had a stroke, being overweight or obese and having had five or more out-patients care visits in the past 12 months. Hypertension was inversely associated with current alcohol use. CONCLUSION This study revealed high rates of hypertension among older adults (50 years and more) in South Africa, which puts them at risk for cardiovascular disease. The percentages of hypertensive subjects who were aware, treated and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure-monitoring systems to better manage hypertension among older adults in South Africa.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/SIT and TB HAST, Human Sciences Research Council, Pretoria, South Africa.
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24
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Doulougou B, Kouanda S, Ouédraogo GH, Meda BI, Bado A, Zunzunegui MV. Awareness, treatment, control of hypertension and utilization of health care services following screening in the North-central region of Burkina Faso. Pan Afr Med J 2014; 19:259. [PMID: 25852802 PMCID: PMC4382071 DOI: 10.11604/pamj.2014.19.259.4707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/27/2014] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION In Africa, a non-urban area is affected by hypertension. But in Burkina Faso, no study on factors associated with awareness, treatment and control of hypertension has not yet been published. The objectives of this report are to: (i) identify the factors associated with awareness, treatment, and control of hypertension in the adult population of Kaya health and demographic surveillance system (Kaya HDSS) and (ii) estimate health care services utilization by participant newly screened as hypertensive. METHODS A screening survey for hypertension was conducted on 1481 adults in Kaya HDSS in late 2012. Hypertensive individuals provided information relating to "awareness", "treatment" and "control" of their hypertension. After approximately two months, unaware hypertensive individuals were interviewed to know whether they had sought treatment. RESULTS During the screening survey, 123 individuals (9.4%) were identified as having hypertension. Among them, 33 (26.8%, 95% CI: 18.9-34.8) were aware of their condition, 25 (75.8%, 95% CI: 60.3-91.2) of them were receiving medication. Among those receiving treatment, 15 (60.0%, 95% CI: 39.4-80.6) had their blood pressure controlled. Semi-urban residence, presence of chronic diseases and physical inactivity were significantly associated with awareness of hypertension. Seventy two of the 90 participants who were classified as unaware were interviewed two months later. Out of them, 37 individuals had consulted a health worker and 28 received a diagnosis of hypertension. CONCLUSION Awareness was low but treatment and control of those who knew they were hypertensive were relatively high. These results could be used to improve management of hypertension in Burkina Faso.
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Affiliation(s)
- Boukaré Doulougou
- Institut de Recherche en Sciences de la Santé (IRSS), 03 BP 7192 Ouagadougou 03, Burkina Faso ; Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, Montréal, QC, Canada
| | - Séni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS), 03 BP 7192 Ouagadougou 03, Burkina Faso
| | - Gautier Henri Ouédraogo
- Institut de Recherche en Sciences de la Santé (IRSS), 03 BP 7192 Ouagadougou 03, Burkina Faso
| | | | - Aristide Bado
- Institut de Recherche en Sciences de la Santé (IRSS), 03 BP 7192 Ouagadougou 03, Burkina Faso
| | - Maria Victoria Zunzunegui
- Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, Montréal, QC, Canada ; Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), Montréal, QC, Canada ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
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25
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Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord 2013; 13:54. [PMID: 23915151 PMCID: PMC3750220 DOI: 10.1186/1471-2261-13-54] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/31/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Inadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. METHODS The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. RESULTS Thirty-eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. CONCLUSION There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.
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Affiliation(s)
- James Kayima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Achilles Katamba
- Clinical Epidemiology Unit, Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Elli Leontsini
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
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Seck SM, Guéye S, Tamba K, Ba I. Prevalence of chronic cardiovascular and metabolic diseases in Senegalese workers: a cross-sectional study, 2010. Prev Chronic Dis 2013; 10:110339. [PMID: 23286359 PMCID: PMC3545700 DOI: 10.5888/pcd10.110339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Noncommunicable diseases (NCDs) are a major public health threat, particularly in developing countries. In sub-Saharan Africa, the scarcity of reliable data on NCDs in the general population makes it difficult to develop efficient prevention strategies. The objective of this cross-sectional study was to assess the prevalence of 4 cardiometabolic NCDs among 402 private-sector workers in Dakar, Senegal: high blood pressure (HBP), diabetes, obesity, and chronic kidney disease (CKD). Methods We collected demographic, clinical, and biological data for each worker during routine occupational health visits between September 1 and November 30, 2010. Multivariate analyses were performed to identify risk factors associated with NCDs. Results Among the 402 study participants, 24.1% had HBP, 9.7% had diabetes, 16.7% were obese, and 22.4% had CKD. About half of participants (48.5%) were not aware of their diseases before the screening. Univariate analysis showed that age was significantly associated with blood pressure, fasting blood glucose, and renal function. After adjusting for age and sex, systolic blood pressure was correlated with renal function, and physical inactivity was significantly associated with obesity. Conclusion Despite its small sample size, our study provides a perspective on the extent of cardiometabolic NCDs in Senegalese workers. Our study also suggests that targeted screening activities focusing on socio-professional groups may be helpful in the absence of national integrated prevention programs.
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Affiliation(s)
- Sidy Mohamed Seck
- Internal Medicine and Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234 Saint-Louis, Sénégal.
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