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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 3, May/June 2021
162
AFRICA
Raised blood pressure and cholesterol
In 2015 the percentage of men and women with raised blood
pressure (BP) [systolic BP (SBP) ≥ 140 mmHg or diastolic BP
(DBP) ≥ 90 mmHg] was 25.1 and 22.6%, respectively.
8
Country
data for raised total cholesterol level (≥ 5.0 mmol/l) in 2015 was
7.3% for men and 12.8% for women.
8
The percentage of DALYs
lost because of hypertension was 4.0%,
11
whereas mortality rate
caused by hypertensive heart disease was 1.7% in 2019,
7
which
was lower than the global figure of 2.05% (Table 1).
Physical activity
Inastudyamongadolescents,86.8%werefoundtobeinsufficiently
active [< 60 minutes of moderate to vigorous-intensity physical
activity (PA) daily].
12
In 2015, the age-standardised estimate
for adults who were insufficiently active (< 150 minutes of
moderate-intensity PA per week, or < 75 minutes of vigorous-
intensity PA per week) was 6.5%, which was much lower than
that of the global data at 27.5% (Table 1).
8
Overweight and obesity
In 2015, adults aged 18 to 69 years had a prevalence of overweight
[body mass index (BMI) ≥ 25–< 30 kg/m
2
] and obesity (BMI ≥
30 kg/m
2
) that was 19 and 8.9%, respectively.
8
More women were
respectively overweight or obese (24.9, 13.7%) than men (13.2,
4.3%) (Table 1).
8
Diabetes
The percentage of the population aged between 18 and 69
years old, defined with a fasting glucose of ≥ 7.0 mmol/l or on
medication for raised blood glucose (age-standardised) in 2015,
was 1.5% for men and 2.3% for women.
8
In 2019, the prevalence
of age-adjusted (adults 20–79 years) diabetes was 3.1%,
13
which is
lower than the global prevalence of 9.3% (Table 1).
13
Part C: Clinical practice and guidelines
Health system capacity and guidelines for NCD
risk factors
Kenya had an average of 1.6 physicians and 10 nurses per 10 000
of the population in 2018/19. The number of hospital beds
was 13.3 and reported as ‘The national average in-patient bed
density’ by the health facility assessment in 2018/19.
14
In 2018, a locally relevant clinical tool was developed to assess
CVD risk, which included locally relevant clinical guidelines for
CVD prevention and detecting and managing AF.
15
Guidelines
for managing pharyngitis were reported in 2009.
16
Locally
relevant clinical guidelines for the management of acute
rheumatic fever (ARF) and RHD have also been implemented,
as have those for the treatment of tobacco dependence and
its detection.
15
However, no clinical registers of people with a
history of ARF and RHD were available. In 2010, national
clinical guidelines for managing diabetes were developed based
on local and international best practices and updated in 2018.
17,18
Table 1. Cardiovascular disease indicators for Kenya
Indicators
Male
Female
Total
Year
Status of the national CVD epidemic
Premature CVD mortality (30–70 years old) (% deaths)
-
-
8
2012
Total CVD mortality (% of deaths)
12.9
15.0
13.8 (31.8)
7
2019
Total RHD mortality (% of deaths)
0.11
0.17
0.14 (.5)
7
2019
DALYs attributable to CVD (%)
6.5
6.04
6.29 (14.7)
7
2019
AF and atrial flutter (%)
0.1
0.07
0.09 (.5)
7
2019
Prevalence of RHD (%)
1.11
1.22
1.17 (.5)
7
2019
Tobacco and alcohol
Prevalence of adult tobacco use (≥ 15 years old) (%)
8
23 (36.1)
6
4.1 (6.8)
6
-
2015
Prevalence of youth (13–15-year-olds) tobacco use (%)
8
12.8 (18.4)
6
6.7 (8.3)
6
-
2013
Estimated direct (healthcare-related) cost of tobacco use in your population (current US$)
-
-
-
Proportion of premature CVD mortality attributable to tobacco (%)
-
-
2 (10)
7
2004
Recorded alcohol consumption per capita (≥ 15 years) (litres of pure alcohol) (three-year average)
1.7
2016-18
Raised blood pressure and cholesterol
Population (15–64 years old) with raised BP (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) (%)
8
25.1 (24.1)
6
22.6 (20.1)
6
-
2015
Population with raised TC (≥ 5.0 mmol/l) (%)
8
7.3
12.8
10.1 (38.9)
6
2015
DALYs attributable to hypertension (%)
4.05
3.95
4.0 (9.3)
7
2019
Mortality caused by hypertensive heart disease (% of deaths)
1.12
2.46
1.73 (2.05)
7
2019
Physical activity
Adolescents (11–17 years old) who are insufficiently active (< 60 minutes of moderate- to vigorous-
intensity PA daily) (%)
12
84.9
88.9
86.8 (80.7)
6
2015
Adults (age-standardised estimate) who are insufficiently active (< 150 minutes of moderate-intensity PA
per week, or < 75 minutes of vigorous-intensity PA per week) (%)
8
6.3
6.8
6.5 (27.5)
6
2015
Overweight and obesity
Adults (18−64 years old) who are overweight (BMI ≥ 25–< 30 kg/m
2
) (%)
8
13.2
24.9
19 (38.9)
6
2015
Prevalence of obesity (BMI ≥ 30 kg/m
2
) (adults 25−64 years old) (%)
8
4.3
13.7
8.9 (13.1)
6
2015
Diabetes
Defined population with fasting glucose ≥ 126 mg/dl (7.0 mmol/l) or on medication for raised blood
glucose (age-standardised) (%)
8
1.5 (9)
6
2.3 (8)
6
1.9
2015
Prevalence of diabetes (20−79 years old) (%)
-
-
3.1 (9.3)
13
2019
CVD, cardiovascular disease; RHD, rheumatic heart disease; DALYs, disability-adjusted life years; AF, atrial fibrillation; SBP, systolic blood pressure; DBP, diastolic
blood pressure; TC, total cholesterol; PA, physical activity; BMI, body mass index.
7
IHME global data exchange;
8
STEPS 2015;
6
WHO GHO data;
12
Guthold
et al
.;
13
IDF diabetes Atlas
.