title: Nationwide prevalence study of hypertension and related non-communicable diseases in The Gambia.
abstract: The prevalence of hypertension, diabetes and obesity in The Gambia was assessed in a 1% population sample of 6048 adults over 15 years of age, 572 (9.5%) subjects were hypertensive according to WHO criteria (a diastolic blood pressure (DBP) of 95 mmHg or above and/or a systolic blood pressure (SBP) of 160 mmHg or above); 325 (5.4%) had a DBP of 95 mmHg or above, and 39 (2.3%) a DBP of 105 mmHg or above; 428 (7.1%) had a SBP of 160 mmHg or above. By less conservative criteria (a DBP of 90 mmHg or above and/or SBP of 140 mmHg or above), 24.2% of subjects were hypertensive. The prevalence of hypertension was similar in the major ethnic groups and in urban and rural communities. Age and obesity were risk factors for hypertension; female sex was an additional risk factor for diastolic hypertension. Several communities had a prevalence of diastolic hypertension double the national rate, and significant community clustering of diastolic hypertension (P < 0.01) was confirmed by Monte Carlo methods. Genetic and/or localized environmental factors (such as diet or Schistosoma haematobium infection), may be involved 140 (2.3%) subjects were obese. Obesity was associated with female sex, increasing age, urban environment, non-manual work and diastolic hypertension. Only 14 (0.3%) subjects were found to be diabetic. Hypertension appears to be very prevalent in The Gambia, with a substantial population at risk of developing target organ damage. Further studies to delineate this risk and appropriate interventions to reduce it are needed.
authors.affiliation: Medical Research Council Laboratories, Fajara, The Gambia.
authors.forename: M A
authors.initials: MA
authors.lastname: van der Sande
authors.forename: R
authors.initials: R
authors.lastname: Bailey
authors.forename: H
authors.initials: H
authors.lastname: Faal
authors.forename: W A
authors.initials: WA
authors.lastname: Banya
authors.forename: P
authors.initials: P
authors.lastname: Dolin
authors.forename: O A
authors.initials: OA
authors.lastname: Nyan
authors.forename: S M
authors.initials: SM
authors.lastname: Ceesay
authors.forename: G E
authors.initials: GE
authors.lastname: Walraven
authors.forename: G J
authors.initials: GJ
authors.lastname: Johnson
authors.forename: K P
authors.initials: KP
authors.lastname: McAdam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population