Ducorps M, Bauduceau B, Mayaudon H, Sonnet E, Groussin L, Castagné C
Service d'endocrinologie, hôpital d'instruction des-armées Bégin, Saint-Mandé.
Arch Mal Coeur Vaiss. 1996 Aug;89(8):1069-73.
It has been established that hypertension prevalence rate was higher in American Blacks than Whites or Mexicans. And hypertension is more frequent in diabetics. The prevalence of hypertension among diabetic African Blacks is not well documented.
A total of 550 diabetic patients attending to Central Hospital of Yaounde (Cameroon) were followed between 1990 and 1994. The 1993 WHO criteria were used to define hypertension (systolic blood pressure (SBP) > or = 140 or diastolic blood pressure (DBP) > or = 90 mmHg. We also have considered as hypertensive patients being treated with an antihypertensive medication before inclusion. All quantitative data are given as means +/- SD.
For the whole study population characteristics were: age (at inclusion): 54.2 +/- 12.8 yrs: sex distribution: 341 men for 209 women (sex ratio: 1.63:1); known duration of diabetes: 5.7 +/- 5.6 yrs; Body Mass Index (BMI): 24.4 +/- 4.8 kg/m2. They are dividing into 136 IDDM, 405 NIDDM and 9 other types. In normotensive patients, blood pressure levels were: SBP 117 +/- 11 and DBP 75 +/- 8 mmHg, while in hypertensive: SBP 156 +/- 23 and DBP 95 +/- 13 mmHg. The difference between normo and hypertensive diabetics was significant (p > or = 0.001). Characteristics of hypertensive group were: age: 57 +/- 11.2 yrs, sex repartition 229 men for 136 women (sex ratio: 1.68:1), BMI: 24.9 +/- 4.8 kg/m2, diabetes classification: 63 IDDM, 297 NIDDM and 5 other types. According to recent WHO criteria (140/90) 365 subjects/550 were found to have high blood pressure, giving an overall prevalence of hypertension of 66.4% in the study population. Using former WHO definition (160/95) the prevalence was 42.2%. There was no statistical difference for prevalence between male (67.2%) and female (65.1%). But the difference was strongly significant (p < 0.001) between IDDM (46.3%) and NIDDM (73.3%).
Hypertension prevalence studies in Africa have shown varying results (2.5-30%), with higher rates in urban than rural population. In African studies hypertension prevalence rates in diabetes were reported in the range 13-44%. The result of the present study is very near the high limit of known data in Africa.
Such a prevalence rate of 66.4% in this Cameroonian diabetic population appears to be high, particularly in patients with NIDDM. These considerations bring to light the question of sensitiveness of African Blacks to hypertension when exposed to high blood pressure risk factors such as inadequate food and diabetes.
已证实美国黑人的高血压患病率高于白人或墨西哥人。而且糖尿病患者中高血压更为常见。非洲黑人糖尿病患者中高血压的患病率尚无充分记录。
1990年至1994年期间，对喀麦隆雅温得中心医院的550名糖尿病患者进行了随访。采用1993年世界卫生组织的标准来定义高血压（收缩压（SBP）≥140或舒张压（DBP）≥90 mmHg）。我们还将纳入研究前正在接受抗高血压药物治疗的患者视为高血压患者。所有定量数据均以平均值±标准差表示。
整个研究人群的特征为：（纳入时）年龄：54.2±12.8岁；性别分布：男性341人，女性209人（性别比：1.63:1）；已知糖尿病病程：5.7±5.6年；体重指数（BMI）：24.4±4.8 kg/m²。他们分为136例胰岛素依赖型糖尿病（IDDM）、405例非胰岛素依赖型糖尿病（NIDDM）和9例其他类型。在血压正常的患者中，血压水平为：收缩压117±11，舒张压75±8 mmHg，而高血压患者中：收缩压156±23，舒张压95±13 mmHg。血压正常和高血压糖尿病患者之间的差异具有显著性（p≥0.001）。高血压组的特征为：年龄：57±11.2岁，性别分布男性229人，女性136人（性别比：1.68:1），BMI：24.9±4.8 kg/m²，糖尿病分类：63例IDDM，297例NIDDM和5例其他类型。根据世界卫生组织最近的标准（140/90），550名受试者中有365人被发现患有高血压，研究人群中高血压的总体患病率为66.4%。采用世界卫生组织以前的定义（160/95），患病率为42.2%。男性（67.2%）和女性（65.1%）之间的患病率无统计学差异。但IDDM（46.3%）和NIDDM（73.3%）之间的差异非常显著（p<0.001）。
非洲的高血压患病率研究结果各不相同（2.5 - 30%），城市人口的患病率高于农村人口。在非洲的研究中，糖尿病患者的高血压患病率报告在13 - 44%的范围内。本研究的结果非常接近非洲已知数据的上限。
喀麦隆糖尿病患者中66.4%的患病率似乎很高，特别是在NIDDM患者中。这些情况揭示了非洲黑人在暴露于高血压风险因素如饮食不足和糖尿病时对高血压的易感性问题。
