Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon.
BACKGROUND
Hypertension is becoming increasingly important in sub-Saharan Africa. However, evidences in support of this trend with time are still not available. The aim of this study was to evaluate the 10-year change in blood pressure levels and prevalence of hypertension in rural and urban Cameroon.


METHODS
Two cross-sectional population-based surveys in Yaounde (urban area) and Evodoula (rural area) in 1994 (1762 subjects) and 2003 (1398 subjects) used similar methodologies in women and men aged >or=24 years. Data on systolic and diastolic blood pressures (SBP and DBP), body mass index, educational level, alcohol consumption and tobacco smoking were collected during the two periods.


RESULTS
Between 1994 and 2003, blood pressure levels significantly increased in rural women (SBP, +18.2 mm Hg; DBP, +11.9 mm Hg) and men (SBP, +18.8 mm Hg; DBP, +11.6 mm Hg), all p<0.001. In the urban area, SBP increased in women (+8.1 mm Hg, p<0.001) and men (+6.5 mm Hg, p<0.001), and DBP increased only in women (+3.3 mm Hg, p<0.001). The OR (95% CI) adjusted on confounders comparing the prevalence of hypertension (blood pressure >or= 140/90 mm Hg and/or treatment) between 2003 and 1994 ranged from 1.5 (1.1 to 2.2) in urban men to 5.3 (3.2 to 8.9) in rural men.


CONCLUSIONS
Blood pressure levels of this population have deteriorated over time, and the prevalence of hypertension has increased by twofold to fivefold. Adverse effects of risk factors could account for some of these changes. Prevention and control programmes are needed to reverse these trends and to avoid the looming complications.
Fezeu
L
L
George Institute for International Health, Level 10, KGV Building, Missenden Road, Camperdown, 2050 NSW, Australia.
Kengne
A P
AP
Balkau
B
B
Awah
P K
PK
Mbanya
J C
JC
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D013599:Systole / Q000502:physiology; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*
Circulation. 2001 Dec 4;104(23):2855-64
11733407
Lancet. 1997 May 3;349(9061):1269-76
9142060
Int J Epidemiol. 1998 Apr;27(2):181-5
9602396
Lancet. 2005 Jan 15-21;365(9455):217-23
15652604
Blood Press. 1998 May;7(3):139-43
9758082
Hypertension. 1999 Sep;34(3):466-71
10489395
Hypertension. 2007 Dec;50(6):1012-8
17954720
S Afr Med J. 1977 Jan 29;51(5):121-3
850843
Atherosclerosis. 2007 Jul;193(1):70-6
17011567
BMJ. 1994 Jul 2;309(6946):23-7
8044063
World Health Stat Q. 1994;47(1):26-30
8085367
Tunis Med. 2005 May;83 Suppl 5:8-13
16094844
J Hum Hypertens. 2000 Dec;14(12):779-87
11114693
BMJ. 1995 Nov 11;311(7015):1255-9
7496233
J Hum Hypertens. 2006 Jan;20(1):91-2
16163363
Circulation. 2001 Nov 27;104(22):2746-53
11723030
Int J Obes Relat Metab Disord. 2002 Jul;26(7):1009-16
12080456
Rev Epidemiol Sante Publique. 1997 Sep;45(4):286-92
9380909
Br Med J (Clin Res Ed). 1983 Jan 22;286(6361):287-9
6402075
Diabetologia. 1997 Jul;40(7):824-9
9243104
J Hum Hypertens. 1996 Feb;10 Suppl 1:S21-5
8965282