ABSTRACT
BACKGROUND: Hypertensives are screened for proteinuria largely to detect kidney involvement. In most reports from urban areas, the burden is considerable. We decided to see the scenario in a rural setting with the opportunity presented by our cardiovascular disease (CVD) survey of a rural area in North Central Nigeria. METHODOLOGY: In 2008 we surveyed a rural population in Mangu Local Government area of Plateau State for CVD risk factors using the protocol of the National survey of 1991; slightly modified. One in three subjects was sequentially randomized to have blood and urine examination. Blood tests included glucose, creatinine, uric acid, total and high density lipoprotein cholesterol. Blood pressures were also taken. RESULTS: Blood and urine tests were done on 282 subjects. Eight of them (2.84%) had proteinuria. Ninety-nine of the 282 (35.11%) were hypertensive. Seven out of the 99 hypertensives (7.07%) had proteinuria. Between those hypertensives (positive or negative for proteinuria), the following indices: glucose, HDL cholesterol, SBP and DBP differed significantly (p = 0.000, p = 0.015, p = 0.000, p = 0.000 respectively). CONCLUSION: Compared with rates in urban centres of Nigeria, our population recorded low proteinuria rates both for the whole population and the hypertensive segment. It therefore appears that proteinuria in hypertension is not only a reflection of severity and burden of hypertension, but has some relation with residence. Rural areas have lower constellation of CVD risk factor (due to different life style) and lower incidence of hypertension. Consequently, their proteinuria rates are low.
Subject(s)
Hypertension/complications , Proteinuria/complications , Adolescent , Adult , Aged , Aged, 80 and over , Blood Glucose , Blood Pressure , Cardiovascular Diseases/epidemiology , Cholesterol, HDL/blood , Cross-Sectional Studies , Female , Humans , Hypertension/epidemiology , Hypertension/metabolism , Life Style , Male , Middle Aged , Nigeria/epidemiology , Proteinuria/epidemiology , Proteinuria/metabolism , Rural Population/statistics & numerical data , Young AdultABSTRACT
BACKGROUND: Epidemiological transition is at various stages in different places. The true situation in sub-Saharan Africa (SSA) is largely unknown. Having studied this rural habitat 17 years ago, we returned there to study several cardiovascular disease (CVD) risk factors to see if any change had occurred. METHODS: The communities studied in 1991 as part of the national CVD survey were returned to in 2008 and re-studied descriptively in a cross-sectional manner. All adults 15 years and above, apart from demographic and personal data had blood pressure (BP) and some blood indices determined. RESULTS: Over the period, some changes occurred. The mean (SD) age increased from 34.1(16.9) to 45.5(18.2) years suggesting an ageing population. More people in 2008 than 1991 lived most of their last 5 years in the urban areas suggesting some influence of urbanisation. Significantly fewer people smoked and drank after 17 years. However mean (SD) of Body Mass Index rose [20.7(2.8) to 23.7(4.5) kg/m²], as well as SBP and DBP. Prevalence of hypertension rose from 7.4% to 20.9%. Both total and HDL cholesterol rose, although atherogenic index dropped. Mean (SD) blood sugar interestingly dropped from 5.0(2.9) to 4.6(1.0) mmol/l. CONCLUSION: Epidemiological transition is evident in this rural SSA habitat, and proactive steps to stem the tide and curb the consequences of CVD should be instituted.
