Author(s): Marleen E. Hendriks 1 , * , Ferdinand W. N. M. Wit 1 , Marijke T. L. Roos 2 , Lizzy M. Brewster 3 , Tanimola M. Akande 4 , Ingrid H. de Beer 5 , Sayoki G. Mfinanga 6 , Amos M. Kahwa 6 , Peter Gatongi 7 , Gert Van Rooy 8 , Wendy Janssens 9 , 10 , Judith Lammers 9 , 11 , Berber Kramer 9 , 11 , Igna Bonfrer 9 , 12 , Esegiel Gaeb 13 , Jacques van der Gaag 9 , 11 , Tobias F. Rinke de Wit 1 , 2 , Joep M. A. Lange 1 , Constance Schultsz 1
Eighty percent of global cardiovascular disease (CVD) mortality occurs in low- and middle-income countries (LMIC) , . According to the World Economic Forum, non-communicable diseases (NCD), such as CVD, are a severe threat to global economic development due to the long-term costs of treatment and the negative effects on productivity . The burden of NCD is expected to increase substantially in LMIC and to represent a greater burden of disease compared to communicable diseases by 2030 . The Unites Nations (UN) High level meeting on NCDs which took place in September 2011, emphasized the urgent need for greater measures to prevent and control NCDs in LMIC .
The INTERHEART and INTERSTROKE studies showed that modifiable risk factors such as hypertension, obesity, smoking, dyslipidemia and diabetes, account for the majority of CVD in LMIC , . Hypertension has been identified as the leading risk factor for mortality worldwide, and is ranked third as a cause of disability-adjusted life-years . Hypertension in SSA is believed to be a problem of the urban areas due to transition to a more Western lifestyle. Early cross-sectional studies from rural areas in SSA report low mean blood pressures that are stable with age, and a low prevalence of hypertension , , , , . Migration studies in LMIC showed that migrants from rural to urban areas showed an increase in blood pressure , . Recent studies from rural areas in SSA suggest that the prevalence of hypertension is increasing in rural populations. However, unrelated studies are difficult to compare due to a lack of age- standardized prevalence data , , , . Hypertension prevalence data are crucial for understanding the magnitude of the problem, identifying groups at high risk for CVD, and evaluating the effects of policy and practice interventions . However, hypertension prevalence data for SSA are scarce , . This study describes the prevalence of hypertension and the determinants of increasing blood pressure in 4 SSA populations in rural Nigeria and Kenya and in urban Namibia and Tanzania.
Ethical clearance for the study reported in this paper was obtained from the Ethical Review Committee of the University of Ilorin Teaching Hospital in Nigeria; the Research Ethics Committee at the Ministry of Health and Social Services in Namibia; the National Institute for Medical Research and the Tanzania Commission for Science and...