Our knowledge of the disease burden components of tropical populations is fragmentary.
Historically, the infectious diseases have been emphasized but, as some populations have undergone socio-economic changes, vital statistics have described a change in the pattern of disease.
The picture is of a decline in infectious and a rise in chronic non-communicable disease.
We focus here on the emergence of chronic cardiovascular diseases, and use hypertension as the paradigmic example.
Early blood pressure surveys showed a virtual absence of hypertension among rural Africans and moderate prevalences in the Caribbean.
Prevalence was highest among US and UK blacks.
In a recent comparative study of blood pressure and its determinants in Nigeria, Jamaica and the US there was a steep gradient in prevalence from 15% through 26% to 33%. Body mass index and salt intake were the major determinants, accounting for 70% of the variance in hypertension prevalence.
Additional information on mechanism comes from the exploration of the renin-angiotensin system across these populations.
Angiotensinogen levels rise steadily from Africa to the US and are modestly associated with body mass index (BMI), and even more modestly with polymorphisms of the angiotensinogen gene. 30% of the variation in angiotensin-converting enzyme levels is attributable to the insertion/deletion polymorphism, and angiotensin-converting enzyme levels are modestly related to BMI and blood pressure. (...)
Mots-clés Pascal : Appareil circulatoire pathologie, Zone tropicale, Emergence, Homme, Paradigme, Pays en développement, Hypertension artérielle, Epidémiologie, Pays industrialisé, Prévalence, Facteur risque, Prévention, Pathogénie
Mots-clés Pascal anglais : Cardiovascular disease, Tropical zone, Emergence, Human, Paradigm, Developing countries, Hypertension, Epidemiology, Industrialized country, Prevalence, Risk factor, Prevention, Pathogenesis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0470237
Code Inist : 002B12A03. Création : 19/02/1999.