Background There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal. Objectives To report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in six sites located in west, east and southern Africa. In addition, we examined regional, sex, and age differences related to hypertension. Methods A population-based cross-sectional study was performed at six sites in four African countries - Burkina Faso (Nanoro), Ghana (Navrongo), Kenya (Nairobi) and South Africa (Agincourt, Dikgale, Soweto). Blood pressure measurements were taken using standardized procedures on 10,696 adults aged 40 to 60 years. Hypertension was defined as SBP ≥ 140mm Hg and/or DBP ≥ 90 mm Hg or taking anti-hypertensive medication. Results The mean prevalence of hypertension ranged from 15.1% in Nanoro to 54.1% in Soweto. All three of the South African sites had a mean prevalence of hypertension of over 40.0%, significantly higher than Nairobi (25.6%) and Navrongo (24.5%). Prevalence increased with age in both sexes and at all sites. A significantly higher prevalence of hypertension was observed in women in Agincourt, Dikgale and Nairobi, while in Nanoro this trend was reversed. Within the hypertensive group the average proportion of participants who were aware of their blood pressure status was only 39.4% for men and 53.8% for women, and varied widely across sites. Conclusions Our study demonstrates that the prevalence of hypertension and the level of disease awareness differ not only between but also within sub-Saharan African countries. Each nation must tailor their regional hypertension awareness and screening programs to match the characteristics of their local populations.

BackgroundThe aim of the study was to determine the prevalence and determinants of chronic non-communicable disease (NCD) risk factors in a rural community in the Limpopo Province of South Africa.MethodsThis survey was conducted using the WHO "STEPwise approach to the surveillance of non-communicable diseases" (STEPS) methodology. Participants were residents of the Dikgale HDSS site and standardised international protocols were used to measure behavioural risk factors (smoking, alcohol consumption, fruit and vegetable intake and, physical activity) and physical characteristics (weight, height, waist and hip circumferences and blood pressure–BP). Fasting blood glucose, triglyceride, cholesterol and HDL-C were determined in 732 participants. Data were analysed using STATA 12 for Windows.ResultsThe prevalence of current smokers amongst the participants was 13.7%, of which 81.3% were daily smokers. Alcohol was consumed by 16.3% of the participants. The majority of participants (88.6%) had low daily intake of fruit and vegetables and low physical activity (66.5%). The prevalence of hypertension amongst the participants was 38.2%. Overweight, obesity and high waist circumference were prevalent in females. The cardio-metabolic risk profile was not significantly different between men and women. People who were older than 40 years, overweight or obese and those who consumed alcohol were more likely to be hypertensive. Smoking was associated significantly with older age, males, never married and divorced people. Alcohol consumption was associated with older age, males, low educational status and low income.ConclusionHigh levels of risk factors for NCDs among adults in the Dikgale HDSS suggest an urgent need for health interventions to control these risk factors at the population level in order to reduce the prevalence of NCDs.

Africa is experiencing a rapid increase in adult obesity and associated cardiometabolic diseases (CMDs). The H3Africa AWI-Gen Collaborative Centre was established to examine genomic and environmental factors that influence body composition, body fat distribution and CMD risk, with the aim to provide insights towards effective treatment and intervention strategies. It provides a research platform of over 10 500 participants, 40–60 years old, from Burkina Faso, Ghana, Kenya and South Africa. Following a process that involved community engagement, training of project staff and participant informed consent, participants were administered detailed questionnaires, anthropometric measurements were taken and biospecimens collected. This generated a wealth of demographic, health history, environmental, behavioural and biomarker data. The H3Africa SNP array will be used for genome-wide association studies. AWI-Gen is building capacity to perform large epidemiological, genomic and epigenomic studies across several African counties and strives to become a valuable resource for research collaborations in Africa.

BackgroundHypertension is problem already faced by urban populations of South Africa, but little is known about its prevalence and risk factors in rural areas.AimTo assess the prevalence of and risk factors associated with hypertension amongst adults in a rural community in South Africa.SettingDikgale Health and Demographic Surveillance Site, Limpopo Province, South Africa.MethodsA community-based cross-sectional survey was carried out at this site where individuals aged 15 years and older were screened using a locally adapted version of the World Health Organization STEPwise questionnaire. Demographics, anthropometry and three independent blood pressure (BP) readings were taken. The average of the three BP measurements was used in analysis, and hypertension taken as systolic and diastolic BP of ≥ 140 or ≥ 90 mmHg respectively, or at least a two-week history of antihypertensive treatment. Analysis included the Chi-square test and statistical significance was set at p ≤ 0.05.ResultsA total of 1407 individuals were interviewed, of whom 1281 had complete BP, weight and height measurements taken. The mean age of participants was 44.2 ± 20.9 years(range 15–98 years), 63% were female, 55% were single and 90% were unemployed, whilst 13% were tobacco smokers and 20% reported drinking alcohol. Overall prevalence of hypertension was 41% and this was significantly associated with age and marital status.ConclusionThe prevalence of hypertension was found to be high. Prevention strategies are urgently needed to address this life-threatening and important risk factor for cardiovascular disease in rural Limpopo Province.

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