Hypertension in Sub-Saharan Africa: Cross-Sectional Surveys in Four Rural and Urban Communities

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From: PLoS ONE(Vol. 7, Issue 3)
Publisher: Public Library of Science
Document Type: Survey
Length: 7,570 words
Lexile Measure: 1430L

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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

Introduction

Eighty percent of global cardiovascular disease (CVD) mortality occurs in low- and middle-income countries (LMIC) [1], [2]. 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 [3]. 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 [4]. 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 [5].

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 [6], [7]. Hypertension has been identified as the leading risk factor for mortality worldwide, and is ranked third as a cause of disability-adjusted life-years [8]. 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 [9], [10], [11], [12], [13]. Migration studies in LMIC showed that migrants from rural to urban areas showed an increase in blood pressure [14], [15]. 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 [16], [17], [18], [19]. 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 [20]. However, hypertension prevalence data for SSA are scarce [21], [22]. 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.

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Ethical clearance

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...

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Gale Document Number: GALE|A477133870