Hypertension in Sudanese individuals and associated risk factors: the critical intersection between salt and sugar intake

Africa is facing an increase in level of non-communicable diseases and this is likely due to parallel increase in obesity epidemic associated with economic growth (1). In cross sectional study in elderly adult population in Tanzania, Sudan and Nigeria, the burden of non-communicable diseases (NCDs) was found to be 81.0% (n=708) of admissions (n=874), and tuberculosis, malaria, and the human immunodeficiency virus and acquired immunodeficiency syndrome accounted for 4.6% (n=40). Cerebrovascular accident (n=224, 25.6%) was the most common reason for admission, followed by cardiac or circulatory dysfunction (n=150, 17.2%). Rate of hypertension in these countries was 40.2% almost similar to rate of hypertension in UK (45.8%) (2). Importantly, several studies showed high prevalence of hypertension in different African countries. For instance, the trial of hypertension in North Africa (Epidemiological Trial of Hypertension in North Africa), an international, multicenter, epidemiological, cross-sectional study conducted in Algeria, Tunisia, and Morocco, showed total prevalence of hypertension was 45.4% (3). Furthermore, the prevalence of hypertension in urban areas in Namibia, Nigeria, Tunisia and Ethiopia was found to be 32%, 33%, 28.9% and 30%, respectively (4-7). Therefore, the Pan-African Society of Cardiology (PASCAR) called for publication of a set of clinical guidelines for the prevention and management of hypertension in Africa in collaboration with the World Heart Federation (WHF) (1). Sudan is located in the heart of Africa and prevalence of hypertension in different regions and ethnic groups were found to be high. For instance, in Urban population in north of Sudan the prevalence of hypertension was estimated to be more than 30% (8). While in rural population the prevalence was estimated to be between 15% to 38% in Sudan (9,10). Importantly, the prevalence of hypertension in Nubia ethnic population in South of Sudan was around 50% (11). Therefore, the aim of this study is to establish prevalence of hypertension in Khartoum region and whether salt and sugar intake can be risk factors