Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study

Abstract Background High salt intake increases blood pressure (BP) and hypertension risk. This study aimed to examine association of urinary sodium excretion with BP and hypertension correlates among Cameroonian pygmies under hunter-gatherer subsistence mode and Bantus, living in urban area under un...

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Main Authors: Daniel Lemogoum, William Ngatchou, Claude Bika Lele, Cecile Okalla, Marc Leeman, Jean-Paul Degaute, Philippe van de Borne
Format: Article
Language:English
Published: BMC 2018-03-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12872-018-0787-3
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author Daniel Lemogoum
William Ngatchou
Claude Bika Lele
Cecile Okalla
Marc Leeman
Jean-Paul Degaute
Philippe van de Borne
author_facet Daniel Lemogoum
William Ngatchou
Claude Bika Lele
Cecile Okalla
Marc Leeman
Jean-Paul Degaute
Philippe van de Borne
author_sort Daniel Lemogoum
collection DOAJ
description Abstract Background High salt intake increases blood pressure (BP) and hypertension risk. This study aimed to examine association of urinary sodium excretion with BP and hypertension correlates among Cameroonian pygmies under hunter-gatherer subsistence mode and Bantus, living in urban area under unhealthy behavioral habits. Methods In this cross-sectional cluster sampling study, we randomly enrolled rural pygmies living in Lolodorf and urban Bantus living in Douala. The World Health Organization steps questionnaire was used to collect socio-demographic and lifestyle data. Height, weight, BP and single overnight spot urine samples were obtained in all participants. BP was measured in triplicate. Urinary sodium and potassium excretion was determined by flame photometry. Data were recorded and analyzed using SPSS 16.0. Results We included 150 Pygmies and 150 Bantus aged 38 ± 12 years and 33 ± 11 years, respectively (p <  0.0001). Compare to Bantus, pygmy’s height and weight were respectively: 1.54 ± 0.09 m vs 1.72 ± 0.12 m; and 54.4 ± 9.2 kg vs 77.2 ± 14.8 kg, all p <  0.0001. Age-standardized prevalence of hypertension was 3.3% among Pygmies and 28% among Bantus (p <  0.0001). Age-adjusted systolic and diastolic BP were lower in Pygmies than in Bantus (107 ± 12 vs 119 ± 17 mmHg and 71 ± 11 vs 78 ± 13 mmHg respectively, all P <  0.0001). BP increased with age but to a lesser extent in Pygmies (all p <  0.01). Urinary sodium excretion was lower in Pygmies than in Bantus (46.9 ± 32.4 vs 121.5 ± 61.0 mmol/l, p <  0.0001). Systolic and diastolic BP were positively associated with urinary sodium excretion in Bantus (all p <  0.05). In the two groups, urinary potassium excretion was similar, and was not related to blood pressure. In the total study group and in Bantus taken separately, urinary sodium excretion was higher in hypertensive than in normotensive subjects. Multivariable logistic regression showed that urinary sodium excretion, Bantu status and age emerged as independent determinants of hypertension in the whole study group (OR (95%CI): 1.012 (1.005–1.018); 11.408 (3.599–36.165); 1.095 (1.057–1.135) respectively, p <  0.0001). Conclusion Hunter-gatherer pygmies exhibit low level of urinary sodium excretion related to low rate of hypertension and slower BP increase with age. Salt intake was a major driver of hypertension in our study population. Our findings highlight the need of efforts to implement nationwide prevention programs promoting risk factor screening and healthier lifestyles including reduction of dietary salt intake in Cameroonian.
