Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey.

Title Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey. Abstract Objective The aim of the study was to investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage and its associated factors among adults in Freetown, Sierra Leone. Design This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants. Setting The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Freetown, Sierra Leone. Participants A total of 2394 adults Sierra Leoneans aged 20 years, or more were enrolled. Outcome measure Anthropometric data, fasting lipid profiles, fasting plasma glucose, target organ damage, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to target organ damage. Results The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by electrocardiogram (ECG), 14.2% had LVH by 2D Echo, and 11.4% had chronic kidney disease. The odds of developing ECG-LVH were higher with diabetes [OR = 1.255, 95% C.I. (0.822 - 1.916) and dyslipidaemia [OR = 1.449, 95% C.I. (0.834 - 2.518). The association factors for higher odds of LVMI by echo were dyslipidemia [OR = 1.844, 95% C.I (1.006-3.380)] and diabetes mellitus [OR =1.176, 95% C.I. (0.759-1.823)]. The odds of having CKD were associated with diabetes mellitus [OR =1.212, 95% CI (0.741-1.983)] and hypertension [OR =1.163, 95% CI (0.887-1.525)]. A low optimal cut-off point for ECG-LVH (male 24.5mm vs female 27.5mm) as a target organ damage was required to maximize sensitivity and specificity by a receiver operating characteristic (ROC) curve since the odds for LVH by ECG was low. Conclusions This study provides novel data-driven information on the burden of cardiometabolic risks and its association with preclinical target organ damage in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management among adults in Sierra Leoneans Close Window * Abstract Write or Paste Abstract Preview {Omega} Special Characters 319 OUT OF 300 WORDS Objective The aim of the study was to investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage and its associated factors among adults in Freetown, Sierra Leone. Design This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants. Setting The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Freetown, Sierra Leone. Participants A total of 2394 adults Sierra Leoneans aged 20 years, or more were enrolled. Outcome measure Anthropometric data, fasting lipid profiles, fasting plasma glucose, target organ damage, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to target organ damage. Results The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by electrocardiogram (ECG), 14.2% had LVH by 2D Echo, and 11.4% had chronic kidney disease. The odds of developing ECG-LVH were higher with diabetes [OR = 1.255, 95% C.I. (0.822 - 1.916) and dyslipidaemia [OR = 1.449, 95% C.I. (0.834 - 2.518). The association factors for higher odds of LVMI by echo were dyslipidemia [OR = 1.844, 95% C.I (1.006-3.380)] and diabetes mellitus [OR =1.176, 95% C.I. (0.759-1.823)]. The odds of having CKD were associated with diabetes mellitus [OR =1.212, 95% CI (0.741-1.983)] and hypertension [OR =1.163, 95% CI (0.887-1.525)]. A low optimal cut-off point for ECG-LVH (male 24.5mm vs female 27.5mm) as a target organ damage was required to maximize sensitivity and specificity by a receiver operating characteristic (ROC) curve since the odds for LVH by ECG was low. Conclusions This study provides novel data-driven information on the burden of cardiometabolic risks and its association with preclinical target organ damage in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management among adults in Sierra Leoneans.