The Seychelles cardiovascular diseases survey 1989.
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Biomedical subjects
C Shamlaye
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Prevalence of diabetes and obesity in the adult population of the Seychelles.
The prevalence of diabetes and obesity were assessed in an age- and sex-stratified sample of 1078 individuals living in Mahé, The Republic of Seychelles. Presence or absence of diabetes mellitus was assessed by measuring glucose concentration in fasting venous blood. Prevalence of obesity (standardized for age) was elevated five-fold in women compared with men (20.9 vs 4.2%). In women, it increased from 8.9% at age 25-34 years to 29.4% at age 35-44 years and plateaued thereafter, whereas it did not change with age in men. Prevalence of diabetes (standardized for age) was 3.4% for men and 4.6% for women. It increased markedly with age, from 0.0 and 0.8% at age 25-34 years to 8.8 and 13.4% at age 55-64 years in men and women, respectively. A strong association of diabetes with excess body weight was observed. Most cases of diabetes can be attributed to Type 2 (non-insulin-dependent) diabetes. Fifty-five percent of diabetic individuals were unaware of their disease at the time of the survey.
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Relationship of fasting serum insulin concentrations with blood pressure in a representative sample of the adult population of the Seychelles.
Several studies have been performed to determine if plasma insulin concentration bears a relationship with blood pressure and may be a causative factor in the genesis of hypertension. The results reported were discrepant between studies: insulin was observed to be independently correlated with blood pressure in some studies, whereas no such relationship was observed in others. Serum insulin, whole blood glucose, weight, height, and diastolic and systolic blood pressure of 839 fasting individuals, randomly selected from the adult population of Mahé Island, The Seychelles, were recorded; this population has a high hypertension prevalence rate. The proportion of hypertension was higher in subgroups of individuals with diabetes mellitus (52.4 percent) and with overweight (34.5 percent) than in the general population. Subgroups of individuals with diabetes, excessive weight or high blood pressure had higher mean fasting plasma insulin (13.6 +/- (s.d.) 7.9, 14.0 +/- 8.0, 11.1 +/- 9.7 respectively) than individuals not affected with these conditions (8.1 +/- 4.6 microU/ml). Both systolic and diastolic blood pressure were positively correlated with age, body mass index and fasting blood glucose in a multivariate model. No correlation with insulin was observed. In contrast, in a subgroup of 223 overweight individuals, age, blood glucose and plasma insulin were each positively correlated with blood pressure. It is concluded that, in this cross-sectional study, insulin was not independently correlated with blood pressure except for overweight individuals.
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High prevalence of cardiovascular risk factors in the Seychelles (Indian Ocean).
In recent years, increasingly high rates of cardiovascular diseases have been recorded in the Seychelles. A survey was performed to investigate the prevalence of cardiovascular risk factors in that population, which is shifting from its traditional habits to a westernized lifestyle. The Seychelles population is of predominantly black African origin. A sex- and age-stratified random sample of 1,309 subjects was drawn from 21,256 people aged 25-64 years. A response rate of 86% was achieved. The data showed a high prevalence of hypertension (25%) and cigarette smoking (54%) in men and a high prevalence of hypertension (20%) and obesity (21%) in women. Hypercholesterolemia (greater than 6.5 mmol/l) was found in 9% of men and 15% of women. High density lipoprotein cholesterol levels (mean +/- SD) were higher in men (1.42 +/- 0.49 mmol/l) than in women (1.36 +/- 0.34 mmol/l). High levels of lipoprotein(a) (mean +/- SD) were found both in men (319 +/- 362 mg/l) and women (328 +/- 415 mg/l). The high prevalence of cardiovascular risk factors identified in the Seychelles indicates a pressing current need for effective preventive strategies.
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