Known, and unknown, hypertension in the Transforming Parkinsons care in Africa ( TraPCAf) cohort: pilot data

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Jessica Walker 1; Yasin Okkaoglu 2; Catherine Dotchin 3; Natasha Fothergill-Misbah 2; Njideka Okubadejo 4; Richard Walker 1,2 on behalf of TraPCAf collaboration

1 Northumbria Healthcare NHS Foundation Trust 2 Population Health Sciences Institute (PHSI), Newcastle University 3 Biomedical Research Unit, Newcastle University 4 College of Medicine, University of Lagos, Nigeria

Scientific Research

SP - Parkinson's Disease

Movement disorders

Abstract

Introduction

There are few data on Parkinson’s disease (PD) in Africa, particularly in sub-Saharan Africa (SSA). The NIHR Global Health Research Group Transforming Parkinson’s Care in Africa (TraPCAf) is a four-year study, running from September 2022, investigating PD in seven African countries (1). In SSA, hypertension is highly prevalent, with many individuals remaining undiagnosed and, among those diagnosed, many untreated or poorly controlled (2).

Method

The TraPCAf project is recruiting a target of 1,000 people with PD (PwP) and 2,000 age- and sex-matched healthy controls. Data collected include demographics, medical history, reported hypertension, use of antihypertensive medication, and sitting blood pressure (BP). Following WHO guidelines, BP was measured sitting after five minutes rest and repeated twice at five-minute intervals, with the mean of the second and third readings utilised. BP values ≥140/90 mmHg were considered indicative of hypertension.

Results

Of 1,061 PwP, 78 had missing data leaving 983. Among these, hypertension was reported by 409 (41.6%), while 274 (27.9%) met the measured BP hypertension threshold. Of 1,673 healthy controls, 185 had missing data, leaving 1,488. Among controls, 26 (1.7%) reported hypertension, whereas 659 (44.2%) met the measured hypertension BP threshold. Reported antihypertensive medication use was higher among PwP with self-reported hypertension (286/409, 69.9%) than among controls (8/26, 30.8%).

Conclusions

There is a high prevalence of previously unrecognised hypertension among healthy controls. We surmise many may not have had their BP measured previously.

Within the PwP group, higher rates of reported hypertension but lower rates on clinical measurement likely reflect higher levels of antihypertensive treatment. Higher diagnosed hypertension rates have been reported in other disease services in SSA, such as for HIV, while asymptomatic individuals often remain undiagnosed.

References

1 Walker et al., BMC Neurol. 2023 Oct 19;23(1):373.

2 Dewhurst et al., Journal of Human Hypertension 2013 Jun; 27 (6): 374-80.