title: Prevalence of cardiovascular disease in Gabon: a population study.
abstract: BACKGROUND
  Data supporting epidemiological transition from a predominant burden of infectious diseases to one of chronic diseases in Africa result mostly from hospital surveys.
  
  
  OBJECTIVE
  To estimate the cardiovascular disease (CVD) burden in Gabon.
  
  
  METHODS
  The study was conducted in Ntoum (8765 inhabitants). All subjects aged greater or equal to 40 years were invited to participate. Participants were interviewed about CVD history and risk factors; they responded to questionnaires on claudication and angina and had a clinical examination, including lower limb pulse palpation and bilateral brachial pressure measurement. Subjects were considered to have CVD in case of history of CVD (coronary artery, cerebrovascular and peripheral arterial diseases), a positive questionnaire or an abnormal finding during clinical examination.
  
  
  RESULTS
  The study included 736 subjects (313 men; 423 women). Systolic hypertension was highly prevalent (up to 47.7% and 53.7% in men and women aged 50 to 60 years, respectively). Of the 382 patients with hypertension, 74 (19.4%) were treated and only 22 (5.8%) were considered to have controlled hypertension. Overall, CVD was identified in 98 (13.3%) cases. Overall and newly diagnosed CVD prevalence rates were 14.7% and 11.5% for men and 14.9% and 8.9% for women, respectively. The presence of CVD was associated with hypertension (hazard ratio [HR] 3.69, 95% confidence interval [CI] 2.21-6.16; P<0.0001). Hypertension was predictive of stroke (HR 4.57, 95% CI 1.26-16.50; P<0.05), peripheral artery disease (HR 2.03, 95% CI 1.03-4.00; P<0.05) and subclavian artery stenosis (HR 5.79, 95% CI 2.21-15.2; P<0.05).
  
  
  CONCLUSIONS
  Our findings provide strong evidence of ongoing epidemiological transition in Gabon, where CVD prevalence rates increase mainly with hypertension, affecting about one in six individuals aged over 40 years.
authors.affiliation: Inserm UMR, Tropical Neuroepidemiology, Limoges, France.
authors.forename: Edgar Brice
authors.initials: EB
authors.lastname: Ngoungou
authors.forename: Victor
authors.initials: V
authors.lastname: Aboyans
authors.forename: Philomène
authors.initials: P
authors.lastname: Kouna
authors.forename: Roger
authors.initials: R
authors.lastname: Makandja
authors.forename: Jean Emmanuel
authors.initials: JE
authors.lastname: Ecke Nzengue
authors.forename: Carine Ndong
authors.initials: CN
authors.lastname: Allogho
authors.forename: Marc
authors.initials: M
authors.lastname: Laskar
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
authors.forename: Philippe
authors.initials: P
authors.lastname: Lacroix
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016009:Chi-Square Distribution; D003906:Developing Countries; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000503:physiopathology; D013349:Subclavian Steal Syndrome / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors