Prevalence, awareness, treatment, and control of hypertension in older people in Central Africa: the EPIDEMCA study

Abstract

Hypertension represents a major global health burden. While older individuals of African descent are at higher risk of hypertension in western countries, epidemiological data on hypertension in older native Africans are scarce. We assessed the prevalence and the level of awareness and control of hypertension among older adults in Central Africa. A total of 1990 individuals 65 years of age and older from the Republic of Congo and the Central African Republic participated into a cross-sectional population-based survey. Hypertension was defined by self-reporting of on-going treatment and/or systolic (SBP)/diastolic (DBP) blood pressures at rest being ≥140 and/or 90 mmHg. Controlled hypertension was defined as treated hypertension with SBP <140 mmHg and DBP <90 mmHg. The overall prevalence of hypertension was 61.1%. Among hypertensive people, 46.7% were aware of their condition and 17.3% were treated. Among the latter 23.8% had their hypertension controlled.Correlates of hypertension were increasing age and body mass index, living in the Republic of Congo, occupation other than employee, no tobacco use, sedentary lifestyle and ≥ 3 meals a day. Our findings indicate a need for the implementation of public health policies to reduce hypertension in older Africans, and to prevent the subsequent burden of cardiovascular diseases.Keywords: Hypertension, epidemiology, elderly, Central Africa M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3According to the United Nations, the number of persons 65 years of age and older is expected to more than double by 2035, from 608 million in 2015 to 1.2 billion in 2035 [1]. Almost a quarter (23%) of the total global burden of disease is attributable to disorders in people aged 60 years of age and older, among whom cardiovascular diseases (CVDs) are the leading contributors to the burden of disease.Among CVDs, hypertension is the leading cause of mortality and morbidity [2]. one of the global non-communicable disease targets of the World Health Organization is to lower the prevalence of raised blood pressure by 25% by 2025 [4]. However, a global increase in the prevalence of hypertension in low-income countries is now being observed, notably in Sub-Saharan Africa [3].In the United States, the prevalence of hypertension is more than 60% among older people and is higher in older African-Americans when compared to non-Hispanic whites [5]. Ethnic differences cannot be explained solely in terms of socio-economic status [5], suggesting the involvement of other factors. It is therefore important to know more about the epidemiology of hypertension in older native Africans.Several community-based epidemiological studies on hypertension were conducted in Africa [6].Most were carried out in adults and reported prevalence for the ≥65 age group [7][8][9][10][11][12][13][14][15][16][17][18][19]. Only one study in rural Tanzania was specifically conducted on the elderly and reported a prevalence of hypertension of 70% in people over 70 years of age [17]. To our knowledge, no data from ...

Prevalence, awareness, treatment, and control of hypertension in Cameroonians aged 50 years and older: A community‐based study

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The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.

“…The factors generally found to be associated with hypertension include age, BMI, sedentary lifestyle, tobacco use, alcohol consumption. Most of these have previously been identified as important risk factors for hypertension by the different studies conducted in different parts of SSA (21)(22)(23)(24)(25)(26). Our results also confirm some of these observed associations such as increasing age, sedentary lifestyle and BMI.…”

The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.

“…Almost twenty years later, our study points out the sociocultural transition in rural areas with a prevalence of HNTN even higher than the prevalence described previously in urban population. (21)(22)(23)(24)(25)(26). Our results also confirm some of these observed associations such as increasing age, sedentary lifestyle and BMI.…”

“…Among treated subjects, only one-third had controlled hypertension. Few studies have analysed awareness and treatment ratios of hypertension, as well as the fraction with controlled hypertension in Africa (8,26).…”