title: Prevalence of hypertension in the Gambia and Sierra Leone, western Africa: a cross-sectional study.
abstract: BACKGROUND
  Hypertension (HTN) is one of the causes of cardiovascular disease (CVD) in Africa, and may be associated with lower socio-economic status (SES). The prevalence of HTN is not well established in the Gambia or in Sierra Leone.
  
  
  METHODS
  A cross-sectional, population-based study of adults was conducted in the Gambia in 2000 and in Sierra Leone from 2001 to 2003 and in 2009. The study was conducted as part of the annual visit to countries in western Africa sponsored by a medical delegation from California. People from the Gambia and Sierra Leone were examined by the medical delegation and blood pressures were measured.
  
  
  RESULTS
  A total of 2 615 adults were examined: 1 400 females and 1 215 males. The mean systolic blood pressure (SBP) of the females was 134.3 ± 29.7 mmHg, mean diastolic blood pressure (DBP) was 84.5 ± 17.5 mmHg, and 46.2% were hypertensive. The mean SBP of the males was 132.8 ± 28.5 mmHg, mean DBP was 82.8 ± 16.2 mmHg, and 43.2% were hypertensive. Overall prevalence of HTN in the subjects was 44.8%. Mean SBP, mean DBP and HTN prevalence increased with age decade, both in males and females. In addition, after age adjustment (known age), females had higher mean SBP (p = 0.042), mean DBP (p = 0.001) and rate of occurrence of HTN (p = 0.016) when compared with males.
  
  
  CONCLUSIONS
  Prevalence rates of HTN in the Gambia and Sierra Leone were higher than 40% in males and females, and may be a major contributor to CVD in both countries. Due to the association of HTN with low SES, improvements in educational, public health, economic, non-governmental and governmental efforts in the Gambia and Sierra Leone may lead to a lower prevalence of HTN. The cause of the higher prevalence in women may be due to post-menopausal hormonal changes.
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California. lawrence.czer@cshs.org.
authors.forename: Morcos
authors.initials: M
authors.lastname: Awad
authors.affiliation: Division of Cardiothoracic Surgery, Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruzza
authors.affiliation: Section of Biostatistics, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: James
authors.initials: J
authors.lastname: Mirocha
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Saman
authors.initials: S
authors.lastname: Setareh-Shenas
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: J Robert
authors.initials: JR
authors.lastname: Pixton
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Camelia
authors.initials: C
authors.lastname: Soliman
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Lawrence S C
authors.initials: LS
authors.lastname: Czer
mesh_terms: D000328:Adult; D000354:Africa, Western / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D012807:Sierra Leone / Q000453:epidemiology; D055815:Young Adult