title: Geographical variation in prevalence of hypertension within The Gambia.
abstract: Hypertension has become an important public health problem for sub-Sahara Africa. In a previous nationwide study, we observed a high degree of geographical variation in the prevalence of diastolic hypertension. Geographical variation provides essential background information for the development of community randomised trials could suggest aetiological mechanisms, inform control strategies and prompt further research questions. We designed a follow-up study from the nine high-prevalence communities, and from 18 communities where hypertension was found least prevalent (controls). In each community, 50 households were randomly selected. In each household, an (unrelated) man and woman were enrolled. The risk for hypertension (blood pressure > or =160/95 mm Hg) was higher in the high prevalence communities compared to the control villages (adjusted OR = 1.7, 95% CI 1.3-2.2). The observed coefficient of variation in hypertension prevalence, k, was 0.30. Thus we confirmed significant geographical variation in prevalence of hypertension over time, which has implications for planning of interventions.
authors.affiliation: Medical Research Council Laboratories, Fajara, The Gambia. mvdsande@mrc.gm
authors.forename: M A
authors.initials: MA
authors.lastname: van der Sande
authors.forename: P J
authors.initials: PJ
authors.lastname: Milligan
authors.forename: G E
authors.initials: GE
authors.lastname: Walraven
authors.forename: W M
authors.initials: WM
authors.lastname: Dolmans
authors.forename: M
authors.initials: M
authors.lastname: Newport
authors.forename: O A
authors.initials: OA
authors.lastname: Nyan
authors.forename: W A
authors.initials: WA
authors.lastname: Banya
authors.forename: T
authors.initials: T
authors.lastname: Thien
authors.forename: R
authors.initials: R
authors.lastname: Ward
authors.forename: K P
authors.initials: KP
authors.lastname: McAdam
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors