Trends in prevalence of obesity and hypertension in an urban Congolese community

Abstract

Objective: We assessed change in the prevalence of overweight/obesity and hypertension among adult Congolese people at two different periods.

Methods: In 2007-8 the prevalence of overweight/obesity and high blood pressure was assessed among 1,292 subjects (56.6% women) representing a random sample of the inhabitants of an urban Congolese community. The data were compared to previous observations in 424 participants (55.2% women) obtained in a 1983-4 survey of the same community. Age structure of the two samples was different. We therefore directly standardized the prevalence of overweight/obesity and hypertension for gender and age. We modeled the risk of hypertension in a multivariable logistic regression analysis and compared the rates of awareness and control of hypertension during both periods.

Results: Crude prevalence of overweight/obesity (26.7 vs. 42.3%; P <.0001) and hypertension (21.5 vs. 30.9%; P =.0002) was higher in 2007-8. Overweight/obesity predominated among women at both periods, hypertension among men in 1983-4. Gender-age directly standardized prevalence remained higher in 2007-8 for overweight/obesity [28.4(24.1-32.7)% vs. 41.3(38.8-43.7)%] and was borderline for hypertension [24.9(20-28.9)% vs. 29.7(27.4-31.9)%]. The 1983-4/2007-8 risk ratio was 0.69 for overweight/obesity (P <.0001), 0.84 for hypertension (P =.054). Awareness, treatment and control of hypertension tended to be better in 2007-8, especially among women. The risk of hypertension in multivariable logistic analysis, was greater for male gender (OR: 1.47[95% CI:1.14-1.88]; P =.0029), and increased with age (5.62[4.37-7.23]; P <.0001), overweight/obesity (2.27[1.77-2.91]; P <.0001) and pulse rate (for each 10 beats/min: 1.20[1.08-1.32]; P =.0005); the risk was 35% higher in 2007-8 (1.35;[1.01-1.80]; P =.0416).

Conclusion: Our data indicate the prevalence of overweight/obesity and hypertension has increased among adult urban Congolese people; they suggest that prevention of cardiovascular diseases might require appropriate control of these conditions.

Keywords

Overweight / Hypertension / Trends in Congolese adults

References

[1] Lim SS, Vos T, Danaei G, et al. A comparative assessment of burden of disease and injury attributable to 67 factors and risk factors clusters in 21 regions, 1990-2010; a systematic analysis for global Burden of Disease Study 2010. Lancet. 2012; 380: 2224-60.

[2] Flack JM, Nasser SA, O’connor SM. Ethnicity and Socioeconomic Status in Hypertension. In: Izzo JL, Sica DA, Black HR, Eds. Hypertension primer. The Essentials of Blood Pressure: Basic Science, 4th ed., 2008; 276-278.

[3] Danaei G, Finucane MM, Lin JK, et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Pressure). National, regional and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet. 2011; 377(9765): 568-577. https://doi.org/10.1016/S0140-6736(10)62036-3

[4] Organisation Mondiale de la Santé. Panorama mondial de l’hypertension. Un"tueur silencieux" responsable d’une crise de santé publique mondiale. Journée mondiale de la santé 2013. Genève: Suisse, Organisation Mondiale de la Santé. 2013. p1-40.

[5] Sobngwi E, Mbanya JC, Unwin NC, et al. Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon. International Journal of Epidemiology. 2004; 33: 769-776. PMid:15166209. https://doi.org/10.1093/ije/dyh044

[6] Bieleli E, Moswa J, Ditu M, et al. Prévalence du diabète sucré au sein de la population de Kinshasa. Congo Médical. 2000; 11: 1051-1061.

[7] Organisation Mondiale de la Santé. Enquête sur les facteurs de risque des maladies non-transmissibles à Kinshasa. Capitale de la République Démocratique du Congo, selon l’approche STEPS de l’OMS, Rapport d’analyse, Kinshasa. 2006.

[8] Katchunga PB, M’Buyamba-Kayamba JR, Masumbuko BE, et al. Hypertension artérielle chez l’adulte congolais du Sud Kivu: résultats de l’étude Vitaraa. Presse Médicale. 2011; 40: e315-e323. PMid:21376507.

[9] M’Buyamba - Kabangu JR, Biswika T, Thijs L, et al. In-hospital mortality among Black patients admitted for hypertension-related Disorders in Mbuji Mayi, Congo. Am J Hypertens. 2009; 22: 643-8. PMid:19282818. https://doi.org/10.1038/ajh.2009.47

[10] Tambwe MJ, Mbala Mukendi M, Dikassa LN, et al. Morbidity and mortality in hospitalized Zairian adults. South African Medical Journal. 1995; 85: 74. PMid:7597537.

