Screen detection and the WHO STEPwise approach to the prevalence and risk factors of arterial hypertension in Kinshasa

Abstract

The trend of hypertension and other risk factors of cardiovascular disease is changing because of epidemiological, demographic and nutritional transitions in sub-Saharan Africa. The aim of this study is to determine the prevalence and risk factors of arterial hypertension in the Kinshasa region, Democratic Republic of Congo (DRC). Data were collected from random sample cross-sectional surveys of adult black Africans from Kinshasa, with the help of a structured questionnaire, physical examinations and blood samples, using the World Health Organisation (WHO) stepwise approach. Sex, age, place of residence (urban versus rural), psychosocial risk factors (socioeconomic status, stress), overweight status (BMI: 25-29.9 kg/m), general obesity (BMI: >or=30 kg/m), abdominal obesity (waist circumference: >or=94 cm) and diabetes mellitus were considered to be the potential risk factors for screen-detected hypertension. The weighted prevalences of hypertension, diabetes mellitus, overweight status, general obesity and abdominal obesity were 15.2, 140.2, 13.5, 4.8 and 7.5%, respectively. Blood pressure and the proportion of participants with hypertension increased with age and BMI group in the population, for both men and women. Age, rural residence, low socioeconomic status, high socioeconomic status, general obesity and abdominal obesity were the risk factors for hypertension. Women aged 55 years and above had higher levels of blood pressure and hypertension than men. Absolute levels of hypertension, all types of obesity and diabetes mellitus are high risk factors in the army camps and semiurban extension cities; general obesity and abdominal obesity are the risk factors for detectable hypertension. Effective control of general obesity and abdominal obesity and psychosocial strategies that target both semirural and urban areas of the Kinshasa region have the potential to prevent much premature cardiovascular disease.