Burden of hypertension in The Gambia: evidence from a national World Health Organization (WHO) STEP survey

被引:26
作者
Cham, Bai [1 ,2 ]
Scholes, Shaun [1 ]
Fat, Linda Ng [1 ]
Badjie, Omar [3 ]
Mindell, Jennifer S. [1 ]
机构
[1] UCL, Dept Epidemiol & Publ Hlth, London, England
[2] Univ Gambia, Dept Publ Hlth, Brikama Campus,POB 3530, Serrekunda, Gambia
[3] Minist Hlth & Social Welf, Noncommunicable Dis Unit, Banjul, Gambia
关键词
Hypertension; Gambia; sub-Saharan Africa; WHO STEP survey; health examination survey; SUB-SAHARAN AFRICA; BODY-MASS INDEX; NONCOMMUNICABLE DISEASES; RISK-FACTORS; BLOOD-PRESSURE; PREVALENCE; OBESITY; DETERMINANTS; ASSOCIATION; OVERWEIGHT;
D O I
10.1093/ije/dyx279
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Non-communicable diseases are increasing in sub-Saharan Africa and are estimated to account for 32% of adult deaths in The Gambia. Worldwide, prevalence of hypertension is highest in the African region (46%) and a very high proportion is undiagnosed. This study examined diagnosed and undiagnosed hypertension in The Gambian adult population. Methods: Data were collected in 2010 from a nationally representative random sample of 4111 adults aged 25-64 years, using the World Health Organization STEPwise cross-sectional survey methods. Analyses were restricted to non-pregnant participants with three valid blood pressure measurements (n = 3573). We conducted gender-stratified univariate and multivariate regression analyses to identify the strongest sociodemo-graphic, behavioural and biological risk factors associated with hypertension. Results: Almost one-third of adults were hypertensive; a high proportion were undiagnosed, particularly among men (86% of men vs 71% of women with hypertension, P < 0.001). Rural and semi-urban residents and overweight/obese persons had increased odds of hypertension. Compared with urban residents, participants from one of the most rural regions had higher odds of hypertension among both men [adjusted odds ratio (AOR) 3.2; 95% CI: 1.6-6.4] and women (AOR 2.5; 95% CI: 1.3-4.6). Other factors strongly associated with hypertension in multivariate analyses were age, smoking, physical inactivity and ethnicity. Conclusions: Rural and semi-urban residence were strongly associated with hypertension, contrary to what has been found in similar studies in sub-Saharan Africa. Intervention to reduce the burden of hypertension in The Gambia could be further targeted towards rural areas.
引用
收藏
页码:860 / 871
页数:12
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