A Survey of the Prevalence and Anthropometric Correlates of the Risk for Obstructive Sleep Apnoea in Abuja, Nigeria

BACKGROUND

Obstructive Sleep Apnoea (OSA) is asignificant public health challenge, with increasing prevalence and mortality. A significant proportion of the burden of this disorder occurs in middle- and low-income countries. Unfortunately, the rising number of individuals with a new OSA diagnosis and its consequences are frequently underestimated. This study aims to evaluate the prevalence and the correlates of OSA in the community setting.

METHODS AND MATERIAL

The study was a cross-sectional community-based survey. A standardized self-administered Berlin questionnaire was administered to all the study participants. The questionnaire has three categories that assess snoring, daytime sleepiness, and OSA. The international physical activity questionnaire and Sheldon Cohen perceived stress was applied to assess physical activity and psychosocial stress levels. The subject's anthropometric and other clinical parameters were measured using the appropriate instrument for measurements. The data obtained were analyzed with SPSS version 21 software.

RESULTS

Four hundred thirty-six (436) participants returned the completed questionnaire, out of which, 234 (53.7%) of the study population were men. The overall prevalence of the risk for OSA was 30% (36% in men vs. 24% in women). The risk of developing OSA was 1.8 times more in men. Hypertension was the most frequently reported comorbidity among the population at risk for developing OSA.

CONCLUSION

Obstructive sleep apnoea is a common but frequently neglected medical condition. The proportion of individuals affected may be more than is currently suggested. Routine screening for OSA and initiation of early treatment is necessary to mitigate the attendant consequences.

Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa

To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After ≥4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (n=89; R) or amlodipine/valsartan 5/160 mg (n=94; E) and followed up for 6 months. To control blood pressure (<140/<90 mm Hg), bisoprolol and amlodipine could be doubled (10 mg per day) and α-methyldopa (0.5-2 g per day) added. Sitting blood pressure fell by 19.5/12.0 mm Hg in R patients and by 24.8/13.2 mm Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2 mm Hg (P<0.0001) systolic, 1.3 mm Hg (P=0.12) diastolic, and 9.6 beats per minute (P<0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5 mm Hg (P<0.0001) systolic, 1.8 mm Hg (P=0.07) diastolic and 9.8 beats per minute (P<0.0001). In R compared with E patients, 45 vs 37% (P=0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (P<0.0001) had α-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P=0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients.