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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 5, September/October 2016
322
AFRICA
Clustering of cardiovascular risk factors in semi-urban
communities in south-western Nigeria
R Oluyombo, PO Akinwusi, MA Olamoyegun, OE Ayodele, MB Fawale, OO Okunola, TO Olanrewaju,
A Akinsola
Abstract
Background:
In addition to poor socio-economic indices
and a high prevalence of infectious diseases, there have been
various reports of a rising prevalence of cardiovascular
diseases, with associated morbidity and mortality in develop-
ing countries. These factors co-exist, resulting in a synergy,
with serious complications, difficult-to-treat conditions and
fatal outcomes. Hence this study was conducted to determine
the clustering of cardiovascular disease risk factors and its
pattern in semi-urban communities in south-western Nigeria.
Methods:
This was a cross sectional study over seven months
in 11 semi-urban communities in south-western Nigeria.
Results:
The total number of participants was 1 285 but only
1 083, with 785 (65%) females, completed the data. Participants
were 18 years and older, and 51.2% were over 60 years. The
mean age was 55.12
±
19.85 years. There were 2.6% current
cigarette smokers, 22% drank alcohol and 12.2% added salt
at the table, while 2% had been told by their doctors they
had diabetes, and 23.6% had hypertension. The atherogenic
index of plasma was at a high-risk level of 11.1%. Elevated
total cholesterol and low-density lipoprotein cholesterol, and
low high-density lipoprotein cholesterol levels were seen in
5.7, 3.7 and 65.1%, respectively. Prevalence of hypertension
was 44.9%, diabetes was 5.2%, obesity with body mass index
(BMI)
>
30 kg/m
2
was 5.7%, and abdominal circumference
was 25.7%. Prevalence of clusters of two, three, and four
or more risk factors was 23.1, 15.5 and 8.4%, respectively.
Increasing age 2.94 (95% CI: 1.30–6.67), BMI 1.18 (95% CI:
1.02–1.37), fasting plasma glucose level 1.03 (95% CI: 1.00–
1.05), albuminuria 1.03 (95% CI: 1.00–1.05), systolic blood
pressure 1.07 (95% CI: 1.04–1.10), diastolic blood pressure
1.06 (95% CI: 1.00–1.11) and female gender 2.94 (95% CI:
1.30–6.67) showed increased odds of clustering of two or
more cardiovascular risk factors.
Conclusion:
Clustering of cardiovascular risk factors is preva-
lent in these communities. Patterns of clustering vary. This
calls for aggressive and targeted public health interventions to
prevent or reduce the burden of cardiovascular disease, as the
consequences could be detrimental to the country.
Keywords:
clustering, cardiovascular, risk factors
Submitted 20/12/14, accepted 8/3/16
Published online 10/6/16
Cardiovasc J Afr
2016;
27
: 322–327
www.cvja.co.zaDOI: 10.5830/CVJA-2016-024
Cardiovascular disease (CVD) is the leading cause of death
globally, accounting for 17.3 million deaths per year. This is
projected to increase to more than 23.6 million by 2030.
1,2
It
would be a crisis for developing countries to have to undergo
this additional burden, as they are already faced with a multiple
burden of other challenges, such as poor socio-economic indices,
high prevalence of infectious diseases,
3
and a trend towards high-
caloric nutrition and sedentary lifestyles.
4
An epidemic of CVD
would have a detrimental effect on their already weakened health
system.
In developing nations, unlike in developed countries, greater
proportions of younger people are affected. Eighty per cent of
deaths resulting from CVD occur between the ages of 30 and 70
years in developing countries.
5
This is in contrast to 14 and 12%
reported for the USA and UK, respectively.
6
This would lead to
depletion of the already insufficient workforce and a worsening
of the poor economic status in developing nations. Nearly half
of the annual output loss of US$ 500 billion is attributable to
CVD.
7
There have been reports of increased prevalence of CVD risk
factors in Nigeria, with hypertension, diabetes, hyperlipidaemia
and obesity as the leading modifiable causes.
8,9
Studies have
shown co-existence and interaction of these risk factors, causing
them to become difficult-to-treat conditions, and resulting in
serious complications and fatal outcomes.
10,11.
Findings from
south-western and southern Nigerian people show a trend
towards a high risk of developing major cardiovascular events
over a 10-year period, with a cardiovascular mortality of 33.5%
among individuals in the productive age group.
12,13
Nigeria is the
most populous country in Africa and has a population of 169
million, with over 50% living in rural communities.
3
Renal Unit, Department of Internal Medicine, Federal
Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
R Oluyombo, MD,
abuky2005@yahoo.co.ukCardiology Unit, College of Health Sciences, Osun State
University, Osogbo, Nigeria
PO Akinwusi, MD
Department of Internal Medicine, Ladoke Akintola
University of Technology Teaching Hospital, Ogbomoso,
Oyo State, Nigeria
MA Olamoyegun, MD
OE Ayodele, MD
Department of Internal Medicine, Obafemi Awolowo
University Teaching Hospitals, Ile-Ife, Osun State, Nigeria
MB Fawale, MD
OO Okunola, MD
A Akinsola, MD
Renal Division, Department of Medicine, University of
Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
TO Olanrewaju, MD