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The Burden of Cardiovascular Disease Attributable to Hypertension in Nigeria: A Modelling Study Using Summary-Level
Adedayo E Ojo1,2, Dike B Ojji2,3, Diederick E Grobbee1
1Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, 3584 CG Utrecht, The Netherlands.
Insights
Hypertension significantly contributes to cardiovascular disease (CVD) and stroke in Nigeria. Targeted public health strategies addressing hypertension are crucial for reducing the CVD burden in the country.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular disease (CVD) is a leading global cause of death and disability.
- Hypertension is the primary modifiable risk factor for CVD, disproportionately affecting African regions.
- Sub-Saharan Africa, particularly Nigeria, faces a significant burden of hypertension-related CVD subtypes.
Purpose of the Study:
- To assess the burden of major cardiovascular disease (CVD) subtypes attributable to hypertension in Nigeria.
- To calculate population attributable fractions (PAF) for myocardial infarction and stroke subtypes linked to hypertension.
- To analyze PAF estimates across different age groups, sexes, and geopolitical zones within Nigeria.
Main Methods:
- Utilized published data from the INTERHEART and INTERSTROKE studies.
- Calculated population attributable fractions (PAF) for myocardial infarction, all strokes, ischaemic stroke, and intracerebral haemorrhagic stroke.
- Estimated PAFs based on hypertension prevalence in Nigeria, stratified by age, sex, and geopolitical zones.
Main Results:
- Hypertension accounted for 13.2% of myocardial infarctions and 24.6% of all strokes in Nigeria.
- Specific contributions included 21.6% for ischaemic stroke and 33.1% for intracerebral haemorrhagic stroke.
- PAF varied significantly by age, sex, and region, highlighting specific high-risk subgroups.
Conclusions:
- Hypertension is a major driver of the cardiovascular disease (CVD) burden in Nigeria.
- Understanding hypertension's impact on specific populations is vital for effective health policy.
- Public health interventions targeting hypertension are essential for mitigating CVD in Nigeria.
Background:
Globally, cardiovascular disease (CVD) remains the leading cause of mortality and disability, with hypertension being the single most important modifiable risk factor. Hypertension is responsible for about 18% of global deaths from CVD, of which African regions are disproportionately affected, especially sub-Saharan Africa. This study assessed the burden of major CVD subtypes attributable to hypertension in Nigeria.
Methods:
The population attributable fractions (PAF) for myocardial infarction, all strokes, ischaemic stroke and intracerebral haemorrhagic stroke attributable to hypertension in Nigeria were calculated using published results from the INTERHEART and INTERSTROKE studies and prevalence estimates of hypertension in Nigeria. PAF estimates were obtained for age, sex, and geopolitical zones.
Results:
Overall, hypertension contributed to 13.2% of all myocardial infarctions and 24.6% of all strokes, including 21.6% of all ischaemic strokes and 33.1% of all intracerebral haemorrhagic strokes. Among men aged ≤55 years, the PAF for myocardial infarction ranged from 11.7% (North-West) to 14.6% (South-East), while in older men, it spanned 9.2% (North-West) to 11.9% (South-East). Among women aged ≤65 years, PAF varied from 18.6% (South-South) to 20.8% (South-East and North-Central), and among women aged >65 years, it ranged from 10.4% (South-South) to 12.7% (South-East).
Conclusion:
Hypertension is a key contributor to the burden of CVD in Nigeria. Understanding the burden of hypertension in the Nigerian population overall and key subgroups is crucial to developing and implementing contextualised health policies to reduce the burden of CVD. Public health interventions and policies centred on hypertension will play a critical role in potentially alleviating the burden of cardiovascular diseases (CVD) in Nigeria.
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