Hypertension, diabetes, and obesity in Barbados: findings from a recent population-based survey

A stratified random sample of 464 persons aged 40 ato 79 years, drawn from enumeration registers in the Bridgetown area of Barbados, participated in this survey. The prevalence of hypertension (defined as systolic blood pressure of at least 160mm Hg, diastolic blood pressure of at least 95 mm Hg, or use of antihypertensive medication) was 47 percent and 43 percent for women and men, respectively. Diabetes was present in 17 percent of all subjects (18 percent of women and 15 percent of men). Of the 209 hypertensive subjects, 82 percent were aware of their blood pressure status. The proportion of previously diagnosed hypertensive subjects on medication was 72 percent for men and 68 percent for women. Fifty-three percent of men and 42 percent of women were overweight (body mass indices [weight in kilograms divided by height in meters squared] between 25 and 30. However, 30 percent of women and 10 percent of men were obese (body mass indices over 30), supporting the growing recognition of the marked gender disparity in obesity among persons of African origin in the Caribbean. Body mass index was positively associated with hypertension (OR=1.33; 95 percent CI: 1.1-1.6). Obese persons experienced a 2.6 times greater risk of hypertension compared to those with body mass indices below 25. Similar statistically significant associations were observed between diabetes and body mass index: Or comparing body mass index over 30 with body mass index under 25 was 2.5 (95 percent CI: 1.3-5.1) for all subjects, 1.0 (0.3-4.1) for men only, and 5.2 (1.9-14) for women only. Preventing obesity in this population could reduce the incidence of hypertension and diabetes by approximately 30 percent and 33 percent among men and women, respectively. (Au)

An epidemiological study of potassium status, hypertension and diabetes in Barbados

The relationships between hypertension, diabetes, potassium status and other factors were examined in a population-based sample of 464 Barbadians. A stratified random sample by gender and age (40-79 years) was obtained from enumeration registers and investigated over a three month period. The previously reported low potassium range for Barbadians was confirmed (2.9-4.7 mmol/l). Within-subject correlation of plasma potassium and 24-hour urine potassium was demonstrated by repeat investigation in 70 subjects one year later. A high prevalence of obesity, hypertension and diabetes was confirmed in this population with relatively good health care. The prevalence of hypertension (by history) was 36 percent in the whole sample. Twenty-six percent of subjects were receiving antihypertensives, yet a diastolic BP of >90 mmHg was found in 17 percent of the whole sample. Six percent of subjects had a fasting plasma glucose greater than that cited by WHO. Subjects not on thiazides, compared to those on thiazides did not show a significant difference in fasting glucose or potassium values, but did show higher uric acid and cholesterol values. Dietary analyses confirmed the traditional high starch, low fruit Barbadian diet. The major risk factors for hypertension were female gender, obesity in females and positive family history. In this study a high prevalence of hypokalemia and moderately low dietary potassium has been demonstrated, but neither potassium deficiency nor thiazide use appeared to be definitely linked to diabetes or hypertension.

Hypertension, diabetes mellitus and potassium status in a population sample of black Barbadians: a preliminary report - abstract

The aims of this study were to assess the previously reported hypokalaemia in black Barbadians and investigate relationships between hypertension (diastolic bloodpressue > 90mm Hg and/or systolic bloodpressure > 160mm Hg), diabetes mellitus (DM, fasting plasma glucose > 7.8 mmol/l), diet and potassium (K) status in Barbadians. A stratified random sample by sex and age (40-70 years) was obtained from enumeration registers of a geographically defined area. Of 955 persons invited, 464 (48.6 per cent) responded and they comprised 190 men and 274 women. A general and a food frequency questionnaire for 24-hr. diet recall were administered, and height, weight and bloodpressure (BP) were measured. Fasting plasma glucose, K and sodium levels were measured in blood, and urine volume, sodium and K were determined in a 24-hr. urine collection. The mean plasma of K was 3.8 mmol/l, S.D. 0.44, giving a range (mean ñ 2 S.D.) of 2.9 - 4.7 mmol/l which was almost identical to that previously reported. Both 24-hr. urinary K and sodium showed a weak negative correlation with systolic BP only. K deficiency was not clearly linked to hypertension and neither K deficiency nor current thiazide use was linked to DM. The prevalence of hypertension (25 per cent), DM (11 per cent), obesity, hypokalaemia and moderately low dietary K were high (AU)