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Hypertension prevalence, awareness, treatment, and control and predicted 10-year CVD risk: a cross-sectional study of seven communities in East and West Africa (SevenCEWA).
Okello, Samson; Muhihi, Alfa; Mohamed, Shukri F; Ameh, Soter; Ochimana, Caleb; Oluwasanu, Abayomi Olabayo; Bolarinwa, Oladimeji Akeem; Sewankambo, Nelson; Danaei, Goodarz.
Afiliación
  • Okello S; Department of Internal Medicine, Mbarara University of Science and Technology, P. O Box 1410, Mbarara, Uganda. okello.samson@must.ac.ug.
  • Muhihi A; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. okello.samson@must.ac.ug.
  • Mohamed SF; Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health Systems, Charlottesville, VA, USA. okello.samson@must.ac.ug.
  • Ameh S; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Ochimana C; Africa Academy for Public Health, Dar es Salaam, Tanzania.
  • Oluwasanu AO; Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
  • Bolarinwa OA; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Sewankambo N; Health and Systems for Health Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya.
  • Danaei G; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
BMC Public Health ; 20(1): 1706, 2020 Nov 13.
Article en En | MEDLINE | ID: mdl-33187491
ABSTRACT

BACKGROUND:

Few studies have characterized the epidemiology and management of hypertension across several communities with comparable methodologies in sub-Saharan Africa. We assessed prevalence, awareness, treatment, and control of hypertension and predicted 10-year cardiovascular disease risk across seven sites in East and West Africa.

METHODS:

Between June and August 2018, we conducted household surveys among adults aged 18 years and above in 7 communities in Kenya, Nigeria, Tanzania, and Uganda. Following a standardized protocol, we collected data on socio-demographics, health insurance, and healthcare utilization; and measured blood pressure using digital blood pressure monitors. We estimated the 10-year cardiovascular disease (CVD) risk using a country-specific risk score and fitted hierarchical models to identify determinants of hypertension prevalence, awareness, and treatment.

RESULTS:

We analyzed data of 3549 participants. The mean age was 39·7 years (SD 15·4), 60·5% of whom were women, 9·6% had ever smoked cigarettes, and 32·7% were overweight/obese. A quarter of the participants (25·4%) had hypertension, more than a half of whom (57·2%) were aware that they had diagnosed hypertension. Among those diagnosed, 50·5% were taking medication, and among those taking medication 47·3% had controlled blood pressure. After adjusting for other determinants, older age was associated with increased hypertension prevalence, awareness, and treatment whereas primary education was associated with lower hypertension prevalence. Health insurance was associated with lower hypertension prevalence and higher chances of treatment. Median predicted 10-yr CVD risk across sites was 4·9% (Interquartile range (IQR), 2·4%, 10·3%) and 13·2% had predicted 10-year CVD risk of 20% or greater while 7·1% had predicted 10-year CVD risk of > 30%.

CONCLUSION:

In seven communities in east and west Africa, a quarter of participants had hypertension, about 40% were unaware, half of those aware were treated, and half of those treated had controlled blood pressure. The 10-year predicted CVD risk was low across sites. Access to health insurance is needed to improve awareness, treatment, and control of hypertension in sub-Saharan Africa.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2020 Tipo del documento: Article País de afiliación: Uganda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2020 Tipo del documento: Article País de afiliación: Uganda