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Published on: April 23, 2021
Factors associated with hypertension among stroke-free indigenous Africans: Findings from the SIREN study
Onoja M Akpa1,2,3, Akinkunmi P Okekunle1,4, Bruce Ovbiagele5
1Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Insights
Physical inactivity, diabetes, older age, and family history of cardiovascular disease (CVD) are key risk factors for hypertension in West Africa. Addressing sedentary lifestyles can help prevent hypertension and stroke in this population.
Area of Science:
- Cardiovascular epidemiology
- Public health
- Preventive medicine
Background:
- Hypertension is a major global risk factor for stroke and cardiovascular diseases (CVD).
- Identifying hypertension risk factors in stroke-free populations is crucial for effective prevention strategies.
- Understanding these factors in West Africa can inform targeted public health interventions.
Purpose of the Study:
- To identify risk factors for hypertension among community-dwelling, stroke-free individuals in Ghana and Nigeria.
- To inform primordial and primary prevention of hypertension and stroke in similar populations.
Main Methods:
- Utilized data from 4267 community-dwelling stroke-free controls in the Stroke Investigative Research and Education Network (SIREN) study.
- Assessed sociodemographic, lifestyle, and metabolic factors using standard methods.
- Defined hypertension as previous diagnosis, anti-hypertensive drug use, or SBP/DBP ≥ 140/90 mmHg; analyzed using logistic regression.
Main Results:
- 56.7% of participants were hypertensive, with higher prevalence in those aged ≥60 years (53.0%).
- Significant risk factors included physical inactivity (aOR: 9.09), diabetes (aOR: 2.70), age ≥60 years (aOR: 2.22), and family history of CVD (aOR: 2.02).
- Lifestyle factors were strongly associated with hypertension in this West African population.
Conclusions:
- Physical inactivity, diabetes, older age, and a family history of CVD are significant risk factors for hypertension in the West African community.
- Community-oriented interventions targeting sedentary lifestyles are recommended to reduce hypertension and stroke incidence.
- Findings support the need for public health initiatives focused on lifestyle modification for cardiovascular health.
Abstract:
Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community-dwelling stroke-free population in Ghana and Nigeria. Data for 4267 community-dwelling stroke-free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti-hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p < .05. Overall, 56.7% of the participants were hypertensive with a higher proportion among respondents aged ≥60 years (53.0%). Factors including physical inactivity (aOR: 9.09; 95% CI: 4.03 to 20.53, p < .0001), diabetes (aOR: 2.70; CI: 1.91 to 3.82, p < .0001), being ≥60 years (aOR: 2.22; 95% CI: 1.78 to 2.77, p < .0001), and family history of CVD (aOR 2.02; CI: 1.59 to 2.56, p < .0001) were associated with increased aOR of hypertension. Lifestyle factors were associated with hypertension in the current population of community-dwelling stroke-free controls in west Africa. Community-oriented interventions to address sedentary lifestyles may benefit this population and reduce/prevent hypertension and stroke among them.
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