Gender Differences in Hypertension and the role of BMI in Sub-Saharan Africa

Abstract

ABSTRACT Background: Chronic disease in Sub-Saharan Africa (SSA) is on the rise with the increase of risk factors such as hypertension and BMI. Studies in European populations show difference in blood pressure between men and women; however this is not the case for some studies in non-European populations. It is not clear whether sex differences in blood pressure and hypertension exist in SSA, and if so, whether differences in body sizes reflect these differences. Methods: A systematic review was done using PubMed database, specific selection criteria and careful data extraction. Blood pressure variables were mean systolic and diastolic blood pressure and hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or treatment of hypertension) while BMI was reported as mean BMI or categories of overweight (25-29.9 kg/m2) and obesity (≥ 30 kg/m2). Results: A total of 23 articles were selected in the systematic review which reported the above mentioned variables for men and women and showed data according to rural or urban location. Overall men had a higher systolic and diastolic blood pressure than women in both rural and urban setting: Men had a mean SBP of 126.82 while women had 123.71. However, more women were hypertensive in urban areas than men while more men were hypertensive in rural areas. Women had much higher BMI than men in all studies with 24.15 compared to 22.0. Conclusion: This review shows sex differences in blood pressure with men having higher levels than women. By contrast, women in urban settings had a higher prevalence of hypertension than men. All studies showed women with a higher BMI than men. Where sex differences in risk factors for disease exist, sex specific interventions are essential.