CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 9, October 2012
AFRICA
515
that levels of overweight and obesity were higher in those who
had migrated to the UK than those who lived in Cameroon or
Jamaica. Compared to other sites, obesity was found to be at its
lowest level in rural males and females in Cameroon. In fact, due
to the rarity of obesity in rural Cameroon, the site was omitted
from the analyses of obesity. Rural Cameroon was used however
as the reference category for analyses of overweight, and urban
Cameroon for analyses of obesity.
30
Two other studies reported on the age- and gender-specific
prevalence of obesity.
33,34
In all localities, the prevalence of
overweight/obesity among men was higher in the older age
group than the younger age group. In addition, a significant
prevalence was observed in younger and older Dutch–Ghanaian
men (50.0 and 84.2%) compared with their urban (14.1 and
39.2%)
and rural Ghanaian counterparts (5.6 and 16.7%). A
higher prevalence of overweight and obesity was also evident
among younger and older Dutch–Ghanaian women (65.0 and
94.7%)
compared with their urban (44.5 and 61.0%) and rural
Ghanaian counterparts (17.8 and 28.4%).
34
In one study,
33
the most significant prevalence of obesity in
both genders occurred between the ages of 55 and 65 years,
at 7.8 and 32.9% in men and women, respectively.
33
In another
study,
30
middle-aged urban men were found to be more prone
to becoming obese than younger men. However, only risk of
obesity and not overweight was evident among older men (60–74
years) compared with younger men.
Similarly, women within the same age group (41 years and
older) in urban Cameroon were also found to be at increased
risk of developing obesity. When compared with younger men,
the risk of overweight and obesity increased among men aged
41
to 59 years.
When age was adjusted for, the rural population in Cameroon
were excluded from the analysis because of non-significant
results. However, at age 41 to 59 years, there was a significant
increase in obesity across the two geographic areas (urban
Cameroon and the UK), which began to decline from age 60
to 70 years. Data from Jamaican subjects were excluded in this
review as they were not considered to be European counterparts.
30
Comparison of cardiovascular parameters and
inflammatory markers
Three studies by Schutte
et al
.
investigated the association
between cardiovascular and inflammatory bio-markers with
obesity (Table 3).
32,35,37
They were part of the POWIRS study and
were carried out in South Africa by the same group.
With the exception of the study by Schutte
et al
.,
37
which
compared normotensive and hypertensive African women, the
remaining two studies investigated the differences in response
between African and Caucasian women.
32,35
Schutte and
co-workers’ findings showed a significant elevation of leptin
levels (
p
<
0.05)
in the overweight and obese normotensive (OW/
OB NT) and hypertensive (HT) groups in comparison with the
lean NT group, but it was similar in the OW/OB NT and HT
groups.
37
Matching healthy African (
n
=
102)
and Caucasian (
n
=
115)
women for age and BMI, Schutte
et al
.
35
sought to determine
the role of ethnicity. In their investigation of the relationship
between inflammation, obesity and cardiovascular disease in a
South African population, they found significantly increased
levels of leptin, high-sensitivity C-reactive protein (hsCRP) and
fibrinogen (
p
<
0.05)
in the African women compared with their
Caucasian counterparts (Table 3).
Similarly, Schutte
et al
.
32
investigated the differences in blood
pressure (BP) for age- andBMI-matchedAfricanwomen and their
Caucasian counterparts. Their study sought to determine whether
obesity was strongly connected to reported cardiovascular risk
markers in black African women. The results revealed that
although the mean BMI and age were matched between the two
groups, the Caucasians were significantly taller (1.68
±
0.07
vs
1.59
±
0.06
m;
p
<
0.01)
and heavier (80.7
±
21.0
vs 70.6
±
15.8
kg;
p
<
0.01).
Moreover, the African women had higher systolic
blood pressure than the Caucasians (128
±
20.3
and 119
±
12.1
mmHg, respectively) (
p
<
0.01)
with higher peripheral
vascular resistance.
Comparison of the effects of obesity on blood
pressure and doctor-diagnosed chronic diseases
Ibhazehiebo and colleagues’ case–control study reported
hypertension and blood pressure responses to graded exercise
in young obese and non-athletic Nigerian university students
(
Table 4).
36
By contrast, Asfaw’s study considered the impact
of obesity on the prevalence of chronic diseases (four doctor-
diagnosed chronic diseases) in South Africa and Senegal (Table
5).
2
Although these two studies were not comparable, both their
findings demonstrated a greater incidence of disease in the obese
than in their non-obese counterparts.
Results from Ibhazehiebo
et al
.
36
revealed a significant (
p
<
0.001)
increase in the incidence of hypertension among the
TABLE 3. COMPARISON OF CARDIOVASCULAR PARAMETERSAND INFLAMMATORY BIO-MARKERSACROSS ETHNIC GROUPS
Author
Control vs
experimental groups
Outcome measured (cardiovascular parameters and inflammatory bio-markers)
SBP (mmHg)
DBP (mmHg)
Leptin (ng/ml)
hsCRP (mg/l)
Fibrinogen (g/l)
Schutte
et al
.
28
OW/OB NT (
n
= 46)
OW/OB HT (
n
= 17)
124
± 1.9
156
± 1.9
a
77
± 1.2
91
± 2.1
a
73.6
± 3.4
69.8
± 5.7
–
–
–
–
Schutte
et al
.
26
Caucasians (
n
= 115)
Africans (
n
= 102)
125 (123; 128)
130 (126; 134)
a
72.5 (70.8; 74.1)
77.7 (75.6; 79.8)
b
51.4 (45.3; 57.5)
57.6 (51.6; 63.6)
a
3.27 (2.56; 3.98)
4.59 (3.17; 6.01)
3.05 (2.95; 3.15)
3.89 (3.67; 4.10)
b
Schutte
et al.
23
Caucasians (
n
= 115)
Africans (
n
= 102)
119
± 12.1
128
± 20.3
a
74.3
±8.78
78.5
±12.0
51.4
± 32.9
57.6
± 30. 2
a
3.27
± 3.84
4.59
± 7.20
3.05
± 0.56
3.89
± 1.08
a
All three studies took place in South Africa. OW/OB NT, overweight/obese normotensive; HT, hypertensive; SBP, systolic blood pressure; DBP, diastolic
blood pressure; hsCRP, high-sensitivity C-reactive protein.
Schutte
et al
. 2005
results report mean ± (standard deviation); Schutte
et al.
2006
values are mean ± (95% confidence intervals); Schutte
et al.
2008
values
are mean ± (standard deviation).
a
p
< 0.05 when comparing the control versus the experimental group
b
p
< 0.001 when comparing the control versus the experimental group
