What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=1777). Intervention: Rural community dwelling. Primary outcome: Prevalence of hypertension.

December 1, 2019Open Access

The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study

Key Result

In a rural population in Benin, the prevalence of hypertension was 32.9%, with only 41.8% of affected individuals aware of their condition and 46.3% of those receiving treatment.

Study Design

Type

Cross-Sectional (n=1,777)

Multicenter

Structured PICO

Population

1,777 adults aged 25 years and older living in a rural community in Benin, assessed for hypertension prevalence, awareness, and management.

Outcome

Prevalence of hypertension (defined as self-reporting ongoing treatment, or SBP ≥140 mmHg and/or DBP ≥90 mmHg)

This study highlights a high prevalence of hypertension (32.9%) in rural Benin, coupled with alarmingly low rates of awareness and control, emphasizing the need for improved screening and management in sub-Saharan Africa.

Limitations

Cross-sectional design does not allow assessment of temporal nature of associations
Survival bias cannot be totally excluded
Recall bias for nutritional factors
24-h urinary salt excretion was not available
Data on dyslipidaemia were lacking

Abstract

BACKGROUND: Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. METHODS: A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. RESULTS: The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. CONCLUSION: This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

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