Ethnic differences in prevalence and risk factors for hypertension in the Suriname Health Study: a cross sectional population study

Abstract

BackgroundLimited information is available about the prevalence, ethnic disparities, and risk factors of hypertension within developing countries. We used data from a nationwide study on non-communicable disease (NCD) risk factors to estimate, explore, and compare the prevalence of hypertension overall and in subgroups of risk factors among different ethnic groups in Suriname.MethodThe Suriname Health Study used the World Health Organization Steps design to select respondents with a stratified multistage cluster sample of households. The overall and ethnic specific prevalences of hypertension were calculated in general and in subgroups of sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index (BMI), and waist circumference (WC). Differences in the prevalence between ethnic subgroups were assessed using the Chi-square test. We used several adjustment models to explore whether the observed ethnic differences were explained by biological, demographic, lifestyle, or anthropometric risk factors.ResultsThe prevalence of hypertension was 26.2 % (95 % confidence interval 25.1 %-27.4 %). Men had higher mean values for systolic and diastolic blood pressure compared to women. Blood pressure increased with age. The prevalence was highest for Creole, Hindustani, and Javanese and lowest for Amerindians, Mixed, and Maroons. Differences between ethnic groups were measured in the prevalence of hypertension in subcategories of sex, marital status, education, income, smoking, physical activity, and BMI. The major difference in association of ethnic groups with hypertension was between Hindustani and Amerindians.ConclusionThe prevalence of hypertension in Suriname was in the range of developing countries. The highest prevalence was found in Creoles, Hindustani, and Javanese. Differences in the prevalence of hypertension were observed between ethnic subgroups with biological, demographic, lifestyle, and anthropometric risk factors. These findings emphasize the need for ethnic-specific research and prevention and intervention programs.

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

“…The comprehensive, nation-wide Suriname Health Study on non-communicable diseases found an overall prevalence of hypertension of 26.2% [32]. This was in the range of values reported for many other developing countries [34] as well as the relatively large Surinamese diaspora in The Netherlands [35].…”

“…These studies reported a higher incidence of prehypertension, hypertension, malignant hypertension, and related renal complications in participants from Afro-Surinamese and Hindustani descent compared to white individuals [35,[38][39][40]. These differences were tentatively explained by ethnic disparities in the perception of hypertension (supporting one of the findings of the Suriname Heath Study [32]), as well in drug adherence, blood pressure control, and/or insurance status [38,[40][41][42].…”

“…Mean values for systolic and diastolic blood pressure were higher in males than in females; increased with older age; and were highest in Creoles Hindustanis, and Javanese, and lowest in Maroons and Amerindians [32]. The prevalence of hypertension in demographic risk factor subgroups differed between ethnic groups, as did the associations of ethnic groups with hypertension [32], implying the need of tailor-made intervention programs to control hypertension in Suriname [32].…”

“…As a result, in 2008, 25.1% of Surinamese was obese [28,29]; 7.4% had prediabetes and 13.0% diabetes mellitus [30]; the overall estimated prevalence of the metabolic syndrome was 39.2% [31]; and more than 25% of adults had a raised blood pressure [29,32]. These observations indicate that Suriname, similarly to many other economically developing countries [19], is facing increasing public health threats of lifestyle-related non-communicable diseases including cardiovascular disease.…”

Metabolic Syndrome in Indigenous Amerindian Women in Suriname; Less on Waist and More on Weight?

“…Both diabetes mellitus and hypertension were less prevalent than the national average for women (resp. 13% and 20%) [22][23]. The relatively high prevalence of Me TS found in both study groups coupled with the relatively low prevalence of hypertension and diabetes mellitus could be an indication that both these subpopulations are in epidemiological transition [2,24], though at different stages.…”