Cardiometabolic disease risk factors in pre- and postmenopausal women from four sub-Saharan African countries: A cross-sectional study
Date
2023-06
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Abstract
Objective: To compare the risk factors for cardiometabolic disease between pre- and
postmenopausal women from four sub-Saharan African countries.
Study design: This cross-sectional study included 3609 women (1740 premenopausal and
1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi),
and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic
variables were compared between pre- and postmenopausal women, within and across sites using
multivariable regression analyses. The sites represent populations at different stages of the health
transition, with those in Ghana and Burkina Faso being rural, whilst those in Kenya and South
Africa are more urbanised.
Main outcome measures: Anthropometric and cardiometabolic variables.
Results: The prevalence rates of risk factors for cardiometabolic disease were higher in South
(Soweto and Dikgale) and East (Nairobi) Africa than in West Africa (Nanoro and Navrongo),
irrespective of menopausal status. Regression models in combined West African populations
demonstrated that postmenopausal women had a larger waist circumference (β = 1.28 (95 % CI:
0.58; 1.98) cm), log subcutaneous fat (β =0.15 (0.10; 0.19)) diastolic (β = 3.04 (1.47; 4.62) mm
Hg) and log systolic (β = 0.04 (0.02; 0.06)) blood pressure, log carotid intima media thickness (β
= 0.03 (0.01; 0.06)), low-density lipoprotein cholesterol (β = 0.14 (0.04; 0.23) mmol/L) and log
triglyceride (β= 0.10 (0.04; 0.16)) levels than premenopausal women. No such differences were
observed in the South and East African women.
Conclusions: Menopause-related differences in risk factors for cardiometabolic disease were
prominent in West but not East or South African study sites. These novel findings should inform
cardiometabolic disease prevention strategies in midlife women specific to rural and urban and
peri-urban locations in sub-Saharan Africa.
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Keywords
Premenopause; Postmenopause; Cardiometabolic disease risk; Sub-Saharan Africa; AWI-Gen