CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 6, July 2012
AFRICA
309
Cardiovascular Topics
Prevalence of cardiovascular risk factors in an urban
area of Togo: a WHO STEPS-wise approach in Lome, Togo
S BARAGOU, M DJIBRIL, B ATTA, F DAMOROU, M PIO, A BALOGOU
Abstract
Objective:
To determine the prevalence of hypertension
and other cardiovascular risk factors in the general adult
population of Lome.
Methods:
A cross-sectional household survey was conducted
in Lome from October 2009 to January 2010, which focused
on hypertension and other cardiovascular risk factors in 2 000
subjects 18 years and older. TheWorld Health Organisation’s
STEPS-wise approach on non-communicable diseases was
used. During the first session, blood pressure (BP) was
measured on three successive occasions, one minute apart,
and the mean was recorded. A second measurement session
was done three weeks later in patients with BP
≥
140/90
mmHg during the first session. Hypertension was defined
as BP > 140/90 mmHg after the second session, or on
antihypertensive treatment. The other risk factors were
studied by clinical and blood analysis.
Results:
We found 532 hypertensive patients out of a total of
2 000 subjects. The prevalence of hypertension was 26.6%.
The mean age of hypertensive patients was 45 ± 10 years,
ranging from 18 to 98 years. The prevalence of other
cardiovascular risk factors was: stress (43%), sedentary
lifestyle (41%), hypercholesterolaemia (26%), obesity
(25.2%), hypertriglyceridaemia (21%), smoking (9.3%),
alcohol use (11%) and diabetes (7.3%).
Conclusions:
The prevalence of hypertension and other
cardiovascular risk factors in the population of Lome is high.
These findings should draw the attention of authorities to
define a national policy to combat hypertension and other
cardiovascular risk factors.
Keywords:
hypertension, risk factors, epidemiology, Togo, sub-
Saharan Africa
Submitted 25/5/11, accepted 22/11/11
Cardiovasc J Afr
2012;
23
: 309–312
DOI: 10.5830/CVJA-2011-071
The whole of sub-Saharan Africa and Togo in particular, have
for some years seen an epidemiological transition, obligating
people to face infectious transmissible diseases as well as
non-transmissible ones, and particularly cardiovascular diseases.
This epidemiological transition is largely associated with
urbanisation and the change in lifestyle.
1-5
In Togo, the prevalence of hypertension in hospital
cardiology departments is 52%,
6
but it is unknown in
the general population. Cardiovascular diseases are the
second cause of death in Togo after malaria.
6
Knowledge
of epidemiological data on cardiovascular risk factors is
fundamental in order to define a national policy and combat
cardiovascular diseases. The purpose of this study was
therefore to determine the prevalence of hypertension and
other cardiovascular risk factors in the general population of
the urban area of Togo.
Methods
A cross-sectional, prospective, community-based study was
conducted in the town of Lome, which is subdivided into five
districts and has approximately 1 056 200 inhabitants.
7
Lome,
the capital of Togo, is cosmopolitan and largely commercial,
with an inter-tropical climate and varied socio-economic layers.
It is located in southern Togo on the coast of the Atlantic Ocean.
The population of subjects aged 18 years and over was
estimated at 497 098 at the time of the study.
7
This work was
conducted from 1 October 2009 to 31 January 2010 using the
STEPS-wise WHO method on the monitoring of risk factors of
non-communicable diseases.
8
The General Director of Health
and local administrative authorities in the town of Lome were
informed of the period and the course of the investigation, and
had issued their written authorisation. Fifteen investigators (10
medical assistants and five nurses), divided into five groups,
were selected and trained. Supervision was provided by three
physicians, including two cardiologists.
Calculation of sample size was done using the formula:
n
=
∑
² ×
P
×
Q/I
²
where
∑
= standard deviation = 4, P = estimated prevalence
of hypertension in Togo (20%),
Q
= 1
–
P
= 0,8;
I
= precision
index = 0.05. The final sample size was 2 000 subjects.
The sampling technique was random; 30 clusters were
selected and 1 000 households were surveyed (34 households
per cluster). In each household, one individual was recruited by
gender, for a total of 68 individuals per cluster. Only subjects
aged 18 years and over were examined. The investigators were
careful to explain the purpose, importance and conduct of
the study to participants. Verbal consent from each selected
individual was acquired.
Department of Cardiology, University of Lome, Lome, Togo
S BARAGOU, MD,
M DJIBRIL, PhD
B ATTA, MD
F DAMOROU, MD
M PIO PhD
A BALOGOU, MD
