区域和性别差异与高血压的流行和认知：在撒哈拉以南非洲的 6 个地点进行的 H3Africa AWI-Gen 研究。
Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa.
机构信息
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana; Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.
Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Glob Heart. 2017 Jun;12(2):81-90. doi: 10.1016/j.gheart.2017.01.007. Epub 2017 Mar 13.
BACKGROUND
There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa, yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal.
OBJECTIVES
The study sought to report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in 6 sites located in West, East, and Southern Africa. In addition, we examined regional, sex, and age differences related to hypertension.
METHODS
A population-based cross-sectional study was performed at 6 sites in 4 African countries: Burkina Faso (Nanoro), Ghana (Navrongo), Kenya (Nairobi), and South Africa (Agincourt, Dikgale, Soweto). Blood pressure measurements were taken using standardized procedures on 10,696 adults 40 to 60 years of age. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or taking antihypertensive medication.
RESULTS
The mean prevalence of hypertension ranged from 15.1% in Nanoro to 54.1% in Soweto. All 3 of the South African sites had a mean prevalence of hypertension of over 40.0%, significantly higher than in Nairobi (25.6%) and Navrongo (24.5%). Prevalence increased with age in both sexes and at all sites. A significantly higher prevalence of hypertension was observed in women in Agincourt, Dikgale, and Nairobi, whereas in Nanoro this trend was reversed. Within the hypertensive group the average proportion of participants who were aware of their blood pressure status was only 39.4% for men and 53.8% for women, and varied widely across sites.
CONCLUSIONS
Our study demonstrates that the prevalence of hypertension and the level of disease awareness differ not only between but also within sub-Saharan African countries. Each nation must tailor their regional hypertension awareness and screening programs to match the characteristics of their local populations.
背景
撒哈拉以南非洲地区高血压和相关心血管疾病的患病率很高，但可用的探索非洲高血压的大型研究很少。实际疾病负担了解甚少，意识和治疗控制往往不理想。
目的
本研究旨在报告测量高血压的患病率，并评估农村和城市环境中 6 个位于西非、东非和南非的地点的老年人对血压的知晓率和控制率。此外，我们还检查了与高血压相关的区域、性别和年龄差异。
方法
在 4 个非洲国家的 6 个地点进行了一项基于人群的横断面研究：布基纳法索（纳诺罗）、加纳（纳夫兰戈）、肯尼亚（内罗毕）和南非（阿格因科特、迪克加莱、索韦托）。对 10696 名 40 至 60 岁的成年人使用标准化程序进行血压测量。高血压定义为收缩压≥140mmHg 或舒张压≥90mmHg 或服用抗高血压药物。
结果
高血压的平均患病率范围从纳诺罗的 15.1%到索韦托的 54.1%。南非的所有 3 个地点的高血压平均患病率均超过 40.0%，明显高于内罗毕（25.6%）和纳夫兰戈（24.5%）。男女两性和所有地点的患病率均随年龄增长而增加。在阿格因科特、迪克加莱和内罗毕，女性高血压的患病率明显更高，而在纳诺罗，这一趋势则相反。在高血压组中，只有 39.4%的男性和 53.8%的女性意识到自己的血压状况，而且各地之间差异很大。
结论
我们的研究表明，高血压的患病率和疾病意识水平不仅在不同国家之间存在差异，而且在撒哈拉以南非洲国家内部也存在差异。每个国家都必须根据本国人口的特点，调整其区域高血压意识和筛查计划。
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