Is sedentary lifestyle a critical driver for hypertension burden in Sub-Saharan Africa?: evidence from a community-based population in Ghana and Nigeria

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Okekunle ◽  
O Akpa ◽  
R Akinyemi ◽  
F Sarfo ◽  
G Ogbole ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Physical Inactivity ◽  
Public Institution ◽  
Sub Saharan Africa ◽  
Antihypertensive Medications ◽  
Hypertension Risk ◽  
Sub Saharan ◽  
Research And Education ◽  
Education Network

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Institute of Health (NIH) OnBehalf SIREN as part of the H3 Africa Consortium Background Hypertension is the principal risk factor for stroke events in Sub-Saharan Africa (SSA). However, international evidence on the significance of physical inactivity as a critical driver of hypertension risk in SSA is sparse. Purpose This study assessed determinants of hypertension risk among a stroke-free population in Ghana and Nigeria. Methods Participants were 4,267 stroke-free individuals recruited in the Stroke Investigative Research and Education Network study from Nigeria and Ghana. Data on sociodemographic, lifestyle, cardiovascular risk and blood pressure were collected using standard protocols. Hypertension was defined as systolic blood pressure (SBP) ≥ 140mmHg or diastolic blood pressure (DBP) ≥ 90mmHg or a previous diagnosis or current use of antihypertensive medications. Odds ratio (OR) and 95% confidence interval (CI) for hypertension risk was estimated using logistic regression at P < 0.05. Results Mean age was 55.9 ± 14.7 and 1.8% were physically inactive. Mean SBP and DBP were 135.8 ± 24.2mmHg and 82.7 ± 14.3mmHg respectively, and 56.7% had hypertension. Factors associated with hypertension were physical inactivity (OR: 9.09; 95%CI: 4.03, 20.53), being diabetic (OR: 2.70; 95%CI: 1.91, 3.82), being older than 60years (OR: 2.22; 95%CI: 1.78, 2.77) and family history of cardiovascular diseases (OR: 2.02; 95%CI: 1.59, 2.56) and elevated waist circumference (OR: 1.01; 95%CI: 1.00, 1.02). Conclusion(s): Physical inactivity was the leading risk factor for hypertension in this population. Community-oriented interventions promoting physical activity should help in the control of hypertension among sub-Saharan African population.

scholarly journals Phenotyping Stroke in Sub-Saharan Africa: Stroke Investigative Research and Education Network (SIREN) Phenomics Protocol

2015 ◽  
Vol 45 (2) ◽  
pp. 73-82 ◽  
Author(s):  
Albert Akpalu ◽  
Fred Stephen Sarfo ◽  
Bruce Ovbiagele ◽  
Rufus Akinyemi ◽  
Mulugeta Gebregziabher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Research ◽  
Evidence Base ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Community Based ◽  
Emerging Risk ◽  
Sub Saharan ◽  
Research And Education ◽  
Education Network

Background: As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, traditional and emerging risk factors for stroke in SSA have not been well characterized, thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics, and bioinformatics for brain research. Methods: SIREN is a transnational, multicentre, hospital and community-based study involving 3,000 cases and 3,000 controls recruited from 8 sites in Ghana and Nigeria. Cases will be hospital-based patients with first stroke within 10 days of onset in whom neurovascular imaging will be performed. Etiological and topographical stroke subtypes will be documented for all cases. Controls will be hospital- and community-based participants, matched to cases on the basis of gender, ethnicity, and age (±5 years). Information will be collected on known and proposed emerging risk factors for stroke. Study Significance: SIREN is the largest study of stroke in Africa to date. It is anticipated that it will shed light on the phenotypic characteristics and risk factors of stroke and ultimately provide evidence base for strategic interventions to curtail the burgeoning burden of stroke on the sub-continent.

scholarly journals Blood pressure-lowering medicines implemented in 12 African countries: the cross-sectional multination EIGHT study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049632
Author(s):  
Pauline Cavagna ◽  
Jean Laurent Takombe ◽  
Jean Marie Damorou ◽  
Charles Kouam Kouam ◽  
Ibrahima Bara Diop ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Traditional Medicine ◽  
Large Scale ◽  
Random Effect ◽  
Sub Saharan Africa ◽  
Antihypertensive Medications ◽  
Large Scale Data ◽  
Number Of Patients ◽  
Sub Saharan ◽  
Scale Data

