Regional Patterns and Association Between Obesity and Hypertension in Africa Evidence From the H3Africa CHAIR Study

被引:47
作者
Akpa, Onoja M. [1 ,2 ,3 ,5 ,6 ]
Made, Felix [4 ,5 ,6 ]
Ojo, Akinlolu [7 ,8 ]
Ovbiagele, Bruce [9 ]
Adu, Dwomoa [10 ]
Motala, Ayesha A. [11 ]
Mayosi, Bongani M. [12 ]
Adebamowo, Sally N. [14 ]
Engel, Mark E. [13 ]
Tayo, Bamidele [15 ]
Rotimi, Charles [16 ]
Salako, Babatunde [1 ]
Akinyemi, Rufus [1 ]
Gebregziabher, Mulugeta [17 ]
Sarfo, Fred [18 ]
Wahab, Kolawole [19 ]
Agongo, Godfred [20 ]
Alberts, Marianne [21 ]
Ali, Stuart A. [5 ,6 ]
Asiki, Gershim [22 ]
Boua, Romuald P. [23 ]
Gomez-Olive, F. Xavier [24 ]
Mashinya, Felistas [21 ]
Micklesfield, Lisa [25 ]
Mohamed, Shukri F. [22 ]
Nonterah, Engelbert A. [20 ]
Norris, Shane A. [25 ]
Sorgho, Hermann [23 ]
Tollman, Stephen [24 ]
Parekh, Rulan S. [26 ,27 ,28 ,29 ]
Chishala, Chishala [13 ]
Ekoru, Kenneth [30 ]
Waddy, Salina P. [31 ]
Peprah, Emmanuel [32 ]
Mensah, George A. [33 ]
Wiley, Ken [34 ]
Troyer, Jennifer [35 ]
Ramsay, Michele [5 ,6 ]
Owolabi, Mayowa O. [1 ]
机构
[1] Univ Ibadan, Coll Med, Ctr Genom & Precis Med, Ibadan, Nigeria
[2] Univ Ibadan, Coll Med, Dept Epidemiol & Med Stat, Ibadan, Nigeria
[3] Univ Ibadan, Inst Cardiovasc Dis, Coll Med, Ibadan, Nigeria
[4] Natl Hlth Lab Serv, Natl Inst Occupat Hlth, Epidemiol & Surveillance Sect, Johannesburg, Gauteng Region, South Africa
[5] Univ Witwatersrand, Fac Hlth Sci, Sydney Brenner Inst Mol Biosci, Johannesburg, South Africa
[6] Univ Witwatersrand, Fac Hlth Sci, Div Human Genet, Johannesburg, South Africa
[7] Univ Arizona Hlth Sci, Clin Res Initiat, Tucson, AZ USA
[8] Univ Arizona Hlth Sci, Global Hlth Initiat, Tucson, AZ USA
[9] Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA
[10] Univ Ghana, Sch Med & Dent, Accra, Ghana
[11] Univ KwaZulu Natal, Nelson R Mandela Sch Med, Dept Diabet & Endocrinol, Durban, South Africa
[12] Univ Cape Town, Groote Schuur Hosp, Dept Med, Cape Town, South Africa
[13] Univ Cape Town, Dept Med, Div Cardiol, Cape Town, South Africa
[14] Univ Maryland, Sch Med, Greenebaum Comprehens Canc Ctr, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA
[15] Loyola Univ Chicago, Stritch Sch Med, Dept Prevent Med & Epidemiol, Maywood, IL USA
[16] NHGRI, Ctr Res Genom & Global Hlth, NIH, Bethesda, MD 20892 USA
[17] Med Univ South Carolina, Dept Publ Hlth Sci, Charleston, SC 29425 USA
[18] Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana
[19] Univ Ilorin, Dept Med, Ilorin, Nigeria
[20] Navrongo Hlth Res Ctr, Navrongo, Ghana
[21] Univ Limpopo, Fac Hlth Sci, Sch Hlth Care Sci, Dept Pathol & Med Sci, Polokwane, South Africa
[22] African Populat & Hlth Res Ctr, Nairobi, Kenya
[23] Inst Rech Sci Sante, Clin Res Unit Nanoro, Bobo Dioulasso, Burkina Faso
[24] Univ Witwatersrand, Fac Hlth Sci, Sch Publ Hlth, MRC Wits Rural Publ Hlth & Hlth Transit Res Unit, Johannesburg, South Africa
[25] Univ Witwatersrand, Fac Hlth Sci, MRC Wits Dev Pathways Hlth Res Unit, Johannesburg, South Africa
[26] Univ Hlth Network, Hosp Sick Children, Dept Pediat, Toronto, ON, Canada
[27] Univ Hlth Network, Hosp Sick Children, Dept Med, Toronto, ON, Canada
[28] Univ Hlth Network, Hosp Sick Children, Dept Epidemiol, Toronto, ON, Canada
[29] Univ Toronto, Toronto, ON, Canada
[30] NHGRI, Ctr Res Genom & Global Hlth, NIH, Bethesda, MD 20892 USA
[31] Atlanta Vet Affairs Med Ctr, Dept Neurol, Decatur, GA USA
[32] NYU, Coll Global Publ Hlth, New York, NY USA
[33] NHLBI, Ctr Translat Res & Implementat Sci, NIH, Bldg 10, Bethesda, MD 20892 USA
[34] NHGRI, Div Genom Med, Bethesda, MD 20892 USA
[35] NIH, Human Hered & Hlth Africa, Div Genome Sci, Bldg 10, Bethesda, MD 20892 USA
基金
美国国家卫生研究院; 英国惠康基金;
关键词
Africa; blood pressure; hypertension; obesity; risk factors; SUB-SAHARAN AFRICA; BLOOD-PRESSURE; GLOBAL BURDEN; DISEASE; NETWORK;
D O I
10.1161/HYPERTENSIONAHA.119.14147
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]>= 140/90 mmHg/BP >= 130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries. We analyzed data from population-based controls and the Entire Harmonized Dataset. Age-adjusted and crude proportions of hypertension were compared regionally, across sex, and between hypertension definitions. Logit generalized estimating equation was used to determine the independent association of obesity with hypertension (P value <5%). Participants were 56% women; with mean age 48.5 +/- 12.0 years. Crude proportions of hypertension (at BP >= 140/90 mmHg) were 47.9% (95% CI, 47.4-48.5) for Entire Harmonized Dataset and 42.0% (41.1-42.7) for population-based controls and were significantly higher for the 130/80 mm Hg threshold at 59.3% (58.7-59.9) in population-based controls. The age-adjusted proportion of hypertension at BP >= 140/90 mmHg was the highest among men (33.8% [32.1-35.6]), in western Africa (34.7% [33.3-36.2]), and in obese individuals (43.6%; 40.3-47.2). Obesity was independently associated with hypertension in population-based controls (adjusted odds ratio, 2.5 [2.3-2.7]) and odds of hypertension in obesity increased with increasing age from 2.0 (1.7-2.3) in younger age to 8.8 (7.4-10.3) in older age. Hypertension is common across multiple countries in Africa with 11.9% to 51.7% having BP >= 140/90 mmHg and 39.5% to 69.4% with BP >= 130/80 mmHg. Obese Africans were more than twice as likely to be hypertensive and the odds increased with increasing age.
引用
收藏
页码:1167 / 1178
页数:12
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