Regional Patterns and Association Between Obesity and Hypertension in Africa

Abstract

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.

Determinants of Selected Cardiovascular Diseases among Adult Patients at Cardiac Clinic of Debre Berhan Referral Hospital, Ethiopia: Unmatched Case-Control Study

“…This study revealed that age is the most important risk factor for the development of cardiovascular diseases. Several studies conducted in Ethiopian, and 13 SSA countries and India showed that there is strong relationship between age and cardiovascular diseases [7,21,27,29]. However, this study is inconsistent with the finding from India with the same study design [26].…”

“…Waist circumference (WC) indicates abdominal obesity and has been shown to be a risk factor for CVDs [7,26]. In our study among biological risk factors, high waist circumference was found to be positively associated with CVDs.…”

“…According to the World Health Organization (WHO) report of 2015, CVDs were the leading cause of deaths globally, and it killed 17.5 million people in 2012, which represented 31% of all global deaths [4,5]. Moreover, the risk factors for NCDs are unacceptably increasing in low-and middle-income countries including Africa [1,6,7]. The Heart Federation on the global strategy and diet, physical activity, and health showed that in 2015 people with CVDs had behavioral risk factors which include unhealthy diet, physical inactivity, tobacco use, and harmful alcohol consumption.…”

“…The Heart Federation on the global strategy and diet, physical activity, and health showed that in 2015 people with CVDs had behavioral risk factors which include unhealthy diet, physical inactivity, tobacco use, and harmful alcohol consumption. These risk factors had an effect on increase in blood glucose, blood pressure, blood lipids, and overweight and obesity [6][7][8].…”

High prevalence of undiagnosed hypertension among men in North Central Nigeria: Results from the Healthy Beginning Initiative

“…Our study corroborates earlier studies that have established a firm relationship between being hypertensive and raised BMI [ 26 , 28 , 29 , 33 , 55 ]. In a recent study that analyzed data from 13 African countries, obese Africans were two to eight times as likely to be hypertensive compared to those with normal BMI, the odds of which increased with age [ 59 ]. Given this established association between obesity and hypertension, as well as its high prevalence, this is an important modifiable risk factor for public health interventions in Nigeria.…”