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spelling doaj.art-59f728f66d3c4ce8a58947c67f5bed352022-12-21T23:38:54ZengBMCBMC Cardiovascular Disorders1471-22612018-03-0118111010.1186/s12872-018-0787-3Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional studyDaniel Lemogoum0William Ngatchou1Claude Bika Lele2Cecile Okalla3Marc Leeman4Jean-Paul Degaute5Philippe van de Borne6Douala School of Medicine and Pharmaceutical Sciences, Douala UniversityDouala School of Medicine and Pharmaceutical Sciences, Douala UniversityDouala Heart InstituteDouala School of Medicine and Pharmaceutical Sciences, Douala UniversityULB-Erasme Hospital, Free Brussels UniversityULB-Erasme Hospital, Free Brussels UniversityULB-Erasme Hospital, Free Brussels UniversityAbstract Background High salt intake increases blood pressure (BP) and hypertension risk. This study aimed to examine association of urinary sodium excretion with BP and hypertension correlates among Cameroonian pygmies under hunter-gatherer subsistence mode and Bantus, living in urban area under unhealthy behavioral habits. Methods In this cross-sectional cluster sampling study, we randomly enrolled rural pygmies living in Lolodorf and urban Bantus living in Douala. The World Health Organization steps questionnaire was used to collect socio-demographic and lifestyle data. Height, weight, BP and single overnight spot urine samples were obtained in all participants. BP was measured in triplicate. Urinary sodium and potassium excretion was determined by flame photometry. Data were recorded and analyzed using SPSS 16.0. Results We included 150 Pygmies and 150 Bantus aged 38 ± 12 years and 33 ± 11 years, respectively (p <  0.0001). Compare to Bantus, pygmy’s height and weight were respectively: 1.54 ± 0.09 m vs 1.72 ± 0.12 m; and 54.4 ± 9.2 kg vs 77.2 ± 14.8 kg, all p <  0.0001. Age-standardized prevalence of hypertension was 3.3% among Pygmies and 28% among Bantus (p <  0.0001). Age-adjusted systolic and diastolic BP were lower in Pygmies than in Bantus (107 ± 12 vs 119 ± 17 mmHg and 71 ± 11 vs 78 ± 13 mmHg respectively, all P <  0.0001). BP increased with age but to a lesser extent in Pygmies (all p <  0.01). Urinary sodium excretion was lower in Pygmies than in Bantus (46.9 ± 32.4 vs 121.5 ± 61.0 mmol/l, p <  0.0001). Systolic and diastolic BP were positively associated with urinary sodium excretion in Bantus (all p <  0.05). In the two groups, urinary potassium excretion was similar, and was not related to blood pressure. In the total study group and in Bantus taken separately, urinary sodium excretion was higher in hypertensive than in normotensive subjects. Multivariable logistic regression showed that urinary sodium excretion, Bantu status and age emerged as independent determinants of hypertension in the whole study group (OR (95%CI): 1.012 (1.005–1.018); 11.408 (3.599–36.165); 1.095 (1.057–1.135) respectively, p <  0.0001). Conclusion Hunter-gatherer pygmies exhibit low level of urinary sodium excretion related to low rate of hypertension and slower BP increase with age. Salt intake was a major driver of hypertension in our study population. Our findings highlight the need of efforts to implement nationwide prevention programs promoting risk factor screening and healthier lifestyles including reduction of dietary salt intake in Cameroonian.http://link.springer.com/article/10.1186/s12872-018-0787-3Urinary sodium excretionHunter-gatherer lifestyleBlood pressureHypertensionPygmyBantu
spellingShingle Daniel Lemogoum
William Ngatchou
Claude Bika Lele
Cecile Okalla
Marc Leeman
Jean-Paul Degaute
Philippe van de Borne
Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
BMC Cardiovascular Disorders
Urinary sodium excretion
Hunter-gatherer lifestyle
Blood pressure
Hypertension
Pygmy
Bantu
title Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
title_full Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
title_fullStr Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
title_full_unstemmed Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
title_short Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study
title_sort association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among cameroonian pygmies and bantus a cross sectional study
topic Urinary sodium excretion
Hunter-gatherer lifestyle
Blood pressure
Hypertension
Pygmy
Bantu
url http://link.springer.com/article/10.1186/s12872-018-0787-3
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