Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville

Abstract

Background and Aim: Cardiovascular risk (CVR) factors, namely hypertension (HT), diabetes mellitus and obesity, are a public health problem in sub-Saharan Africa because of health transition. The additional effect of the social gradient within the railway companies in Congo-Brazzaville on high CVR is not yet established. The aim of this study was to determine the extent of hypertension, diabetes mellitus, overweight, and obesity and to identify the contributing factors of fatness and hypertension. Methods: This was a cross-sectional study conducted in April 2013. A simple random sample of 255 out of all 2550 workers from the railway companies of Congo was examined for epidemiological, clinical and biological variables. Results: Out of the study sample, 231 (90.6%), 79 (31%), and 52 (20.4%) were men, rural dwellers, and senior executives, respectively. The mean age was 45 ± 13 years (range 19 to 63 years). The rates of overweight, hypertension, obesity, and diabetes mellitus were 40.3% (n = 103), 29.4% (n = 75), 7.5% (n = 19), and 3.5% (n = 9), respectively. In univariate analysis, female sex (OR 2.7, 95% CI 1.13 - 6.45, p = 0.01), senior executive (OR 2.4; 95% CI: 1.3 - 4.5; p = 0.003) and physical inactivity (OR 2.5; 95% CI: 1.5 - 4.2; p < 0.001) were significantly associated with overweight. Female sex (OR 7.5, 95% CI: 2.6 - 21; p < 0.001) and senior executive (OR 3.17; 95% CI: \r1.2 - 8.3) were also significantly associated with obesity. In logistic regression, overweight (OR = 4.8, 95% CI 2.8 - 11, p < 0.0001), and obesity (OR = 6.8, 95%CI 2.1 - 22, p = 0.01) were identified as the most important and independent determinants of hypertension. Conclusions: Fatness is emerging and it is the most contributing factor of hypertension among workers at the Congolese railway companies. There is also a significant interaction between non-modifiable factors (genetic: females and family history) and modifiable factors (inactivity, fatness) for higher risk of hypertension. H