Hypertension in Northern Angola: prevalence, associated factors, awareness, treatment and control

Abstract

BackgroundSeventy-five million people are estimated to be hypertensive in sub-Saharan Africa. This translates in high morbidity and mortality, as hypertension is now considered to be the number one single risk factor for death worldwide. Accurate data from countries lacking national disease surveillance is needed to guide future evidence-driven health policies. The authors aimed to estimate the prevalence, awareness, management and control of hypertension and associated factors in an adult population of Angola.MethodsA community-based survey of 1,464 adults, following the World Health Organization's Stepwise Approach to Chronic Disease Risk Factor Surveillance, was conducted to estimate the prevalence of hypertension, awareness, treatment and control in Dande, Northern Angola. Using a demographic surveillance system database, a representative sample of subjects, stratified by sex and age (18–40 and 41–64 years old), was selected.ResultsPrevalence of hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or hypertensive therapy) was of 23% (95% CI: 21% to 25.2%). A follow-up consultation confirmed the hypertensive status in 82% of the subjects who had a second measurement on average 23 days after the first. Amongst hypertensive individuals, 21.6% (95% CI: 17.0% to 26.9%) were aware of their status. Only 13.9% (95% CI: 5.9% to 29.1%) of the subjects aware of their condition were under pharmacological treatment, of which approximately one-third were controlled. Older age, lower level of education, higher body mass index and abdominal obesity were found to be significantly (p<0.01) associated with hypertension.ConclusionsOur survey is the first to provide insightful data on hypertension prevalence in Angola. There is an urgent need for strategies to improve prevention, diagnosis and access to adequate treatment in this country, where a massive economic growth and consequent potential impact on lifestyle risk factors could lead to an increase in the prevalence of hypertension and cardiovascular disease.

Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

“…2,6,10,30,31 This finding supports the conclusion that as age increases, the BP is difficult to control because of loss of elasticity of vasculature, which in turn leads to peripheral vascular resistance and raise in BP. 32 Similarly, this study also revealed that BP control is poor in overweight patients (AOR=2.241, 95% CI=1.239-4.053, p=0.008), as due to weight gain there is increased afterload on the heart or increase in peripheral vascular resistance, which increases cholesterol and triglyceride levels, and decreases HDL levels in the blood, and thereby exacerbate poor BP control 33 and coherent with similar studies in Uganda, Angola, Singapore, and SSA but BMI had no association in Nigerian studies.…”

“…32 Similarly, this study also revealed that BP control is poor in overweight patients (AOR=2.241, 95% CI=1.239-4.053, p=0.008), as due to weight gain there is increased afterload on the heart or increase in peripheral vascular resistance, which increases cholesterol and triglyceride levels, and decreases HDL levels in the blood, and thereby exacerbate poor BP control 33 and coherent with similar studies in Uganda, Angola, Singapore, and SSA but BMI had no association in Nigerian studies. 27,28,30,31 The respondents' awareness of hypertension-related complication revealed that participants who did not know at least two complications were more likely to have uncontrolled hypertension than those who knew at least two complications (AOR=2.140, 95% CI=1.272-3.600, p=0.004) and this idea was also speculated in Algeria. 34 This might be because having awareness of short-and long-term complications of hypertension leads to fear, frequent visit of health setup, increased health-seeking behavior, and better BP control.…”

Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach

“…A survey performed in Kerala State of India reported an estimated prevalence of hypertension ranging between 15.3 % in women and 30.5 % in men and women aged from 20 and 29, and 25.8 and 37.7 % in those aged from 30 to 39 years old, respectively [19]. Also, the prevalence of hypertension in a cohort of 1464 African individuals was estimated to be 8.5 % for women and 21.2 % for men aged between 18 and 40 years old [20]. In this study, people with borderline BP or hypertension seem to be characterized by a high consumption of alcohol and salt in the diet, by high body mass index, by a physically active lifestyle and low cultural and socio-economic levels [20].…”

“…Also, the prevalence of hypertension in a cohort of 1464 African individuals was estimated to be 8.5 % for women and 21.2 % for men aged between 18 and 40 years old [20]. In this study, people with borderline BP or hypertension seem to be characterized by a high consumption of alcohol and salt in the diet, by high body mass index, by a physically active lifestyle and low cultural and socio-economic levels [20].…”

Educational views and practices of medical and nursing professionals: a descriptive study

“…Por meio da educação em saúde, pode se gerar oportunidades de reflexão sobre saúde, práticas de cuidados e mudanças de costumes, o que previne ou pelo menos retarda os agravos decorrentes desta patologia. (5) Assim, é fundamental que o setor saúde embase a educação não apenas na transmissão de conhecimento historicamente acumulado, mas que, principalmente, trabalhe na perspectiva da construção de conhecimentos e de qualidade de vida por todos aqueles que a integram. (6) Além disso, no âmbito da Estratégia Saúde da Família (ESF), a educação em saúde é uma prá-tica prevista e atribuída a todos os profissionais que compõem a equipe.…”