Prevalence And Association Of Conventional And Novel Risk Factors For Coronary Heart Disease In Langata Constituency, Nairobi, Kenya

ABSTRACT 

There has been considerable progress in the understanding of conventional risk factors for cardiovascular disease such as cigarette smoking, hypertension, hyperlipideamia and diabetes. However they do not fully account for cardiovascular disease-associated complications. As a result, novel risk factors such as C-reactive protein (CRP) and homocysteine have come under investigation. The aim of this study was to determine the prevalence and interrelation of conventional and novel risk factors for coronary heart disease among an urban population in Kenya. This was a cross-sectional study carried out in Langata Constituency of Nairobi County. The design was based on a three-stage cluster sampling methodology. The first stage involved random selection of 30 clusters, followed by random selection of households within the clusters, and finally selection of respondents from the household. Permission to carry out this study was granted by Kenya Medical Research Institute/National Ethical Review Committee. Information on demographics and behavioural habits was collected using a structured questionnaire. Body composition was determined based on measurements of height and weight, and a general clinical examination performed including blood pressure check. Biochemical measurements included fasting blood glucose, homocysteine, CRP and the lipid profile. Data was weighted and analyzed using SPSS 16.0 with values of p< 0.05 considered statistically significant. Results were expressed as mean +SD or as proportions (%). Unpaired t-test was used for continuous normally distributed variables and Chi-square test and Fisher’s exact probability for categorical variables. Linear associations were calculated using the Spearman’s correlation coefficient and the Odds ratios calculated using EPI info 6. A total of 539 adults (m: 299; w: 240) with mean age of 38.09 + 13.4 years participated. Prevalence of homocysteine >12µmol/L, CRP >5mg/L, diabetes, high blood pressure and obesity was 42.7%, 18.4%, 9.5%, 50.2% and 16.3% respectively. Homocysteine was significantly associated with increasing blood pressure (AOR 6.3 [95% CI 1.5-6.3]; p=0.002), and obesity (AOR 0.15 [95% CI 0.06-0.4]; p