[11] Bayauli MP, M’Buyamba-Kayamba JR, Lemogoum D, et al. Prehypertension, Hypertension and Associated Cardiovascular Risk Factors among Adult Congolese Urban Dwellers: Results of the Vitaraa Study. World Journal of Cardiovascular Diseases. 2014; 4: 390-398. https://doi.org/10.4236/wjcd.2014.48049

[12] Bayauli MP, M’Buyamba-Kayamba JR, Lemogoum D, et al. Cardiovascular risk factors among the inhabitants of an urban Congolese community: results of the VITARAA Study. IJC Metabolic & Endocrine. 2014; 4: 33-38. https://doi.org/10.1016/j.ijcme.2014.07.003

[13] M’Buyamba-Kabangu JR, Fagard R, Staessen J, et al. Correlates of blood pressure in rural and urban Zaïre. Journal of Hypertension. 1987; 5: 371-375. https://doi.org/10.1097/00004872-198706000-00018

[14] M’Buyamba-Kabangu JR, Fagard R, Lijnen P, et al. Epidemiological study of blood pressure and hypertension in a sample of urban Bantu of Zaire. Journal of Hypertension. 1986; 4: 485-491. https://doi.org/10.1097/00004872-198608000-00015

[15] Bonita R, de Courten M, Dweyer T, et al. Surveillance of risk factors for non communicable diseases: the WHO STEPwise approach; 2001 [Summary, Geneva]

[16] Donnison C. Blood pressure in the African natives: its bearing upon aetiology of hyperpiesa and arteriosclerosis. Lancet. 1929; 1: 6-7. https://doi.org/10.1016/S0140-6736(00)49248-2

[17] Campbell NR, Lemogoum D. Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution. Cardiovasc J Afr. 2015; 26(4): 152-154. PMid:26407216.

[18] Poulter NR, Khaw KT, Hopwood BEC, et al. The Kenyan Luo migration study: Observations on the initiation of a rise in blood pressure. British Medical Journal. 1990; 300: 967-972. PMid:2344502. https://doi.org/10.1136/bmj.300.6730.967

[19] Shaper AG. Cardiovascular disease in the tropics-3: Blood pressure and hypertension. British Medical Journal. 1972; 3(5830): 805-807. https://doi.org/10.1136/bmj.3.5830.805

[20] Liu XL, Gu W, Li ZL, et al. Hypertension prevalence, awareness, treatment, control, and associated factors in Southwest China: an update. Journal of Hypertension. 2016. https://doi.org/10.1097/HJH.0000000000001203

[21] Erem C, Hacihasanoglu A, Kocak M, et al. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. Journal of Public Health. 2008; 31(1): 47-58. PMid:18829520. https://doi.org/10.1093/pubmed/fdn078

[22] Lai SW, Li TC, Lin CC, et al. Hypertension and its related factors in Taiwanese elderly people. Yale J Biol Med. 2001; 74(2): 89-94. PMid:11393265.

[23] Önal AE, Erbil S, Özel S, et al. The prevalence of and risk factors for hypertension in adults living in Istambul. Blood Pressure. 2004; 13: 31-36. https://doi.org/10.1080/08037050410025762

[24] Jousilahti P, Vartiainen E, Tuomilehto S, et al. Sex, Age, Cardiovascular Risk Factors, and Coronary Heart Disease: A Prospective Follow-Up Study of 14 786 Middle-Aged Men and Women in Finland. Circulation. 1999; 99(9): 1165-1172. https://doi.org/10.1161/01.CIR.99.9.1165

[25] Wilson PWF, D’Agostino RB, Levy D, et al. Prediction of Coronary Heart Disease Using Risk Factor Categories. Circulation. 1998; 97(18): 1837-1847. https://doi.org/10.1161/01.CIR.97.18.1837

[26] Seedat YK, Reddy J. The clinical pattern of hypertension in the South African black population: a study of 1000 patients. African Journal of Medicine and Medical Sciences. 1976; 5: 1-7. PMid:829699.

[27] Kodama S, Horikawa C, Fujihara K, et al. Comparisons of the strength of associations with future type 2 diabetes risk among anthropometric obesity indicators, including waist-to-height ratio: a meta-analysis. American Journal of Epidemiology. 2012; 176(11): 959-969. PMid:23144362. https://doi.org/10.1093/aje/kws172

[28] Opie Lh, Seedat YK. Hypertension in subSaharan Afrcan populations. Circulation. 2005; 112: 3562-3568. PMid:16330697.

[29] Addo J, Smeeth L, Leon DA. Hypertension in sub-Saharan Africa: a systematic review. Hypertension. 2007; 50: 1012-8. PMid:17954720. https://doi.org/10.1161/HYPERTENSIONAHA.107.093336

[30] Kearney PM, Whelton M, Reynolds K. Global burden of hypertension: analysis of worldwide data. Lancet. 2005; 365: 217-23. https://doi.org/10.1016/S0140-6736(05)70151-3