ObjectiveIn Africa, the number of patients with hypertension is expected to reach 216.8 million by 2030. Large-scale data on antihypertensive medications used in Sub-Saharan Africa (SSA) are scarce.Here, we describe antihypertensive drug strategies and identify treatment factors associated with blood pressure (BP) control in 12 Sub-Saharan countries.SettingOutpatient consultations for hypertension in urban tertiary cardiology centres of 29 hospitals from 17 cities across 12 SSA countries between January 2014 and November 2015.ParticipantsPatients ≥18 years of age with hypertension were enrolled at any visit during outpatient consultations in the cardiology departmentsMain outcome measureWe collected BP levels, demographic characteristics and antihypertensive treatment use (including traditional medicine) of patients with hypertension attending outpatient visits. BP control was defined as seated office BP <140/90 mm Hg. We used logistic regression with a random effect on countries to assess factors of BP control.ResultsOverall, 2198 hypertensive patients were included and a total of 96.6% (n=2123) were on antihypertensive medications. Among treated patients, 653 (30.8%) patients received a monotherapy by calcium channel blocker (n=324, 49.6%), renin–angiotensin system blocker (RAS) (n=126, 19.3%) or diuretic (n=122, 18.7%). Two-drug strategies were prescribed in 927 (43.6%) patients including mainly diuretics and RAS (n=327, 42% of two-drug strategies). Prescriptions of three-drugs or more were used in 543 (25.6%) patients. Overall, among treated patients, 1630 (76.7%) had uncontrolled BP, of whom 462 (28.3%) had BP levels ≥180/110 mm Hg, mainly in those on monotherapy. After adjustment for sociodemographic factors, the use of traditional medicine was the only factor significantly associated with uncontrolled BP (OR 1.72 (1.19 to 2.49) p<0.01).ConclusionOur study provided large-scale data on antihypertensive prescriptions in the African continent. Among patients declared adherent to drugs, poor BP control was significantly associated with the use of traditional medicine.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Ghana-Sub-Saharan Africa

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B62-B65
Author(s):  
Betty Twumasi-Ankrah ◽  
Neil R Poulter ◽  
Elliot K Tannor ◽  
Yaw Adu-Boakye ◽  
Obed O Nyarko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sub Saharan Africa ◽  
Sports Facilities ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Standardized Protocol ◽  
Sub Saharan ◽  
Global Initiative ◽  
Set Up

Abstract Raised blood pressure (BP) remains the biggest single risk factor contributing to the global burden of disease and to global mortality. Although a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 7102 participants gave their consent and were screened during MMM 2019. After multiple imputation, of all 7102 participants 1836 (25.9%) had hypertension. Of all 1836 participants with hypertension, 36.5% were aware of their status and 30.0% were on anti-hypertensive medication. Of 550 participants on antihypertensive medications, 46.1% had controlled BP (systolic BP &lt;140 mmHg and diastolic BP &lt;90 mmHg). Also, of all 1836 participants with hypertension, 13.8% had their BP controlled. Again, the proportion of participants with hypertension of those not receiving anti-hypertensive treatment was 1286 (19.6%). Data obtained from this project demonstrates that there is still a significant number of people with hypertension who are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the significance of BP screening campaigns as a tool to identify persons with elevated BP.

scholarly journals Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

2021 ◽  
Vol 6 (1) ◽  
pp. e003499
Author(s):  
Ryan G Wagner ◽  
Nigel J Crowther ◽  
Lisa K Micklesfield ◽  
Palwende Romauld Boua ◽  
Engelbert A Nonterah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
South African ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Cvd Risk ◽  
Genomic Studies ◽  
Sub Saharan ◽  
Context Specific ◽  
The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

