Multiple cardiovascular disease risk factors in rural Kenya: evidence from a health and demographic surveillance system using the WHO STEP-wise approach to chronic disease risk factor surveillance

Abstract

Background: To describe the distribution of obesity, hypertension, dysglycaemia and dyslipidaemia (which are risk factors for cardiovascular disease) using a Health and Demographic Surveillance System (HDSS) site in western Kenya. Design: Descriptive cross-sectional population survey. Setting: Webuye Health and Demographic Surveillance System (HDSS) site in western Kenya. Participants: Persons aged 18 years and above. Interventions: Body mass index (BMI), blood pressure levels, fasting blood sugar and fasting lipid profile. Main outcome measures: Cardiovascular disease risk factors in a rural Kenyan population. Results: The mean age was 44 years and 57% were female. The distribution of BMI was: mean = 20 kg/m 2 (range 24–36); 18.5– 25 kg/m 2 = 57%;< 18.5 kg/m 2 = 35%. Distribution of blood pressure levels: Normal in 40%; pre-hypertensive 40%; hypertension stages 1 and 2 was 13% and 8% respectively. Nearly all affected were unaware of their elevated blood pressure. Impaired fasting glucose was found in 4.5% while 6.5% were diabetic. Fasting serum lipid profile was normal in over 85% of the population. Conclusions: This rural population had low BMI with 92% having a BMI below 25 kg/m 2 and about 20% of them being in hypertension stage 1 and 2 and nearly all unaware of it. Despite the majority having below normal BMI, it was noted that rates of hypertension increased with increasing BMI. There was significant presence of dysglycaemia but not dyslipidaemia.