Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of the Congo.
Cardiology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, Democratic Republic of the Congo.
PLoS One. 2019 Aug 8;14(8):e0219377. doi: 10.1371/journal.pone.0219377. eCollection 2019.
Data on blood pressure trends are scarce or unavailable in Sub-Saharan Africa in general and especially in the Democratic Republic of the Congo. This work addresses this gap by analyzing the dynamics in the prevalence and control of hypertension in a cohort of Congolese adults in South Kivu.
Two phases of data collection were conducted including a baseline at the beginning in 2012 and a follow up in 2016. The subjects were ≥ 18 years old living in urban (n = 4413) or rural areas (n = 6453). Hypertension was defined as a blood pressure ≥ 140/90 mmHg and/or taking antihypertensive medications. The crude prevalence of hypertension was age-adjusted to the WHO population.
Between 2012 and 2016, there was a significant increase in blood pressure (+2.5/+1.4 mmHg; p = 0.001), age standardized prevalence of hypertension [19.0% vs. 18.0%; OR = 1.05 (1.02-1.08); p<0.0001], and obesity (7.9% to 9.8%; p<0.0001) as well as the proportion of subjects > 60 years old (8.8% to 11.3%; p<0.0001) and those with tachycardia (10.5% to 14.4%; p<0.0001). The number of subjects under treatment of hypertension were statistically non-significant [16.1% vs. 14.3%; p = 0.29), but the level of control of hypertension was significantly reduced by 32.4% in 2016 compared in 2012 (43.5% vs. 64.4%; p = 0.0008).
There was an increase in the prevalence of hypertension as well as cardiovascular-associated risk factors in the population. However, this trend did not increase for treated subjects with no improvements in the level of AHT control. Therefore, improved strategies for the prevention and management of non-communicable diseases are very important in Sub-Saharan Africa.
一般来说,撒哈拉以南非洲,特别是刚果民主共和国,有关血压趋势的数据稀缺或缺乏。本工作通过分析南基伍省刚果成年人队列中高血压的流行和控制情况,填补了这一空白。
进行了两个阶段的数据收集,包括 2012 年初的基线调查和 2016 年的随访。研究对象为居住在城市(n=4413)或农村地区(n=6453)的年龄≥18 岁成年人。高血压定义为血压≥140/90mmHg 和/或服用降压药物。高血压的粗患病率按世界卫生组织人口进行年龄调整。
2012 年至 2016 年间,血压显著升高(+2.5/+1.4mmHg;p=0.001),年龄标准化高血压患病率[19.0%比 18.0%;比值比=1.05(1.02-1.08);p<0.0001]、肥胖率(7.9%升至 9.8%;p<0.0001)以及>60 岁人群比例(8.8%升至 11.3%;p<0.0001)和心动过速人群比例(10.5%升至 14.4%;p<0.0001)均升高。高血压患者治疗人数虽无统计学意义[16.1%比 14.3%;p=0.29],但 2016 年高血压控制水平较 2012 年显著下降 32.4%(43.5%比 64.4%;p=0.0008)。
人群中高血压及心血管相关危险因素的流行率有所增加。然而,治疗患者的这一趋势并未增加,高血压的控制水平也没有改善。因此,在撒哈拉以南非洲,改善非传染性疾病的预防和管理策略非常重要。