Migration as a Risk Factor for HIV Infection among Youths in Sub-Saharan Africa

2013 ◽  
Vol 648 (1) ◽  
pp. 136-158 ◽  
Author(s):  
Monica A. Magadi
Keyword(s):  
Risk Factor ◽  
Hiv Infection ◽  
Urban Areas ◽  
Young Female ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Country Level ◽  
Female Migrants ◽  
Sub Saharan ◽  
Living With Hiv

Of the estimated 10 million youths living with HIV worldwide, 63 percent live in sub-Saharan Africa. This article focuses on migration as a risk factor of HIV infection among the youths in sub-Saharan Africa. The study is based on multilevel modeling, applied to the youth sample of the Demographic and Health Surveys (DHS), conducted from 2003 to 2008 in nineteen countries. The analysis takes into account country-level and regional-level variations. The results suggest that across countries in sub-Saharan Africa, migrants have on average about 50 percent higher odds of HIV infection than nonmigrants. The higher risk among migrants is to a large extent explained by differences in demographic and socioeconomic factors. In particular, migrants are more likely to be older, to have been married, or to live in urban areas, all of which are associated with higher risks of HIV infection. The higher risk among youths who have been married is particularly pronounced among young female migrants.

Abstract 14615: The Preventable Causes of Cardiovascular Diseases in China: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yanping Li ◽  
Frank Hu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
High Blood Pressure ◽  
Physical Inactivity ◽  
Metabolic Risk Factors ◽  
Morbidity And Mortality ◽  
Metabolic Risk ◽  
Rapid Urbanization ◽  
Exposure Distribution

Background: fuelled by rapid urbanization and changes in dietary and lifestyle choices, cardiovascular disease (CVD) has emerged as the leading cause of death in China. Purposes: to estimate the CVD events that potentially contributed to 9 modifiable dietary, lifestyle, and metabolic risk factors in China. Methods: We used data on risk factor exposures in the Chinese population from nationally representative health surveys and CVD morbidity and mortality statistics from the China Health Statistical Yearbook and the National Population Census. We obtained the etiological effects of risk factors on CVD risk, by age, from systematic reviews and meta-analyses of epidemiological studies. We estimated the number of CVD events attributable to all non-optimal levels of each risk factor exposure, by urban/rural, age and sex. Results: Based on the exposure distribution estimated by 2009 China Health Nutrition Survey, the population attributable risk (PAR) on CVD events was 47.3% for high blood pressure, 23.2%, for physical inactivity, 18.5% for smoking, 13.5 for high BMI, 13.0% for high LDL cholesterol, 11.8% for high blood glucose, 11.1% for low dietary intakes of fruit and vegetable, 7.1% for high sodium intake and 3.5% for low PUFA intake, which was 78.0%, 18.8%, 20.9%, 21.9%, 8.2%, 16.1%, 12.0%, 20.3% and 2.0%, respectively, based on exposure distribution of 2002 China National Nutrition and Health Survey. In 2009, high blood pressure was responsible for 3.9 million CVD events, including 1.4 million CHD, 1.5 million ischemic strokes and 1 million hemorrhagic strokes. Large gender difference was found for PAR% of smoking (male 27.8%/female 6.5%). Conclusions: High blood pressure, smoking and physical inactivity, which all have effective interventions, are responsible for the largest number of CVD events in China. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of CVD morbidity and mortality in China.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

scholarly journals May Measurement Month 2017: an analysis of blood pressure screening results in Cote d’Ivoire—Sub-Saharan Africa

2019 ◽  
Vol 21 (Supplement_D) ◽  
pp. D47-D49 ◽  
Author(s):  
Kramoh Kouadio Euloge ◽  
Ekoua Daniel ◽  
Abina Audrey ◽  
Koffi Kouassi Florent ◽  
Koffi Djinguin Ben Justin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Sub Saharan Africa ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Blood Pressure Screening ◽  
Sub Saharan

scholarly journals The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ileana Desormais ◽  
Salimanou Ariyoh Amidou ◽  
Yessito Corine Houehanou ◽  
Stephan Dismand Houinato ◽  
Gwladys Nadia Gbagouidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Large Population ◽  
Community Dwelling ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
World Health ◽  
Cross Sectional ◽  
Men And Women ◽  
Sub Saharan

Abstract Background Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

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