Renin-angiotensin system: biochemistry and mechanisms of action.

OBJECTIVES: This study was undertaken to describe the distribution of blood pressures, hypertension prevalence, and associated risk factors among seven populations of West African origin. METHODS: The rates of hypertension in West Africa (Nigeria and Cameroon), the Caribbean (Jamaica, St. Lucia, Barbados), and the United States (metropolitan Chicago, Illinois) were compared on the basis of a highly standardized collaborative protocol. After researchers were given central training in survey methods, population-based samples of 800 to 2500 adults over the age of 25 were examined in seven sites, yielding a total sample of 10014. RESULTS: A consistent gradient of hypertension prevalence was observed, rising from 16% in West Africa to 26% in the Caribbean and 33% in the United States. Mean blood pressures were similar among persons aged 25 to 34, while the increase in hypertension prevalence with age was twice as steep in the United States as in Africa. Environmental factors, most notably obesity and the intak...

The prevalence of hypertension in seven populations of west African origin.

https://web.media.mit.edu/~raskar/Eye/Wong_Retinal%20Microvascular%20Review_Survey_2001-1.pdf

Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality.

Background— Hypertension in sub-Saharan Africa is a widespread problem of immense economic importance because of its high prevalence in urban areas, its frequent underdiagnosis, and the severity of its complications. Methods and Results— We searched PubMed and relevant journals for words in the title of this article. Among the major problems in making headway toward better detection and treatment are the limited resources of many African countries. Relatively recent environmental changes seem to be adverse. Mass migration from rural to periurban and urban areas probably accounts, at least in part, for the high incidence of hypertension in urban black Africans. In the remaining semirural areas, inroads in lifestyle changes associated with “civilization” may explain the apparently rising prevalence of hypertension. Overall, significant segments of the African population are still afflicted by severe poverty, famine, and civil strife, making the overall prevalence of hypertension difficult to determine. Blac...

Hypertension in Sub-Saharan African Populations

The association of socioeconomic status (SES) with morbidity and mortality is a ubiquitous finding in the health literature. One of the principal challenges for biobehavioral researchers is understanding the mechanisms that link SES with health outcomes. This article highlights possible pathways by which SES may influence health. It also provides a discussion of sociodemographic and geographical modifiers of the SES-health relationship and offers several potentially fruitful directions for future research.

Toward understanding the association of socioeconomic status and health: a new challenge for the biopsychosocial approach.

It has been suggested that the prevalence of coronary artery disease (CAD) is steadily increasing in sub-Saharan Africa. To address this issue, we conducted a Medline search of English language articles on cardiovascular diseases-and specifically CAD in Africa- from 1966 to 1997. The prevalence of CAD and related complications is relatively low in most regions in Africa compared to that obtained in the economically developed countries, although the situation is rapidly changing due to trends in urbanization, changes in lifestyle, acquisition of technology and the increasing numbers of tertiary care institutions. There are variations in reported prevalence rates within the different regions, but there is an upward trend in all the regions of the sub-Saharan Africa. This trend is believed to be related to the increasing frequencies of CAD risk factors in the subcontinent.

Trends in Coronary Artery Disease and Associated Risk Factors in sub-Saharan Africans

World epidemiology of hypertension in blacks.

An epidemiological survey of blood pressure was carried out among men employed at a single factory in Ibadan, Nigeria. All available employees participated, with only four persons excluded at the time of analysis for missing data. Hypertension was uncommon (blood pressure greater than or equal to 160/95 = 8%) and little rise in mean blood pressure was observed with age. Obesity was likewise uncommon, although body mass index was related to blood pressure (r = 0.22; P less than 0.01). Contrary to reports from Western industrialised countries, education was found to have a significant positive association with blood pressure, and this finding was independent of age, body mass index, pulse, and alcohol consumption. The process of modernisation is associated with rising blood pressure in West Africa at the present time, but the absolute risk remains low.

Akinkugbe Oo

Papers

Trends in Coronary Artery Disease and Associated Risk Factors in sub-Saharan Africans

World epidemiology of hypertension in blacks.

Blood pressure and educational level among factory workers in Ibadan, Nigeria.

The rarity of hypertensive retinopathy in the African

Pressor effects of angiotensin infusions into different vascular beds in the rabbit.