Gender-related differences in the prevalence of cardiovascular disease risk factors and their correlates in urban Tanzania

Marina A Njelekela,Enju Liu,Julia L Finkelstein,Nuru L Mligiliche,Walter C Willett,Donna Spiegelman,Rose Mpembeni,Ellen Hertzmark,Wafaie W Fawzi,Jacob Mtabaji,Alfa Muhihi

doi:10.1186/1471-2261-9-30

Abstract

BackgroundUrban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. However in East Africa, there is limited literature in this research area. The objective of this study was to examine the prevalence of cardiovascular disease risk factors and their correlates among adults in Temeke, Dar es Salaam, Tanzania. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases.MethodsThe study design was a cross sectional epidemiological study. A total of 209 participants aged between 44 and 66 years were included in the study. A structured questionnaire was used to evaluate socioeconomic and lifestyle characteristics. Blood samples were collected and analyzed to measure lipid profile and fasting glucose levels. Cardiovascular risk factors were defined using World Health Organization criteria.ResultsThe age-adjusted prevalence of obesity (BMI ≥ 30) was 13% and 35%, among men and women (p = 0.0003), respectively. The prevalence of abdominal obesity was 11% and 58% (p < 0.0001), and high WHR (men: >0.9, women: >0.85) was 51% and 73% (p = 0.002) for men and women respectively. Women had 4.3 times greater odds of obesity (95% CI: 1.9–10.1), 14.2–fold increased odds for abdominal adiposity (95% CI: 5.8–34.6), and 2.8 times greater odds of high waist-hip-ratio (95% CI: 1.4–5.7), compared to men. Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001) compared to male counterparts, including abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components. In contrast, female participants had 50% lower odds of having hypertension, compared to men (95%CI: 0.3–1.0). Among men, BMI and waist circumference were significantly correlated with blood pressure, triglycerides, total, LDL-, and HDL-cholesterol (BMI only), and fasting glucose; in contrast, only blood pressure was positively associated with BMI and waist circumference in women.ConclusionThe prevalence of CVD risk factors was high in this population, particularly among women. Health promotion, primary prevention, and health screening strategies are needed to reduce the burden of cardiovascular disease in Tanzania.

Highlights

Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources
Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001); in particular, abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components of metabolic syndrome, compared to their male counterparts
In this study among adults in an urban East African setting, we noted a high prevalence of cardiovascular disease risk factors, including obesity, abdominal obesity, hypertension, dyslipidemia, diabetes mellitus, and metabolic syndrome

Summary

Introduction

Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases. Attention to health problems by researchers and policy makers in Sub-Saharan Africa (SSA) has focused on infectious diseases. The dual burden of persistent infectious diseases such as HIV/AIDS, malaria, and tuberculosis, and emerging chronic diseases such as cardiovascular diseases and diabetes mellitus, poses a serious threat to population health and limited health care resources [2]. Overweight and obesity are leading risk factors for a number of chronic diseases, including cardiovascular disease (CVD), diabetes, and cancer. Hypertension is the most common CVD risk factor worldwide, and one of the most important preventable risk factor for premature death [4]

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