The African diaspora hypertensive load: An observation of hypertensive prevalence in Haiti, associated co-factors, and comparison with geographically diverse African diaspora populations with reference to latitude North of the equator

摘要

Background: The prevalence of hypertension in Haiti is suspected to be high, in accordance with an increasing global burden of hypertension and higher rates in African diaspora populations. Data on prevalence of hypertension in Haiti is sparse, and given the population's mono-ethnicity comparison with hypertension rates in both African and diaspora populations may explore the underlying disparity.;Methods: a prospective descriptive cross-sectional study of 684 adults randomly selected from attendees at a general community health clinic in Port-au-Prince, Haiti; utilizing standardized surveillance questionnaire and standardized collection of biophysical measurements.;Results: Crude prevalence of Hypertension is 50.9%. Age-specific prevalence rates of hypertension are significantly higher through all age groups 18-60 years, (18-39 yrs - 30.2%; 40-59yrs -- 65.9%) in the Haitian population when compared to pooled NHANES 2001-2008 subgroup of African American subjects, with less significant difference in ages greater than 60 years. Age -specific mean systolic blood pressures are significantly higher in both genders for ages 40 years and older {40-59 yrs -- 137mmHg (males), 134mmHg (females); ≥60yrs-145mmHg (male), 151mmHg (female)}with similar comparison. Age is the most significant associated co-factor with hypertension, but limited to age under 60 years. Hypertension was significantly associated with BMI in female subjects with waist circumference ≥88cm. The age-adjusted prevalence of hypertension across the African diaspora and in comparison with West African subjects increases with increasing latitude north of the equator. {latitude 0.28,20.2%; latitude 37.5, 59.1%}.Mean systolic blood pressure in male subjects in West Africa and across the African diaspora is higher than in male populations of the African diaspora in latitudes <30° North of the equator {latitude 5.5°, 134.4mmHg; latitude 18.5°,137mmHg}, {latitude 33°,118.4mmHg; latitude 46.8°, 124.3mmHg },however, both groups demonstrate increasing mean systolic blood pressure with increasing latitude north of the equator.;Conclusions: There is a high prevalence of hypertension in Haiti, particularly in younger adults. Standard associations of BMI, waist circumference and reduced physical activity with hypertension prevalence are not apparent in this population. There is an apparent geographical influence on hypertension prevalence and mean systolic blood pressure in African and African diaspora populations, which requires further explanation.