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RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
18
VOLUME 15 NUMBER 1 • JULY 2018
Discussion
The prevalence of hypertension among participants in the range of
15 to 64 years old was 18.0%. This value rose to 26.6% among
participants aged 25 to 64 years, which is slightly higher than
those previously described for Angola over the last eight years,
14-15
particularly a study conducted in the same region in 2010,
16
and the
WHO age-standardised (25 to 64 years old) estimated hypertension
prevalence for 2014 in Angola of 23.9% (95% CI: 16.3–31.1).
1
More recently, a cross-sectional study conducted in Uganda,
South Africa, Tanzania and Nigeria encountered an overall age-
standardised prevalence of hypertension of 25.9%.
24
The estimated 9.2% prevalence of diabetes (9.8% in urban
and 6.8% in rural areas) was higher than previous reports from
Angola of 5.7% among an urban population (aged 20 to 72 years)
in 2010,
15
and 2.8% for a rural community (aged 30 to 69 years)
in 2009.
17
The value of 9.8% estimated in individuals older than
18 years is in the middle range of prevalence levels encountered
in STEPS surveys, with values from 3.0% in Benin to 22.5% in
Niger.
25,26
This value also falls within the confidence intervals of the
WHO estimate of 12.1% (95% CI: 5.6–18.9) for increased blood
glucose levels in those over 18 years in Angola for 2014.
1
This rise in diabetes is aligned with the global tendency for this
disease, which has increased faster in LMIC than in highincome
countries since 1980.
27
Since the end of the Angolan civil war in
2002, the population has been increasing and ageing. This, together
with changes in food habits and the urbanisation process, may have
led to the increased prevalence of diabetes in this region.
The prevalence of hypercholesterolaemia (5.3% among
participants 25 and 64 years old) in this study was lower than
that found in a previous study in Luanda among an older urban
population.
15
However, this value falls within a wide range of values
from several STEPS surveys measuring the prevalence of total
cholesterol, from 2.1% in Mozambique to 26.0% in Tanzania.
25,26
This prevalence may also be tied to the ageing population and
changes in dietary habits that most African countries are currently
facing.
28
There is a lack of solid knowledge regarding the prevalence
levels of hypercholesterolaemia in Africa, mainly owing to the
difficulties in determining values of blood cholesterol in African
communities because of the high cost of laboratory tests. This
situation presents a challenge when comparing research results.
As described in other studies worldwide, the clustering of risk
factors helps to explain the known impacts of age, education
Table 5.
Prevalence of hypercholesterolaemia and relationship with other factors by gender (Caxito, 2016)
All Participants
Female
Male
(
n
= 1 781)
(
n
= 978)
(
n
= 803)
Prevalence
Prevalence
Adjusted OR
a, b
Prevalence
Adjusted OR
a, b
Associated factor
% (95% CI)*
% (95% CI)*
(95% CI)*
% (95% CI)*
(95% CI)*
Total
4.0 (3.2–5.0)
5.6 (4.3–7.2)
2.3 (1.3–4.0)
2.0 (1.2–3.2)
1
Age (years)
15–24
0.7 (0.3–1.8)
1.1 (0.4–3.2)
1
0.3 (0.1–1.9)
1
25–34
2.5 (1.4–4.3)
2.8 (1.4–5.7)
2.6 (0.6–10.8)
2.5 (1.1–5.3)
5.0 (0.8–31.6)
35–44
3.6 (2.0–6.4)
5.4 (2.9–9.6)
5.2 (1.4–20.0)
0.9 (0.2–4.7)
2.1 (0.2–24.4)
45–54
9.4 (6.3–13.7)
10.8 (6.9–16.7)
11.9 (3.30–42.7)
5.7 (2.5–12.8)
13.7 (2.1–88.1)
55–64
11.4 (7.6–16.8)
15.4 (10.0–23.0)
17.2 (4.8–61.9)
4.5 (1.6–12.5)
9.0 (1.2–69.5)
Residence
Urban
3.9 (3.0–5.0)
5.6 (4.2–7.4)
–
1.8 (1.0–3.2)
–
Rural
4.2 (2.5–7.0)
5.3 (2.8–9.8)
–
3.5 (1.5–7.9)
–
Education (years completed)
None
10.8 (7.0–16.2)
10.7 (6.9–16.3)
–
11.1 (2.0–43.5)
–
1–4
5.7 (3.9–8.3)
6.4 (4.3–9.5)
–
2.5 (0.7–8.8)
–
5–9
2.6 (1.7–4.1)
3.3 (1.9–5.9)
–
2.0 (1.0–3.9)
–
>10
2.0 (1.0–3.7)
2.3 (0.8–6.5)
–
1.9 (0.9–4.0)
–
BMI class (kg/m
2
)
Underweight (< 18.5)
2.3 (0.9–5.7)
3.2 (1.1–9.1)
–
1.2 (0.2–6.5)
–
Normal (18.5–24.9)
3.5 (2.6–4.7)
5.1 (3.6–7.3)
–
1.9 (1.1–3.3)
–
Overweight (25.0–29.9)
5.3 (3.3–8.3)
6.0 (3.6–10.1)
–
3.8 (1.5–9.3)
–
Obese (≥ 30)
6.7 (3.5–12.2)
8.6 (4.6–15.5)
–
–
a
–
Abdominal obesity
No
2.4 (1.7–3.4)
3.5 (2.3–5.2)
–
1.5 (0.8–2.7)
–
Yes
8.1 (6.0–10.9)
8.8 (6.4–12.2)
–
5.9 (2.9–11.6)
–
Tobacco smoking
Non-current
3.7 (2.9–4.8)
5.1 (3.9–6.7)
–
2.0 (1.2–3.3)
–
Current
6.4 (3.1–12.6)
17.9 (7.9–35.6)
–
2.5 (0.7–8.6)
–
Alcohol consumption
No consumption
4.3 (3.2–5.6)
5.7 (4.2–7.7)
–
2.2 (1.2–4.1)
–
Occasional (< 3 days per week)
2.7 (1.4–5.0)
4.6 (2.5–8.6)
–
–
c
–
Frequent (≥ 3 days per week)
3.9 (2.2–6.7)
5.6 (2.6–11.6)
–
2.5 (1.1–5.7)
–
*Post-stratification weights used as described in the methods section.
a
Adjusted for age (categorical: 15–23, 25–34, 35–44, 45–54, and 55–64).
b
Only variables with relations with statistical significance shown.
c
No cases in this category.