Trends in prevalence of obesity and hypertension in an urban Congolese community

Abstract

Objective: To assess trends over time in the prevalence of overweight/obesity and hypertension among adult Congolese people.

Methods: Data from 1292 inhabitants of an urban Congolese community collected in 2007-8 were confronted to observations from a 1983-4 survey of 424 participants from the same location. Prevalence of overweight/obesity and hypertension was directly standardized for gender and age. We modeled the risk of hypertension in a multivariable logistic regression analysis including the participants from the two periods and a dummy variable (coded 0 for 1983-4, 1 for 2007-8).

Results: Gender distribution was similar in 2007-8 and 1983-4 with women representing 56.6% and 55.2% of the participants, respectively. Age averaged 37±15 years in 2007-8 vs. 33±12 years in 1983-4 (P˂.0001). Crude prevalence of overweight/obesity (26.7 vs 42.3%; P<.0001) and hypertension (21.5% vs. 30.9%; P=.0002) was higher in 2007-8. The 2007-8 prevalence of overweight/obesity was 15.6%, 14.2% and 16.8% higher respectively for all subjects, women and men. The respective differences were 9.4%, 16.7% and 0.3% for hypertension. Overweight/obesity predominated among women at both periods, hypertension among men in 1983-4 with a trend in women at the latter period. The gender-age directly standardized prevalence was higher in 2007-8 for overweight/obesity [28.4(24.1–32.7)% vs. 41.3(38.8–43.7)%] and borderline for hypertension [24.9(20–28.9)% vs. 29.7(27.4–31.9)%]. The 1983-4/2007-8 risk ratio was 0.69 for overweight/obesity (P<.0001), 0.84 for hypertension (P=.054). Awareness, treatment and control of hypertension were higher in 2007-8 for all subjects and women, not for men.  They were similar in both genders in 1983-4 but higher among women in 2007-8. In the logistic model including participants from both periods, the risk of hypertension increased with gender (OR for men vs women: 1.47 [95% CI:1.14–1.88]; P=.0029), age (for age ≥ 45 years: 5.62 [4.37–7.23]; P<.0001), overweight/obesity (present vs absent; 2.27 [1.77–2.91]; P<.0001) and pulse rate (for each 10 beats/min: 1.20 [1.08–1.32]; P=.0005); the risk was 35% higher in 2007-8 compared to 1983-4 (OR:1.35;95% CI:1.01–1.80; P=.0416).

Conclusion: The data highlight the increment overtime in the prevalence of hypertension and overweight/obesity among adult urban Congolese dwellers whose global cardiovascular risk is rather high. Control of these features should be considered mandatory for prevention of cardiovascular diseases.