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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 3, May/June 2017
150
AFRICA
including hypercholesterolaemia, increased WC, overweight and
obesity, and excessive alcohol consumption, was not significantly
different between the participants with and without diabetes.
Details of the risk factors according to presence or absence of
diabetes are shown in Table 4.
The overall prevalence of the MS, impaired fasting glucose
levels (IFG) and diabetes mellitus was 39.4, 9.3 and 15.7%,
respectively. Detailed prevalences of the MS, IFG and diabetes
according to urban or rural and hypertensive status, gender and
country are presented in Fig. 1. The highest prevalence of the
MS was reported in Nigeria (62.1%), then Cameroon (45.2%),
DRC (31.9%), and the lowest in Madagascar (27.7%).
IFG was most prevalent in Cameroon (15.3%), followed by
Madagascar (10.4%), DRC (8.3%) and Nigeria (4.0%). Nigeria
had the highest prevalence of diabetes (25.0%), then Cameroon
(15.6%), DRC (15.0%) and finally Madagascar (8.7%). Both the
MS and IFG were more prevalent in hypertensive patients than
in non-hypertensive subjects (47.8 vs 8.3% and 10.1 vs 6.2%,
respectively).
Comparing gender, the MS was more prevalent in females
(44.7 vs 32.1%), but incidence of IFG and diabetes was higher
in males (13.6 and 17.2%) compared to females (6.2 and 12.7%),
respectively. With regard to urban and rural status, the MS and
diabetes were more prevalent in semi-urban dwellers (57 and
24.1%), opposed to urban dwellers (34.3 and 12.3%, respectively).
Discussion
In this self-selected group of participant in a hospital-based
study of cardiometabolic risk factors among adults in four
SSA countries, we found a high prevalence of the MS, IFG
and diabetes mellitus in all countries. In spite of the differences
observed between countries, which may reflect differences in
healthcare access and resources, and possibly selection bias,
these findings clearly signify the rapid growth of cardiovascular
risk factors in a region of the world that has traditionally been
known as the hotspot of nutritional and infectious diseases. This
study is therefore relevant for understanding the epidemiology of
cardiovascular and metabolic risk profiles of adults in the region,
a pivotal step in the control of the incidence of CVDs.
The overall prevalence of the MS in our study population
was 39.4% and ranged from 62.1% in Nigeria to 27.7% in
Table 2. Prevalence of selected risk factors across participating countries
Risk factor
Cameroon
n
(%)
Nigeria
n
(%)
DRC
n
(%)
Madagas-
car
n
(%)
Total
n
(%)
p
-value
Hypertension (
n
=
844)
Yes
141 (91.5) 141 (66.8) 237 (99.1) 108 (45.0) 630 (74.1) 0.000
No
13 (8.5) 70 (33.2) 02 (0.9) 132 (55.0) 220 (25.9)
Diabetes (
n
=
839)
Yes
24 (15.6) 51 (24.8) 36 (15.0) 21 (8.7) 132 (15.7) 0.000
No
130 (84.4) 154 (75.2) 204 (85.0) 219 (91.3) 707 (84.3)
Alcohol consumption (
n
=
309)
Low–moderate 71 (63.4) 03 (100.0) 98 (79.0) 58 (82.8) 230 (74.4) 0.007
Excessive
41 (36.6) 00 (0.0) 26 (21.0) 12 (17.2) 79 (25.6)
Smoking (
n
=
844)
Current
10 (6.5) 04 (1.8) 11 (4.6) 48 (20.0) 73 (8.6) 0.000
Former
10 (6.5) 18 (8.5) 15 (6.3) 31 (12.9) 74 (8.7)
Never
133 (87.0) 190 (89.7) 213 (89.1) 161 (67.1) 697 (82.7)
Obesity (
n
=
844)
Normal
28 (18.2) 53 (25.1) 64 (26.7) 122 (50.8) 267 (31.6)
Overweight
45 (29.2) 60 (28.4) 76 (31.6) 94 (39.2) 275 (32.6) 0.000
Obese
69 (44.8) 85 (40.3) 88 (36.7) 24 (10.0) 266 (31.5)
Morbidly obese 12 (8.8) 13 (6.2) 11 (5.0) 00 (0.0) 36 (4.3)
p
-values
=
comparison of variables across countries.
