CORONARY HEART-DISEASE RISK-FACTORS IN SUB-SAHARAN AFRICA - STUDIES IN TANZANIAN ADOLESCENTS

Study Objective-To assess the level of cardiovascular risk factors in young people in sub-Saharan Africa living in rural and urban settings. Design-Cross sectional survey of the population aged 15 to 19 years. Setting-Eight rural Tanzanian villages in three regions, and two distr icts in Dar es Salaam. Participants-664 males and 803 females in rural villages and 85 males and 121 females in the city. Response rates for total population were 74% to 94% in the rural areas and 60% in the ci ty. Measurements and results-Measurements included blood pressure, bod y mass index, serum lipids, and blood glucose concentrations (fasting and two hours after 75 g glucose). Blood pressure was slightly but sig nificantly higher in young women than in young men (115/67 mmHg versus 113/65 mmHg) and increased significantly with age. Only 0.4% subjects had blood pressure greater than 140 and/or 90 mmHg. There were no urb an-rural differences. Body mass index was higher in females (mean (SD) 20.3 (2.8) kg/m2) than males (18.5 (2.1)). Overweight was found in on ly 0.6% at age 15 years but 5.4% at age 19 years. Serum cholesterol co ncentrations were low at 3.5 mmol/l in males and 3.7 mmol/l in females . Only 7% had values above 5.2 mmol/l. The highest concentrations were found in the city and in Kilimanjaro, the most prosperous rural regio n. Serum triglycerides were 1.0 (0.5) mmol/l in males and 1.1 (0.5) mm ol/l in females, and were highest in the city dwellers. Diabetes was r are (0.28% males, 0.12% females) but impaired glucose tolerance was pr esent in 4.7% and 4.1% respectively. Drinking alcohol was equally prev alent in males and females, reaching 30% at age 19 years. Only 0.4% of females smoked compared with 7.3% of males. Smoking was commoner in r ural areas that in the city. Conclusions-Several risk factors for card iovascular disease were found in Tanzanian adolescents, but levels wer e much lower than in studies reported from developed nations. The chal lenge is to maintain these low levels as the population becomes more u rbanised and more affluent.