Original Research
Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa
Authors:
F. Xavier Gómez-Olivé,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA; INDEPTH Network, Accra, GH; Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, US
Stuart A. Ali,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Felix Made,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Catherine Kyobutungi,
African Population and Health Research Center, Nairobi, KE
Engelbert Nonterah,
Navrongo Health Research Centre, Navrongo, GH
Lisa Micklesfield,
MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Marianne Alberts,
Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, ZA
Romuald Boua,
Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, BF
Scott Hazelhurst,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg; School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, ZA
Cornelius Debpuur,
Navrongo Health Research Centre, Navrongo, GH
Felistas Mashinya,
Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, ZA
Sekgothe Dikotope,
Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, ZA
Hermann Sorgho,
Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, BF
Ian Cook,
Physical Activity Epidemiology Laboratory (EDST), School of Education, Faculty of Humanities, University of Limpopo, Polokwane, ZA
Stella Muthuri,
African Population and Health Research Center, Nairobi, KE
Cassandra Soo,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Freedom Mukomana,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Godfred Agongo,
Navrongo Health Research Centre, Navrongo, GH
Christopher Wandabwa,
African Population and Health Research Center, Nairobi, KE
Sulaimon Afolabi,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Abraham Oduro,
Navrongo Health Research Centre, Navrongo, GH
Halidou Tinto,
Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, BF
Ryan G. Wagner,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Tilahun Haregu,
African Population and Health Research Center, Nairobi, KE
Alisha Wade,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Kathleen Kahn,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Shane A. Norris,
MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Nigel J. Crowther,
Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Stephen Tollman,
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
Osman Sankoh,
INDEPTH Network, Accra, GH; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA; Department of Mathematics and Statistics, Njala University, Njala, SL
Michèle Ramsay ,
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg; Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA
as members of AWI-Gen and the H3Africa Consortium
Abstract
Background: There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa, yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal.
Objectives: The study sought to report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in 6 sites located in West, East, and Southern Africa. In addition, we examined regional, sex, and age differences related to hypertension.
Methods: A population-based cross-sectional study was performed at 6 sites in 4 African countries: Burkina Faso (Nanoro), Ghana (Navrongo), Kenya (Nairobi), and South Africa (Agincourt, Dikgale, Soweto). Blood pressure measurements were taken using standardized procedures on 10,696 adults 40 to 60 years of age. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or taking antihypertensive medication.
Results: The mean prevalence of hypertension ranged from 15.1% in Nanoro to 54.1% in Soweto. All 3 of the South African sites had a mean prevalence of hypertension of over 40.0%, significantly higher than in Nairobi (25.6%) and Navrongo (24.5%). Prevalence increased with age in both sexes and at all sites. A significantly higher prevalence of hypertension was observed in women in Agincourt, Dikgale, and Nairobi, whereas in Nanoro this trend was reversed. Within the hypertensive group the average proportion of participants who were aware of their blood pressure status was only 39.4% for men and 53.8% for women, and varied widely across sites.
Conclusions: Our study demonstrates that the prevalence of hypertension and the level of disease awareness differ not only between but also within sub-Saharan African countries. Each nation must tailor their regional hypertension awareness and screening programs to match the characteristics of their local populations.
Highlights
- Stark differences in hypertension prevalence, awareness, and control across Africa.
- Hypertension prevalence ranges between 15.1% and 54.1% in sub-Saharan Africans.
- Only 47.7% of hypertensive individuals knew their blood pressure status.
- Levels of blood pressure control ranged from 30.0% to 61.1%.
- Urgent need for localized monitoring and treatment of blood pressure.
How to Cite:
Gómez-Olivé FX, Ali SA, Made F, Kyobutungi C, Nonterah E, Micklesfield L, et al.. Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa. Global Heart. 2017;12(2):81–90. DOI: http://doi.org/10.1016/j.gheart.2017.01.007
Published on
01 Jun 2017.
Peer Reviewed
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