Table 3. Risk factors according to hypertension
status in the study participants
Variable
Hyper-
tensives
n
(%)
Non-
hyper-
tensives
n
(%)
Total
(
n
=
844)
n
(%)
p
-value
Tobacco smoking (
n
=
844)
Current
42 (6.7)
31 (14.1)
73 (8.6)
0.002
Former
52 (8.3)
22 (10.0)
74 (8.8)
Never
530 (85.0) 167 (75.9) 697 (82.6)
Alcohol consumption (
n
=
309)
Low to moderate
195 (73.6) 35 (79.5) 230 (74.4) 0.460
Excessive
70 (26.4) 09 (20.5) 79 (25.6)
Obesity (
n
=
844)
Normal
152 (24.3) 115 (52.7) 267 (31.5)
Overweight
208 (33.2) 67 (30.5) 275 (32.5) 0.000
Obese
232 (37.1) 34 (15.9) 266 (31.5)
Morbidly obese
34 (5.4)
02 (0.9)
36 (4.5)
Waist circumference (
n
=
486)
Men (
>
102 cm)
76 (31.9) 86 (34.7) 162 (33.3) 0.564
Women (
>
88 cm)
189 (79.4) 168 (67.7) 357 (73.4) 0.004
Diabetes mellitus (
n
=
839)
Yes
110 (17.7) 22 (10.0) 132 (15.7) 0.007
No
509 (82.3) 198 (90.0) 707 (84.3)
Hypercholesterolaemia (
n
=
811)
Yes
102 (25.8) 75 (18.0) 177 (21.8) 0.008
No
293 (74.2) 341 (82.0) 634 (78.2)
p
-value
=
comparison of variables between the two groups.
Table 4. Risk factors according to diabetes
status in the study participants
Variable
Diabetics
n
(%)
Non-
diabetics
n
(%)
Total
n
(%)
p
-value
Tobacco smoking (
n
=
834)
Current
07 (5.3)
66 (9.4)
73 (10.6)
Former
19 (14.4)
54 (7.9)
73 (10.6)
0.019
Never
106 (80.3) 582 (82.7) 688 (78.8)
Alcohol consumption (
n
=
308)
Low to moderate
30 (69.7) 199 (75.0) 229 (75.1) 0.456
Excessive
13 (30.2) 66 (25.0) 79 (24.9)
Obesity (
n
=
839)
Normal
37 (28.0) 228 (32.2) 265 (31.6)
Overweight
42 (31.8) 228 (32.2) 270 (32.2) 0.462
Obese
44 (33.3) 222 (31.6) 266 (31.7)
Morbidly obese
09 (6.9)
29 (4.0)
38 (4.5)
Waist circumference
Men (
>
102 cm) (
n
=
359)
10 (29.4) 85 (26.1) 95 (26.4)
0.685
Women (
>
88 cm) (
n
=
478)
29 (76.3) 319 (72.5) 348 (72.8) 0.706
Hypertension (
n
=
839)
Yes
110 (83.3) 509 (71.9) 619 (73.7) 0.007
No
22 (16.7) 198 (28.1) 220 (26.3)
Hypercholesterolaemia (
n
=
809)
Yes
15 (22.1) 161 (21.7) 176 (21.8) 0.949
No
53 (77.9) 580 (78.3) 633 (78.2)
Diabetics
=
participants with diabetes mellitus; non-diabetics
=
participants
without diabetes mellitus;
p
-values
=
comparison of variables between both
groups.