Hypertension in people with diabetes in sub-Saharan Africa: revealing the hidden face of the iceberg.
OBJECTIVE
To evaluate the prevalence, awareness, treatment and control of hypertension in a diabetic population of Cameroon, a sub-Saharan African country.


METHODS
Two hundreds and ten diabetic patients were consecutively enrolled over a 6-month period. A questionnaire was administered and physical examination done. The JNC VI and the latest WHO criteria were used to diagnose hypertension and diabetes, respectively, and control of hypertension was assessed against five different targets.


RESULTS
Ninety-one percent of the participants had type 2 diabetes. Prevalence and awareness rates for hypertension were 66.7% (n=140) and 87.1% (n=122), respectively. Treatment rate among those aware of their hypertension status was 80.3% (n=98). Patients with hypertension were older, more overweight/obese and had a longer duration of diabetes. ACE inhibitors and diuretics were the two most used blood pressure (BP) lowering drugs. Following the ADA/JNC 7 goal, the control rate of hypertension among treated patients was 10.2% (n=10).


CONCLUSIONS
Diabetic patients in Cameroon exhibit a very high prevalence of hypertension and are about three times more affected than the general population. Awareness and treatment rates are high, but the control rate is very low. Large scale studies with intervention component are urgently required.
Choukem
Simeon Pierre
SP
Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon.
Kengne
Andre Pascal
AP
Dehayem
Yefou Mesmin
YM
Simo
Nenwouo Leonie
NL
Mbanya
Jean Claude
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001364:Awareness; D001794:Blood Pressure; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000145:classification; D003924:Diabetes Mellitus, Type 2 / Q000145:classification / Q000150:complications* / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires