| Titre : | Are behavioural risk factors to be blamed for the conversion from optimal blood pressure to hypertensive status in Black South Africans ? A 5-year prospective study. (2012) |
| Auteurs : | Aletta-E SCHUTTE ; Carla-Mt FOURIE ; Hugo-W HUISMAN ; KRUGER (Annamarie) : ZAF. Africa Unit for Transdisciplinary Health Research (AutheR). North-West University. Potchefstroom. ; Nico-T MALAN ; Leoné MALAN ; Catharina-Mc MELS ; MOSS (Sarah-J) : ZAF. Physical Activity Sport and Recreation. North-West University. Potchefstroom. ; Johannes-Mvan ROOYEN ; H. SALOME KRUGER ; Rudolph SCHUTTE ; Wayne Smith ; Gwayne TOWERS ; Hester-H VORSTER ; Edelweiss WENTZEL-VILJOEN ; Centre of Excellence for Nutrition. North-West University. Potchefstroom. ZAF ; Hypertension in Africa Research Team. (H.A.R.T.). North-West University. Potchefstroom. ZAF |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 41, n° 4, 2012) |
| Pagination : | 1114-1123 |
| Langues: | Anglais |
| Mots-clés : | Hypertension artérielle ; Artériosclérose ; Obésité ; Comportement ; Facteur risque ; Pression artérielle ; République sud africaine ; Etude prospective ; Ethnie ; Alcool ; Afrique ; Enzyme |
| Résumé : | [BDSP. Notice produite par INIST-CNRS ER0x97Cq. Diffusion soumise à autorisation]. Background Longitudinal cohort studies in sub-Saharan Africa are urgently needed to understand cardiovascular disease development. We, therefore, explored health behaviours and conventional risk factors of African individuals with optimal blood pressure (BP) (<=120/80 mm Hg), and their 5-year prediction for the development of hypertension. Methods The Prospective Urban Rural Epidemiology study in the North West Province, South Africa, started in 2005 and included African volunteers (n=1994 ; aged>30 years) from a sample of 6000 randomly selected households in rural and urban areas. Results At baseline, 48% of the participants were hypertensive (>=140/90mmHg). Those with optimal BP (n=478) were followed at a success rate of 70% for 5 years (213 normotensive, 68 hypertensive, 57 deceased). Africans that became hypertensive smoked more than the normotensive individuals (68.2% vs 49.8%), and they also had a greater waist circumference [ratio of geometric means of 0.94cm (95% CI : 0.86-0.99) ] and greater amount of gamma-glutamyltransferase [0.74 U/l (95% CI : 0.62-0.88) ] at baseline. The 5-year change in BP was independently explained by baseline gamma-glutamyltransferase [R2=0.23, bêta=0.13 U/l (95% CI : 0.01-0.19) ]. Alcohol intake also predicted central systolic BP and carotid cross-sectional wall area (CSWA) at follow-up. Waist circumference was another predictor of BP changes [bêta=0.18 cm (95% CI : 0.05-0.24) ] and CSWA. HIV infection was inversely associated with increased BP. Conclusions During the 5 years, 24% of Africans with optimal BP developed hypertension. The surge in hypertension in Africa is largely explained by modifiable risk factors. Public health strategies should focus aggressively on lifestyle to prevent a catastrophic burden on the national health system. |
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