title: Cohort Profile: Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study.
abstract: Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008-09 and repeated after 3-year follow-up in 2011-12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans.
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa, leone.malan@nwu.ac.za.
authors.forename: Leoné
authors.initials: L
authors.lastname: Malan
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.affiliation: Department of Psychiatry and School of Nursing, McGill University, Montreal, QC, Canada, Centre Hospitalier de l'Université de Montréal and Montreal Heart Institute Research Center, Montreal, QC, Canada and.
authors.forename: Nancy
authors.initials: N
authors.lastname: Frasure-Smith
authors.affiliation: Statistical Consultation Services, North-West University, Potchefstroom Campus, South Africa.
authors.forename: Hendrik S
authors.initials: HS
authors.lastname: Steyn
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa.
authors.forename: Nicolaas T
authors.initials: NT
authors.lastname: Malan
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism*; D044383:Black People; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011446:Prospective Studies; D012084:Renin-Angiotensin System / Q000502:physiology; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014505:Urban Population; D044465:White People
chemical_list: D015415:Biomarkers