A prevalence of cardiometabolic risk factors among a rural Yoruba south-western Nigerian population: a population-based survey.

BACKGROUND: It has been hypothesised that rural sub-Saharan Africa is at an early stage of epidemiological transition from communicable to non-communicable diseases (NCD). Limited information exists about the prevalence of cardiometabolic risk factors and the burden of cardiovascular disease (CVD) in the adult Nigerian population, especially in the rural setting.

OBJECTIVES: The aim of this study was to assess and describe the prevalence of several cardiometabolic risk factors in the sub-Saharan adult population of a rural Yoruba community, living in south-western Nigeria.

METHODS: The study was a descriptive, cross-sectional, random-sample survey. Participants were visited at home by trained nurses and community health extension workers (CHEW) who administered a questionnaire, took the relevant history, carried out clinical examinations and measurements and took samples for laboratory tests. They were supervised by primary healthcare physicians serving the community. The variables recorded comprised clinical history, CVD risk factors including blood pressure (BP), body mass index (BMI), waist circumference, blood sugar and serum lipid levels, cigarette use, and dietary habits. The participants included 2 000 healthy adults aged 18 to 64 years who had been living in the area for more than three years.

RESULTS: The average age was 42.1 +/- 21.6, with 43.7% (873) being males and 56.3% (1127) females; 20.8% were hypertensive with BP > or = 140/90 mmHg, 42.3% of the men and 36.8% of the women had BP > or = 130/85 mmHg; 2.5% had diabetes, 1.9% had hypertriglycerideaemia, 43.1% had low HDL-C, 3.9% had general obesity, 14.7% had abdominal obesity, 3.2% were physically inactive, and 1.7% smoked cigarettes. Overall, 12.9% of the subjects were found to have at least one CVD risk factor. Using the Adult Treatment Panel (ATP) III criteria, 2.1% of men and 2.7% of women in the study population had at least three of the criteria, the commonest being HDL-C < 40 mg/dl in men or < 50 mg/dl in women, followed by BP >or = 130/85 mmHg, then waist circumference > 88 cm in women or > 102 cm in men, followed by blood glucose > or = 110 mg/dl.

CONCLUSION: The results obtained from this study strongly suggest a high prevalence of cardiometabolic risk factors in this rural population and that the epidemiological transition is not restricted to the urban population. This serves as a wake-up call for action in the planning of health services for the management of CVD and other chronic NCDs.