The Rising Burden of Diabetes and Hypertension in Southeast Asian and African Regions: Need for Effective Strategies for Prevention and Control in Primary Health Care Settings

Viswanathan Mohan,Yackoob K Seedat,Rajendra Pradeepa

doi:10.1155/2013/409083

Abstract

Aim. To review the available literature on burden of diabetes mellitus (DM) and hypertension (HTN) and its coexistence in Southeast Asian (SEA) and the African (AFR) regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC) in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million), while the AFR region had the smallest number (14.7 million). Screening studies identified high proportions (>50%) of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India to 78.4% in Thailand in the SEA region and ranging from 9.7% in Nigeria to 70.4% in Morocco in the AFR region. There is evidence that by lifestyle modification both DM and HTN can be prevented. Conclusion. To meet the twin challenge of DM and HTN in developing countries, PHCs will have to be strengthened with a concerted and multipronged effort to provide promotive, preventive, curative, and rehabilitative services.

Highlights

Diabetes mellitus (DM) and hypertension (HTN) have emerged as major medical and public health issues worldwide, and both are important risk factors for coronary artery disease (CAD), heart failure, and cerebrovascular disease
Extensive epidemiological studies conducted in AFR region show that HTN is one of the commonest cardiovascular ailments and that blood pressure (BP) assumes more importance with increasing age, in the SubSaharan Africa [8]
The aim of this paper is to review the available literature on the burden of DM and HTN in the Southeast Asian (SEA) and AFR regions and to suggest strategies to improve DM and HTN prevention and control in primary care in the two regions

Summary

Introduction

Diabetes mellitus (DM) and hypertension (HTN) have emerged as major medical and public health issues worldwide, and both are important risk factors for coronary artery disease (CAD), heart failure, and cerebrovascular disease. The recent Burden of Metabolic Risk Factors of Chronic Diseases Study [2]. Conducted in 199 countries worldwide to assess the national, regional, and global trends in diabetes reported that the agestandardized adult diabetes prevalence was 9⋅8% (8.6–11.2) in men and 9.2% (8.0–10.5) in women in 2008, up from 8.3%. Extensive epidemiological studies conducted in AFR region show that HTN is one of the commonest cardiovascular ailments and that BP assumes more importance with increasing age, in the SubSaharan Africa [8]. There is a strong correlation between changing lifestyle factors and increase in both DM and HTN. The aim of this paper is to review the available literature on the burden of DM and HTN in the SEA and AFR regions and to suggest strategies to improve DM and HTN prevention and control in primary care in the two regions

Burden of Diabetes in SEA and AFR Regions

Burden of HTN in SEA and AFR Regions

Coexistence of Diabetes and Hypertension

Findings

Conclusion