Gender-related differences in the prevalence of cardiovascular disease risk factors and their correlates in urban Tanzania.
BACKGROUND
Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. However in East Africa, there is limited literature in this research area. The objective of this study was to examine the prevalence of cardiovascular disease risk factors and their correlates among adults in Temeke, Dar es Salaam, Tanzania. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases.


METHODS
The study design was a cross sectional epidemiological study. A total of 209 participants aged between 44 and 66 years were included in the study. A structured questionnaire was used to evaluate socioeconomic and lifestyle characteristics. Blood samples were collected and analyzed to measure lipid profile and fasting glucose levels. Cardiovascular risk factors were defined using World Health Organization criteria.


RESULTS
The age-adjusted prevalence of obesity (BMI > or = 30) was 13% and 35%, among men and women (p = 0.0003), respectively. The prevalence of abdominal obesity was 11% and 58% (p < 0.0001), and high WHR (men: >0.9, women: >0.85) was 51% and 73% (p = 0.002) for men and women respectively. Women had 4.3 times greater odds of obesity (95% CI: 1.9-10.1), 14.2-fold increased odds for abdominal adiposity (95% CI: 5.8-34.6), and 2.8 times greater odds of high waist-hip-ratio (95% CI: 1.4-5.7), compared to men. Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001) compared to male counterparts, including abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components. In contrast, female participants had 50% lower odds of having hypertension, compared to men (95%CI: 0.3-1.0). Among men, BMI and waist circumference were significantly correlated with blood pressure, triglycerides, total, LDL-, and HDL-cholesterol (BMI only), and fasting glucose; in contrast, only blood pressure was positively associated with BMI and waist circumference in women.


CONCLUSIONS
The prevalence of CVD risk factors was high in this population, particularly among women. Health promotion, primary prevention, and health screening strategies are needed to reduce the burden of cardiovascular disease in Tanzania.
Njelekela
Marina A
MA
Department of Physiology, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania. mnjelekela@muhas.ac.tz
Mpembeni
Rose
R
Muhihi
Alfa
A
Mligiliche
Nuru L
NL
Spiegelman
Donna
D
Hertzmark
Ellen
E
Liu
Enju
E
Finkelstein
Julia L
JL
Fawzi
Wafaie W
WW
Willett
Walter C
WC
Mtabaji
Jacob
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000150:complications / Q000453:epidemiology; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*