Arterial hypertension in urban Africa

OBJECTIVE: To assess the prevalence and risk markers of arterial hypertension in the context of a rapidly growing urbanization in Africa. DESIGN: A cross-sectional study was performed on a representative sample of inhabitants of Pikine, an urban suburb of Dakar, Senegal. METHODS: Blood pressure was measured by properly trained field workers at subject homes. A total of 2580 individuals were included, aged > or = to 15 years and with a duration of residence > or = 2 months. Complete data including risk markers were obtained for 2300 subjects. RESULTS: The prevalence of hypertension (World Health Organization criteria) was found to be 10.4%. Due to the young age of the population, nearly half of the cases of moderate-to-severe hypertension were observed in middle-aged subjects. Risk markers of hypertension were age and obesity in both sexes: illiterate and multiparous women also had a higher prevalence of hypertension. Awareness of hypertension was infrequent among the hypertensive subjects: of the 189 subjects who had been labelled hypertensive, 10 were treated with antihypertensive therapy but 111 had normal blood pressure levels without any treatment, suggesting poor-quality prior diagnosis. CONCLUSIONS: Hypertension was found to be frequent in this urban African population. These findings emphasize the need for improvement in the management of hypertension, focusing upon the high-risk groups.