Abstract
Blood biomarkers of oxidative stress and inflammation have been associated with increased risk of hypertension development; yet their application in sub-Saharan Africa has been limited due to the lack of blood collection facilities. In this study, we evaluated the usefulness of dried blood spots (DBS), a more feasible alternative to venous blood, in rural sub-Saharan residents. We recruited 342 women with incident hypertension from rural Senegal, and measured C-reactive protein (CRP) and malondialdehyde (MDA) in DBS and concurrent blood pressure (BP) at baseline and 1-year follow-up. Associations of DBS biomarkers with current levels of and 1-year changes in BP were examined after adjusting for demographic, medical, and socioeconomic covariates. DBS concentrations of MDA were significantly associated with concurrent systolic BP (SBP) (p < 0.05), while DBS baseline concentrations of CRP were associated with longitudinal changes in SBP between baseline and follow-up. Compared to participants with baseline CRP < 1 mg/L, those with CRP of 1–3 mg/L and 3–10 mg/L had 2.11 mmHg (95%CI: −2.79 to 7.02 mmHg) and 4.68 mmHg (95%CI: 0.01 to 9.36 mmHg) increases in SBP at follow-up, respectively. The results support the use of DBS biomarkers for hypertension prevention and control, especially in settings with limited clinical resources.
Highlights
We modeled the change of blood pressure (BP) as a function of C-reactive protein (CRP) relative risk scale or quartiles of dried blood spots (DBS) biomarkers as categorical variables (Model 1), with adjustment for demographic and medical, and socioeconomic covariates
These results suggest that increased inflammation and oxidative stress may contribute to elevated systolic BP (SBP) in this population and support the use of DBS specimens for monitoring BP risk indicators
Among women with incident hypertension living in rural Senegal, DBS CRP, a biomarker of chronic inflammation, was significantly associated with SBP change over a
Summary
Hypertension is a leading modifiable cardiovascular risk factor worldwide [1]. 1975 to 2015, the mean systolic and diastolic blood pressures increased rapidly in subSaharan African populations, even as the same measures decreased in most high-income countries [2]. The average blood pressure (BP) levels in sub-Saharan. African populations are among the highest in the world [2]. The inadequate diagnosis and control of high BP in sub-Saharan African countries has contributed to a rising burden of cardiovascular diseases, which have become the leading cause of death among adults over the age of 30 years in the region [3]. Due to the high cost of management of cardiovascular complications, and the lack of access of many people to such services, the Antioxidants 2021, 10, 2026.
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