Cardiovascular risk factors in rural Kenyans are associated with differential age gradients, but not modified by sex or ethnicity

Abstract

Background: The relationship between metabolic disease and the non-modifiable risk factors sex, age and ethnicity in Africans is not well-established.

Aim: This study aimed to describe sex, age and ethnicity differences in blood pressure (BP) and lipid status in rural Kenyans.

Subjects and methods: A cross-sectional study was undertaken among rural Kenyans. BP and pulse rate (PR) were measured while sitting and fasting blood samples were taken for analysis of standard lipid profile. Standard anthropometric measurements were collected. Physical activity energy expenditure was obtained objectively and lifestyle data were obtained using questionnaires.

Results: In total, 1139 individuals (61.0% women) participated aged 17–68 years. Age was positively associated with BP and plasma cholesterol levels. Sitting PR was negatively associated with age in women only (sex-interaction p < 0.001). Ethnicity did not modify any of the age-associations with haemodynamic or lipid outcomes. Differences in intercept between women and men were found in all parameters except for diastolic BP (p = 0.154), with men having lower HDL-C but higher values in all other cardiovascular risk factors.

Conclusion: BP and plasma cholesterol levels increase with age at a similar gradient in men and women, but absolute levels of the majority of the risk factors were higher in men.

• Dyslipidaemia
• hypertension
• sub-Saharan Africa

Acknowledgements

We are grateful to all participants, the local chiefs and sub-chiefs, the local elder councils and district politicians. We are also indebted to the late Benedict Omondi (KEMRI), Tobias Oketch (CVBCR and KEMRI), Arthur J. Ukumu (DVBD), Odero Sabiano (DVBD) and Saidi Kisiwa (KEMRI) for their skillful collection and analysis of blood samples in the field. We sincerely thank Philista Singore for excellent clinical health assessment of the study participants and we are thankful to all local assistants for their effort in excellent social mobilization and collection of data. We acknowledge the permission by the Director of KEMRI to publish this manuscript. The study was supported by DANIDA (J. no. 104.DAN.8-871, RUF project no. 91202), Cluster of International Health (University of Copenhagen), Steno Diabetes Center, Beckett Foundation, Dagmar Marshall Foundation, Dr Thorvald Madsen’s Grant, Kong Christian den Tiende’s Foundation, Brdr Hartmann Foundation and the Novo Nordisk Foundation (Grant no. 29847).

Declaration of interest

The authors report no conflicts of interest. The funding bodies (see under Acknowledgement for details) had no role in the study design, data collection, data analysis, data interpretation or decision to publish the findings.

Supplementary material available online

Supplementary Table S1.