Dyslipidemias and cardiovascular risk scores in urban and rural populations in north-western Tanzania and southern Uganda


Autoři: Bazil Kavishe aff001;  Fiona Vanobberghen aff001;  David Katende aff003;  Saidi Kapiga aff001;  Paula Munderi aff003;  Kathy Baisley aff002;  Samuel Biraro aff003;  Neema Mosha aff001;  Gerald Mutungi aff004;  Janneth Mghamba aff005;  Peter Hughes aff003;  Liam Smeeth aff002;  Heiner Grosskurth aff001;  Robert Peck aff001
Působiště autorů: Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania aff001;  MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom aff002;  Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda aff003;  Ministry of Health, Kampala, Uganda aff004;  Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania aff005;  Weill Bugando School of Medicine, Mwanza, Tanzania aff006;  Weill Cornell Medical College, New York, NY, United States of America aff007
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223189

Souhrn

Background

Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.

Methods

We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.

Results

One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32–45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as “low risk”. Among older adults (>55 years), 30% were classified as “high” or “very high” risk.

Conclusions

Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed.

Klíčová slova:

Cholesterol – Lipids – Obesity – Rural areas – Tanzania – Uganda – Apolipoproteins


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2019 Číslo 12