Socioeconomic Status and Hypertension Control in Sub-Saharan Africa: The Multination EIGHT Study (Evaluation of Hypertension in Sub-Saharan Africa)

被引：39

作者：

Antignac, Marie ^{[1
,2
]}

Diop, Ibrahima Bara ^{[3
]}

de Terline, Diane Macquart ^{[1
,2
,4
]}

Kramoh, Kouadio Euloge ^{[5
]}

Balde, Dadhi M. ^{[6
]}

Dzudie, Anastase ^{[7
]}

Ferreira, Beatriz ^{[8
]}

Houenassi, Martin Dedonougbo ^{[9
]}

Hounsou, Dominique ^{[9
]}

Ikama, Meo Stephane ^{[10
]}

Kane, Adama ^{[11
]}

Kimbally-Kaki, Suzy Gisele ^{[10
]}

Kingue, Samuel ^{[12
]}

Kouam, Charles Kouam ^{[13
]}

Limbole, Emmanuel ^{[14
]}

Kuate, Liliane Mfeukeu ^{[12
,15
]}

Mipinda, Jean Bruno ^{[16
]}

N'Guetta, Roland ^{[5
]}

Nhavoto, Carol ^{[8
]}

Sesso, Zouwera ^{[17
]}

Ali, Abdallahi Sidy ^{[18
]}

Toure, Ibrahim Ali ^{[19
]}

Plouin, Pierre Francois ^{[2
,4
,20
]}

Perier, Marie Cecile ^{[2
]}

Narayanan, Kumar ^{[21
]}

Empana, Jean Philippe ^{[2
]}

Jouven, Xavier ^{[2
,4
,20
]}

机构：

[1] HUEP, St Antoine Hosp, AP HP, Dept Pharm, 184 Rue Faubourg St Antoine, F-75012 Paris, France

[2] Hop Europeen Georges Pompidou, INSERM, U970, Paris Cardiovasc Res Ctr, Paris, France

[3] Univ Hosp Fann, Dept Cardiol, Dakar, Senegal

[4] Paris Descartes Univ, Paris, France

[5] Inst Cardiol Abidjan, Abidjan, Cote Ivoire

[6] Univ Hosp Conakry, Dept Cardiol, Conakry, Guinea

[7] Douala Gen Hosp, Cardiac Intens Care & Cardiac Pacing Unit, Douala, Cameroon

[8] Inst Coracao, Maputo, Mozambic, Mozambique

[9] Natl Univ Hosp Hubert K Maga CNHU HKM, Cotonou, Benin

[10] Marien Ngouabi Univ, Natl Univ Hosp Brazzaville, Dept Cardiol, Brazzaville, Rep Congo

[11] Univ Hosp Aristide Le Dantec, Dept Cardiol, Dakar, Senegal

[12] Univ Yaounde, Minist Publ Hlth, Yaounde, Cameroon

[13] Reg Hosp, Dept Internal Med, Bafoussam, Cameroon

[14] Ngaliema Hosp, Dept Internal Med CMCG, Kinshasa, DEM REP CONGO

[15] Cent Hosp Yaounde, Yaounde, Cameroon

[16] Univ Hosp Libreville, Libreville, Gabon

[17] Dept Cardiol, Lome, Togo

[18] Natl Hosp Ctr, Cardiol Unit, Nouakchott, Mauritania

[19] Niamey Univ, Univ Hosp Lamorde, Dept Internal Med & Cardiol, Niamey, Niger

[20] Hop Europeen Georges Pompidou, AP HP, Dept Cardiol, Paris, France

[21] Maxcure Hosp, Hyderabad, Andhra Pradesh, India

来源：

HYPERTENSION | 2018年 / 71卷 / 04期

关键词：

cardiology; developing countries; humans; hypertension; socioeconomic factors; CARDIOVASCULAR-DISEASE; PRACTICE GUIDELINES; BLOOD-PRESSURE; GLOBAL BURDEN; RISK-FACTORS; PREVALENCE; MANAGEMENT; COUNTRIES; MIDDLE; DRUGS;

D O I：

10.1161/HYPERTENSIONAHA.117.10512

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Systemic hypertension is a rapidly growing epidemic in Africa. The role of socioeconomic status on blood pressure control has not been well studied in this part of the world. We, therefore, aimed to quantify the association of socioeconomic status both at the individual and at the country level with blood pressure control in Sub-Saharan Africa. We conducted a cross-sectional survey in urban clinics of 12 countries, both low income and middle income, in Sub-Saharan Africa. Standardized blood pressure measures were made among the hypertensive patients attending the clinics. Blood pressure control was defined as blood pressure <140/90 mmHg, and hypertension grades were defined according to the European Society of Cardiology guidelines. A total of 2198 hypertensive patients (58.4 +/- 11.8 years; 39.9% men) were included. Uncontrolled hypertension was present in 1692 patients (77.4%), including 1044 (47.7%) with grade 2 hypertension. The proportion of uncontrolled hypertension progressively increased with decreasing level of patient individual wealth, respectively, 72.8%, 79.3%, and 81.8% (P for trend, <0.01). Stratified analysis shows that these differences of uncontrolled hypertension according to individual wealth index were observed in low-income countries (P for trend, 0.03) and not in middle-income countries (P for trend, 0.26). In low-income countries, the odds of uncontrolled hypertension increased 1.37-fold (odds ratio, 1.37 [0.99-1.90]) and 1.88-fold (odds ratio, 1.88 [1.10-3.21]) in patients with middle and low individual wealth as compared with high individual wealth. Similarly, the grade of hypertension increased progressively with decreasing level of individual patient wealth (P for trend, <0.01). Strategies for hypertension control in Sub-Saharan Africa should especially focus on people in the lowest individual wealth groups who also reside in low-income countries.

引用

页码：577 / 584

页数：8

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