LOW-PREVALENCE OF RISK-FACTORS FOR CORONARY HEART-DISEASE IN RURAL TANZANIA

A community-based survey was used to assess the prevalence of risk fac tors for coronary heart disease (CHD) in rural Tanzanians. In all, 858 1 subjects (3705 men, 4876 women) aged greater-than-or-equal-to 15 yea rs in eight villages in three regions in rural Tanzania representing a range of socioeconomic deprivation were studied. The main outcome mea sures were serum cholesterol and triglyceride level, blood pressure an d prevalence of dyslipidaemia, hypertension, smoking, overweight, impa ired glucose tolerance (IGT) and diabetes; as well as ECG changes. Mea n serum cholesterol levels in men were 4.2, 3.4 and 3.7 mmol/l, and in women 4.4 3.6 and 3.9 mmol/l in Kilimanjaro, Morogoro and Mara region s respectively. In Kilimanjaro region 17.4% of men and 19.0% of women had values above 5.2 mmol/l compared with only 5.0% and 6.7% in Morogo ro region and 4.8% and 6.9% respectively in Mara region. Systolic and diastolic blood pressures increased with age in both men and women in all three regions with the most marked increase in Kilimanjaro region and the smallest rise in Mara region. Mean age-adjusted values were hi ghest in Kilimanjaro region (124/75 mm Hg, and 125/76 mm Hg in men and women respectively) and lowest in Mara region (120/70 mm Hg in men an d 118/68 mm Hg in women). Hypertension was found in 6.6% of men and 7. 5% of women in Kilimanjaro region, 3.3% and 4.7% in Morogoro, and 2.6% and 3.4% in Mara region. Cigarette smoking was found in 42.6% of men in Kilimanjaro region, 28.2% of Morogoro region and 8.6% in Mara regio n. Less than 4% of women smoked in all three regions. Only 2.4-4.0% of men, and 7.9-10.5% of women were overweight or obese. ST,T and Q,QS c hanges on ECG were recorded in 7.8% and 2.7% of men, and 17.4% and 3.7 % of women aged greater-than-or-equal-to 40 years. Diabetes was found in 0.6-0.8% as previously reported. The proportion of men with two or more risk factors for CHD ranged from 0.2% in Mara region to 4.6% in K ilimanjaro region. For women the corresponding figures ranged from 0% in Mara region to 1.1% in Morogoro region. The proportion was increase d in those with IGT (9.3%) and diabetes (14.1%). Similarly those with ischaemic (Q,QS) changes on ECG had a twofold increase in risk factors . Cardiovascular risk factor levels make it unlikely that CHD will eme rge as a significant health problem among rural Tanzanians in the near future.