High Rates of Undiagnosed Target Organ Damage Among Adults with Elevated Blood Pressure or Diabetes Mellitus in a Community-Based Survey in Lesotho.
Arterial hypertension
Diabetes mellitus
Left ventricular hypertrophy
Lesotho
Non-communicable chronic diseases
Peripheral neuropathy
Renal impairment
Retinopathy
Journal
Journal of epidemiology and global health
ISSN: 2210-6014
Titre abrégé: J Epidemiol Glob Health
Pays: Switzerland
ID NLM: 101592084
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
18
05
2023
accepted:
21
09
2023
medline:
30
11
2023
pubmed:
26
10
2023
entrez:
26
10
2023
Statut:
ppublish
Résumé
Prevalence of elevated blood pressure (BP) and diabetes mellitus (DM) is increasing in sub-Saharan Africa. Data on target organ damage such as retinopathy, left ventricular hypertrophy (LVH), renal impairment and peripheral neuropathy (PN) among persons with elevated BP and/or DM in sub-Saharan Africa remain scarce. To determine at community-level the prevalence of retinopathy, LVH, renal impairment, and PN among adults with elevated BP and/or DM, and assess the association of elevated BP and/or DM with target organ damage in Lesotho. During a household-based survey, a sub-sample of adults with elevated BP (≥ 140/90 mmHg) and/or DM (glycosylated hemoglobin ≥ 6.5%), as well as comparators (BP < 140/90 mmHg, HbA1c < 6.5%) were screened for retinopathy, LVH, renal impairment, and PN. We used multivariable logistic regression for inferential analysis. Out of 6108 participants screened during the survey, 420 with elevated BP only, 80 with DM only, 61 with elevated BP and DM, and 360 comparators were assessed for target organ damage. Among those with elevated BP, and among those with DM with or without elevated BP, prevalence of retinopathy was 34.6% (89/257) and 14.4% (15/104); renal impairment was 45.0% (156/347) and 42.4% (56/132), respectively. Among those with elevated BP, 2.3% (7/300) and 65.7% (224/341) had LVH and left ventricular concentric remodeling, respectively. PN, only assessed among those with DM, was present in 32.6% (42/129). Elevated BP was associated with increased odds of retinopathy (aOR, 19.13; 95% CI, 8.52-42.94; P < 0.001) and renal impairment (aOR, 1.80; 95% CI, 1.27-2.55; P = 0.001). Presence of both elevated BP and DM was associated with an increased odds of retinopathy (aOR, 16.30; 95%CI, 5.69-46.68; P < 0.001), renal impairment (aOR, 2.55; 95% CI, 1.35-4.81; P = 0.004), and PN (aOR, 2.13; 95% CI, 1.04-4.38; P = 0.040). We found a high prevalence of undiagnosed target organ damage among adults with elevated BP and/or DM during community-based screening. These findings emphasize the importance of regular prevention and screening activities in this setting.
Identifiants
pubmed: 37883005
doi: 10.1007/s44197-023-00158-5
pii: 10.1007/s44197-023-00158-5
pmc: PMC10686968
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
857-869Informations de copyright
© 2023. The Author(s).
Références
Clin Nephrol. 2010 Nov;74 Suppl 1:S51-6
pubmed: 20979964
Ultrasound J. 2022 Jul 7;14(1):27
pubmed: 35796842
High Blood Press Cardiovasc Prev. 2018 Sep;25(3):283-289
pubmed: 29956112
PLoS One. 2009 Aug 18;4(8):e6672
pubmed: 19701488
J Hypertens. 2014 Mar;32(3):487-94
pubmed: 24299916
PLoS One. 2018 Oct 31;13(10):e0205326
pubmed: 30379902
Nat Rev Cardiol. 2021 Nov;18(11):785-802
pubmed: 34050340
Int J Hypertens. 2017;2017:2637051
pubmed: 28695006
J Clin Med. 2022 Dec 28;12(1):
pubmed: 36615030
Nat Rev Nephrol. 2020 Apr;16(4):223-237
pubmed: 32024986
Circulation. 2005 Aug 16;112(7):984-91
pubmed: 16103253
J Am Heart Assoc. 2020 Dec 15;9(24):e017492
pubmed: 33283559
Eur Heart J. 2007 Jun;28(12):1462-536
pubmed: 17562668
Niger J Clin Pract. 2011 Oct-Dec;14(4):436-9
pubmed: 22248945
Diabet Med. 2002 May;19(5):400-5
pubmed: 12027928
Lancet. 2017 Sep 16;390(10100):1151-1210
pubmed: 28919116
Trop Med Int Health. 2020 Oct;25(10):1214-1225
pubmed: 33400338
JAMA Netw Open. 2019 Sep 4;2(9):e1911891
pubmed: 31539072
Am J Hypertens. 2008 Aug;21(8):896-902
pubmed: 18551103
Lancet Glob Health. 2016 May;4(5):e307-19
pubmed: 27102194
PLoS Med. 2007 Oct 16;4(10):e296
pubmed: 17941714
Int Health. 2023 Aug 18;:
pubmed: 37593886
Cardiovasc Diabetol. 2006 Nov 03;5:23
pubmed: 17083718
Nephron. 2001 Mar;87(3):223-30
pubmed: 11287757
J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
pubmed: 16376782
Clin Exp Nephrol. 2021 Jul;25(7):718-726
pubmed: 33651200
Diabetes Res Clin Pract. 2018 Apr;138:271-281
pubmed: 29496507
PLOS Glob Public Health. 2022 Jun 15;2(6):e0000599
pubmed: 36962416
JACC Cardiovasc Imaging. 2021 May;14(5):1038-1052
pubmed: 32828781
Eye (Lond). 2022 May;36(Suppl 1):1-3
pubmed: 35590048
PLoS One. 2015 Apr 17;10(4):e0122433
pubmed: 25886375
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Nat Commun. 2022 Nov 9;13(1):6776
pubmed: 36351912
Diabetes Res Clin Pract. 2022 Jan;183:109119
pubmed: 34879977
Circulation. 1977 Apr;55(4):613-8
pubmed: 138494
Diabet Med. 2014 Dec;31(12):1643-50
pubmed: 24823871
Cardiovasc J Afr. 2012 Aug;23(7):379-84
pubmed: 22914995
J Diabetes Res. 2021 Feb 04;2021:5304124
pubmed: 33628833
J Indian Med Assoc. 2013 Apr;111(4):245-7
pubmed: 24475555
Clin Chim Acta. 2009 Jan;399(1-2):54-8
pubmed: 18834870
Kidney Int. 2013 Sep;84(3):622-3
pubmed: 23989362
World J Diabetes. 2013 Dec 15;4(6):290-4
pubmed: 24379919
Lancet Glob Health. 2014 Mar;2(3):e174-81
pubmed: 25102850
Cardiovasc Diabetol. 2017 May 12;16(1):64
pubmed: 28499385
Am J Cardiol. 1986 Feb 15;57(6):450-8
pubmed: 2936235
Blood Press Monit. 2008 Oct;13(5):299-303
pubmed: 18799957
Lancet Glob Health. 2019 Dec;7(12):e1632-e1643
pubmed: 31708144
Diabetes Technol Ther. 2011 Dec;13(12):1229-33
pubmed: 21864017
BMC Fam Pract. 2011 Jul 14;12:75
pubmed: 21756310
J Am Coll Cardiol. 2020 Dec 22;76(25):2982-3021
pubmed: 33309175