Dyslipidemias and cardiovascular risk scores in urban and rural populations in north-western Tanzania and southern Uganda
Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations o...
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Published in | PloS one Vol. 14; no. 12; p. e0223189 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Public Library of Science
06.12.2019
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Abstract | Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.
We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.
One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk.
Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. |
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AbstractList | Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda. We conducted a cross-sectional survey of randomly-selected, community-dwelling adults ([greater than or equal to]18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids. One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in 55 years), 30% were classified as "high" or "very high" risk. Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. Background Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda. Methods We conducted a cross-sectional survey of randomly-selected, community-dwelling adults ([greater than or equal to]18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids. Results One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in 55 years), 30% were classified as "high" or "very high" risk. Conclusions Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. Background Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda. Methods We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids. Results One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32–45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as “low risk”. Among older adults (>55 years), 30% were classified as “high” or “very high” risk. Conclusions Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. Background Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda. Methods We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids. Results One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32–45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as “low risk”. Among older adults (>55 years), 30% were classified as “high” or “very high” risk. Conclusions Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. BackgroundDyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.MethodsWe conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.ResultsOne-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk.ConclusionsDyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda. We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids. One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk. Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.BACKGROUNDDyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.We conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.METHODSWe conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.One-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk.RESULTSOne-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk.Dyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed.CONCLUSIONSDyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed. |
Audience | Academic |
Author | Peck, Robert Kapiga, Saidi Katende, David Kavishe, Bazil Vanobberghen, Fiona Biraro, Samuel Hughes, Peter Munderi, Paula Smeeth, Liam Baisley, Kathy Mutungi, Gerald Mosha, Neema Mghamba, Janneth Grosskurth, Heiner |
AuthorAffiliation | 7 Weill Cornell Medical College, New York, NY, United States of America University of the Witwatersrand, SOUTH AFRICA 2 MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom 6 Weill Bugando School of Medicine, Mwanza, Tanzania 1 Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania 3 Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda 4 Ministry of Health, Kampala, Uganda 5 Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania |
AuthorAffiliation_xml | – name: 3 Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda – name: 5 Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania – name: 1 Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania – name: University of the Witwatersrand, SOUTH AFRICA – name: 2 MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – name: 6 Weill Bugando School of Medicine, Mwanza, Tanzania – name: 4 Ministry of Health, Kampala, Uganda – name: 7 Weill Cornell Medical College, New York, NY, United States of America |
Author_xml | – sequence: 1 givenname: Bazil orcidid: 0000-0003-4839-4590 surname: Kavishe fullname: Kavishe, Bazil organization: Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania – sequence: 2 givenname: Fiona surname: Vanobberghen fullname: Vanobberghen, Fiona organization: MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – sequence: 3 givenname: David surname: Katende fullname: Katende, David organization: Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda – sequence: 4 givenname: Saidi surname: Kapiga fullname: Kapiga, Saidi organization: MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – sequence: 5 givenname: Paula surname: Munderi fullname: Munderi, Paula organization: Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda – sequence: 6 givenname: Kathy surname: Baisley fullname: Baisley, Kathy organization: MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – sequence: 7 givenname: Samuel surname: Biraro fullname: Biraro, Samuel organization: Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda – sequence: 8 givenname: Neema surname: Mosha fullname: Mosha, Neema organization: Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania – sequence: 9 givenname: Gerald surname: Mutungi fullname: Mutungi, Gerald organization: Ministry of Health, Kampala, Uganda – sequence: 10 givenname: Janneth surname: Mghamba fullname: Mghamba, Janneth organization: Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania – sequence: 11 givenname: Peter surname: Hughes fullname: Hughes, Peter organization: Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda – sequence: 12 givenname: Liam surname: Smeeth fullname: Smeeth, Liam organization: MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – sequence: 13 givenname: Heiner surname: Grosskurth fullname: Grosskurth, Heiner organization: MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom – sequence: 14 givenname: Robert surname: Peck fullname: Peck, Robert organization: Weill Cornell Medical College, New York, NY, United States of America |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31809516$$D View this record in MEDLINE/PubMed |
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Copyright | COPYRIGHT 2019 Public Library of Science 2019 Kavishe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Kavishe et al 2019 Kavishe et al |
Copyright_xml | – notice: COPYRIGHT 2019 Public Library of Science – notice: 2019 Kavishe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2019 Kavishe et al 2019 Kavishe et al |
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Snippet | Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in... Background Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding... BackgroundDyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia... Background Dyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding... |
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Title | Dyslipidemias and cardiovascular risk scores in urban and rural populations in north-western Tanzania and southern Uganda |
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