CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 1, January/February 2010
Cardiovascular Topics
26
AFRICA
A prevalence of cardiometabolic risk factors among a
rural Yoruba south-western Nigerian population:
a population-based survey
OO OLADAPO, L SALAKO, O SODIQ, K SHOYINKA, K ADEDAPO, AO FALASE
Summary
Background:
It has been hypothesised that rural sub-Saha-
ran Africa is at an early stage of epidemiological transition
from communicable to non-communicable diseases (NCD).
Limited information exists about the prevalence of cardio-
metabolic risk factors and the burden of cardiovascular
disease (CVD) in the adult Nigerian population, especially in
the rural setting.
Objectives:
The aim of this study was to assess and describe
the prevalence of several cardiometabolic risk factors in the
sub-Saharan adult population of a rural Yoruba community,
living in south-western Nigeria.
Methods:
The study was a descriptive, cross-sectional,
random-sample survey. Participants were visited at home
by trained nurses and community health extension workers
(CHEW) who administered a questionnaire, took the relevant
history, carried out clinical examinations and measurements
and took samples for laboratory tests. They were supervised
by primary healthcare physicians serving the community.
The variables recorded comprised clinical history, CVD
risk factors including blood pressure (BP), body mass index
(BMI), waist circumference, blood sugar and serum lipid
levels, cigarette use, and dietary habits. The participants
included 2 000 healthy adults aged 18 to 64 years who had
been living in the area for more than three years.
Results:
The average age was 42.1
±
21.6, with 43.7% (873)
being males and 56.3% (1127) females; 20.8% were hyper-
tensive with BP
≥
140/90 mmHg, 42.3% of the men and
36.8% of the women had BP
≥
130/85 mmHg; 2.5% had
diabetes, 1.9% had hypertriglycerideaemia, 43.1% had low
HDL-C, 3.9% had general obesity, 14.7% had abdominal
obesity, 3.2% were physically inactive, and 1.7% smoked
cigarettes. Overall, 12.9% of the subjects were found to have
at least one CVD risk factor. Using the Adult Treatment
Panel (ATP) III criteria, 2.1% of men and 2.7% of women
in the study population had at least three of the criteria, the
commonest being HDL-C
<
40 mg/dl in men or
<
50 mg/dl in
women, followed by BP
≥
130/85 mmHg, then waist circum-
ference
>
88 cm in women or
>
102 cm in men, followed by
blood glucose
≥
110 mg/dl.
Conclusion:
The results obtained from this study strongly
suggest a high prevalence of cardiometabolic risk factors in
this rural population and that the epidemiological transition
is not restricted to the urban population. This serves as a
wake-up call for action in the planning of health services for
the management of CVD and other chronic NCDs.
Keywords:
cardiometabolic risk factors, cardiovascular disease,
Nigeria
Submitted 22/4/09, accepted 29/6/09
Cardiovasc J Afr
2010;
21
: 26–31
Worldwide, cardiovascular diseases (CVD) and the metabolic
syndrome are major causes of morbidity and mortality, including
sudden death.
1-3
CVD is emerging as a significant health problem
in sub-Saharan countries such as Nigeria, with a population of
140 million. These countries are undergoing epidemiological
transition from communicable to non-communicable diseases
(NCDs).
4,5
Epidemiological transition has been closely linked
to changes in the demographic, social and economic status of
various populations, causing a global rise in chronic diseases,
especially cardiovascular diseases (CVD).
4,5
The prevalence of CVD, specifically stroke and heart attack
is on an upward trend in the sub-Saharan region, accounting
for one-tenth of all deaths.
6
Nigeria has a double burden of
communicable and non-communicable diseases. Maternal and
childhood mortality, tuberculosis, malaria fever and HIV/AIDS
are still the leading causes of death. However, increased urbani-
sation with rapid rural–urban migration, demographic, environ-
mental, social, cultural and behavioural changes might have led
to unhealthy lifestyles, with increased motorisation, decreased
physical activity, poor dietary habits, and tobacco use and alco-
Cardiovascular Unit, Department of Medicine, University
College Hospital, College of Medicine, University of Ibadan,
Nigeria
OO OLADAPO, BSc, MB BS, MSc, FWACP,
AO FALASE, MD, FRCP
Department of Pharmacology and Therapeutics, University
of Ibadan, Nigeria
L SALAKO, DSc, FRCP
Country office, World Health Organisation, Lagos, Nigeria
O SODIQ, MD
Primary Health, Egbeda Local Government, Egbeda, Oyo
State, Nigeria
K SHOYINKA, BM ChB
Department of Chemical Pathology, College of Medicine,
University of Ibadan, Nigeria
K ADEDAPO, MB BS, FWACP
