Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, Jan 28, 2015
To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTA... more To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65-70 years was associated with fewer RTAs, but more falls; age 55-64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries...
WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% o... more WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability. We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry. Communit...
BACKGROUND: Hypertension is an important public health challenge worldwide. A systematic review o... more BACKGROUND: Hypertension is an important public health challenge worldwide. A systematic review on the evidence for hypertension in sub-Saharan Africa reported a prevalence of hypertension ranging between 13% and 48% with urban dwellers at higher risk than rural. Hypertension has long been an established risk factor for stroke and the timely diagnoses and treatment of hypertension is not debateable at all. OBJECTIVE: To determine the use of secondary prevention drugs for cardiovascular disease in rural and urban communities from a middle income country (South Africa) and a low-income country (Zimbabwe). METHODS: A group of 4585 volunteers from South Africa (3301urban and 1284 rural) and 1240 from Zimbabwe (458 Urban and 782 rural) with a mean age of 49,5 years participated in the Prospective Urban and Rural Epidemiology study. We assessed rates of previous cardiovascular disease and the use of effective secondary preventive drugs (anti-platelet drugs) and blood-pressure-lowering dru...
The prevalence of microalbuminuria (MAU) in African populations has not been reported, nor has th... more The prevalence of microalbuminuria (MAU) in African populations has not been reported, nor has the relationship between MAU and hypertension been reported for these populations. We collected spot urine samples from 370 women, 25 years and older as a part of a population-based, cross-sectional blood pressure survey in an urban community in Zimbabwe and analysed the samples for albumin and beta2-microglobulin. The age-adjusted prevalence of hypertension was 30% for women 25 years and older in this community. After excluding the samples with hematuria (11%), the prevalence of MAU (3.0 < or = albumin-to-creatinine ratio (ACR, mg/mmol) <25.0) in the study population was 9%. When age-adjusted to the population in the community, the prevalence was 8% among women 25 years and older. The prevalence of MAU was substantially higher in hypertensive (HT) than in normotensive (NT) women (16% vs 4%, P<0.001). A significantly higher level of log ACR in HT was found in each age group except...
High Blood Pressure & Cardiovascular Prevention, 2012
The objective of the study was to compare blood pressure changes during exercise between low and ... more The objective of the study was to compare blood pressure changes during exercise between low and normal birth weight young Black adults. Eighty medical students in their first and second year who had neonatal clinic cards as proof of birth weight were included in the study. Resting blood pressures and heart rates were recorded. Participants then underwent a multistage 9-minute exercise stress test while blood pressure responses were recorded at 3-minute intervals. The study was conducted in the Department of Physiology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe. Of the 80 subjects recruited, 34 had low birth weight (LBW), 26 of these were female and 8 were male. The proportion of LBW individuals, 62% (n = 21), who developed exercise-induced hypertension (EIH) was significantly higher (p &amp;amp;amp;amp;lt; 0.05) than the proportion of those with normal birth weight (NBW), 32% (n = 11). In addition to LBW being significantly associated with EIH (χ2 test p &amp;amp;amp;amp;lt; 0.05, odds ratio 7.5) compared with NBW, the LBW group had a significantly higher (p &amp;amp;amp;amp;lt; 0.05) and exaggerated systolic and diastolic response in stages I and II of the exercise protocol compared with the NBW group. LBW was associated with EIH in these young Black adults.
To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory meth... more To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory method using a mercury manometer. Blood pressures of randomly selected subjects were measured using both the Omron HEM-713C and the mercury manometer. Dombotombo surburb in Marondera, Zimbabwe. One hundred and sixteen subjects 25 years and above (47 males and 69 females) randomly selected in Marondera. Systolic blood pressure and diastolic blood pressure. The Omron HEM-713C passed with a grade B for both systolic and diastolic blood pressures when using the British Hypertension Society protocol. It also passed both systolic and diastolic criteria for Association of the Advancement of Medical Instrumentation. The Omron HEM-713C compares well with the standard mercury manometer, we therefore recommend its use in both research and clinical applications which require blood pressure measurements.
The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on ... more The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on projections from a limited number of reports. In the absence of national health surveys in Zimbabwe, all data nationally generated between 1990 and 1997 were analyzed. From 1990 to 1997, prevalence rates (expressed per 100,000 people) of hypertension increased from 1000 to 4000, rates of diabetes increased from 150 to 550, and rates of cerebrovascular accidents (CVA) increased from 5 to 15. The case fatality rate (CFR) for CVA decreased substantially during the period of study, implying improved case management of the disease, while the CFR for most other diseases did not change significantly throughout the study period. The observation of increased prevalence of some NCDs during the study period was corroborated by findings from a blood pressure survey subsequently conducted in an urban environment of Zimbabwe, which revealed a hypertension (blood pressure > or =140/90 mm Hg) prevale...
Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise... more Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise high blood pressure has been observed to develop in some rural people who migrate to urban areas in developing countries like Zimbabwe. The pathogenesis of this urbanisation-related hypertension is still unknown. We therefore investigated aspects of insulin resistance in urbanisation-related hypertension in Zimbabwean blacks using oral glucose tolerance tests. Thirty normotensive subjects and 30 newly diagnosed hypertensive patients participated in this study. All subjects had blood pressures measured by random zero sphygmomanometry. Fasting blood samples were taken before a 75 g oral glucose load was given. Four other blood samples were subsequently collected at 30 minute intervals and determination of blood glucose and insulin levels was made. Fasting glucose (mmol/l) and fasting insulin (in microU/ml) levels were, respectively, 4.8 +/- 0.2 and 19 +/- 2 in hypertensive patients which ...
The World Health Organization Regional Office for Africa (WHO AFRO) commissioned a study to compi... more The World Health Organization Regional Office for Africa (WHO AFRO) commissioned a study to compile and analyze published reports on non-communicable diseases (NCDs) in Africa to build evidence on the burden of NCDs in the region. Anecdotally, little information or literature was available on this subject. The objective of the study was to establish the status of NCDs in Africa by using published sources of information. A literature search was done through MEDLINE/PubMed and Google to identify studies that reported on prevalence rates of NCD risk factors. The study confirmed that information on NCDs in Africa was lacking. The prevalence of hypertension was found to be rapidly increasing, from 3% in rural areas to > 30% in some urban settings. In some populations, hypertension prevalence rates were higher in women than in men while the opposite was true in others. Most people with hypertension were not aware of their condition, and of those who were on treatment, < 20% had opti...
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
This study examined the role of endothelin (ET), the thromboxane A2 (TXA2)-prostacyclin (PGI2) ra... more This study examined the role of endothelin (ET), the thromboxane A2 (TXA2)-prostacyclin (PGI2) ratio (TXA2/PGI2), plasma renin activity (PRA) and urinary aldosterone excretion (ALDO) in urban hypertensive patients and in the sodium pressor response in normotensives. Twenty-seven urban hypertensive patients and the same number of normotensive controls were studied on baseline diet, after 5 days of sodium restriction and after 5 days of sodium loading. Mean arterial blood pressure, plasma and ET values, PRA, TXA2/PGI2 and ALDO were assessed on each diet. The results showed that baseline PRA was suppressed in the hypertensive patients; this indicates that urbanisation-related hypertension is of the low renin type. ET levels and TXA2/PGI2 were higher in hypertensive than in normotensive subjects, suggesting an association between high blood pressure and these factors. Although the baseline PRA in hypertensives was suppressed, urinary ALDO was no different from that in the normotensive c...
A growing body of evidence suggests that low birth weight (LBW) offspring are associated with lon... more A growing body of evidence suggests that low birth weight (LBW) offspring are associated with long-term structural and functional changes in cardiovascular and neuroendocrine systems. We tested the hypothesis that muscle metaboreflex activation produces exaggerated responses in cardiac autonomic tone (represented by heart rate variability ratio) and cutaneous vascular sympathetic tone (represented by plethysmography pulse wave amplitude) in LBW compared to normal birth weight (NBW) young adults. We recruited 23 LBW (18 females and five males) and 23 NBW (14 females and nine males) University of Zimbabwe students with neonatal clinical cards as proof of birth weight at term. Resting electrocardiogram, pulse waves, and blood pressures were recorded. Participants then underwent a static/isometric handgrip exercise until fatigue and a post-exercise circulatory arrest period of 2 minutes. We observed (results mean ± standard deviation) a greater mean increase in heart rate variability ra...
To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory meth... more To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory method using a mercury manometer. Blood pressures of randomly selected subjects were measured using both the Omron HEM-713C and the mercury manometer. Dombotombo surburb in Marondera, Zimbabwe. One hundred and sixteen subjects 25 years and above (47 males and 69 females) randomly selected in Marondera. Systolic blood pressure and diastolic blood pressure. The Omron HEM-713C passed with a grade B for both systolic and diastolic blood pressures when using the British Hypertension Society protocol. It also passed both systolic and diastolic criteria for Association of the Advancement of Medical Instrumentation. The Omron HEM-713C compares well with the standard mercury manometer, we therefore recommend its use in both research and clinical applications which require blood pressure measurements.
Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise... more Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise high blood pressure has been observed to develop in some rural people who migrate to urban areas in developing countries like Zimbabwe. The pathogenesis of this urbanisation-related hypertension is still unknown. We therefore investigated aspects of insulin resistance in urbanisation-related hypertension in Zimbabwean blacks using oral glucose tolerance tests. Thirty normotensive subjects and 30 newly diagnosed hypertensive patients participated in this study. All subjects had blood pressures measured by random zero sphygmomanometry. Fasting blood samples were taken before a 75 g oral glucose load was given. Four other blood samples were subsequently collected at 30 minute intervals and determination of blood glucose and insulin levels was made. Fasting glucose (mmol/l) and fasting insulin (in microU/ml) levels were, respectively, 4.8 +/- 0.2 and 19 +/- 2 in hypertensive patients which were significantly higher than 4.0 +/- 0.2 and 13 +/- 1.6 in normotensive patients (P &lt; 0.05). In addition the area under the insulin curve was significantly higher in hypertensive than in normotensive patients (P &lt; 0.05). These findings suggest that insulin resistance may play a role in urbanisation-related hypertension.
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, Jan 28, 2015
To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTA... more To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65-70 years was associated with fewer RTAs, but more falls; age 55-64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries...
WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% o... more WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability. We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry. Communit...
BACKGROUND: Hypertension is an important public health challenge worldwide. A systematic review o... more BACKGROUND: Hypertension is an important public health challenge worldwide. A systematic review on the evidence for hypertension in sub-Saharan Africa reported a prevalence of hypertension ranging between 13% and 48% with urban dwellers at higher risk than rural. Hypertension has long been an established risk factor for stroke and the timely diagnoses and treatment of hypertension is not debateable at all. OBJECTIVE: To determine the use of secondary prevention drugs for cardiovascular disease in rural and urban communities from a middle income country (South Africa) and a low-income country (Zimbabwe). METHODS: A group of 4585 volunteers from South Africa (3301urban and 1284 rural) and 1240 from Zimbabwe (458 Urban and 782 rural) with a mean age of 49,5 years participated in the Prospective Urban and Rural Epidemiology study. We assessed rates of previous cardiovascular disease and the use of effective secondary preventive drugs (anti-platelet drugs) and blood-pressure-lowering dru...
The prevalence of microalbuminuria (MAU) in African populations has not been reported, nor has th... more The prevalence of microalbuminuria (MAU) in African populations has not been reported, nor has the relationship between MAU and hypertension been reported for these populations. We collected spot urine samples from 370 women, 25 years and older as a part of a population-based, cross-sectional blood pressure survey in an urban community in Zimbabwe and analysed the samples for albumin and beta2-microglobulin. The age-adjusted prevalence of hypertension was 30% for women 25 years and older in this community. After excluding the samples with hematuria (11%), the prevalence of MAU (3.0 < or = albumin-to-creatinine ratio (ACR, mg/mmol) <25.0) in the study population was 9%. When age-adjusted to the population in the community, the prevalence was 8% among women 25 years and older. The prevalence of MAU was substantially higher in hypertensive (HT) than in normotensive (NT) women (16% vs 4%, P<0.001). A significantly higher level of log ACR in HT was found in each age group except...
High Blood Pressure & Cardiovascular Prevention, 2012
The objective of the study was to compare blood pressure changes during exercise between low and ... more The objective of the study was to compare blood pressure changes during exercise between low and normal birth weight young Black adults. Eighty medical students in their first and second year who had neonatal clinic cards as proof of birth weight were included in the study. Resting blood pressures and heart rates were recorded. Participants then underwent a multistage 9-minute exercise stress test while blood pressure responses were recorded at 3-minute intervals. The study was conducted in the Department of Physiology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe. Of the 80 subjects recruited, 34 had low birth weight (LBW), 26 of these were female and 8 were male. The proportion of LBW individuals, 62% (n = 21), who developed exercise-induced hypertension (EIH) was significantly higher (p &amp;amp;amp;amp;lt; 0.05) than the proportion of those with normal birth weight (NBW), 32% (n = 11). In addition to LBW being significantly associated with EIH (χ2 test p &amp;amp;amp;amp;lt; 0.05, odds ratio 7.5) compared with NBW, the LBW group had a significantly higher (p &amp;amp;amp;amp;lt; 0.05) and exaggerated systolic and diastolic response in stages I and II of the exercise protocol compared with the NBW group. LBW was associated with EIH in these young Black adults.
To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory meth... more To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory method using a mercury manometer. Blood pressures of randomly selected subjects were measured using both the Omron HEM-713C and the mercury manometer. Dombotombo surburb in Marondera, Zimbabwe. One hundred and sixteen subjects 25 years and above (47 males and 69 females) randomly selected in Marondera. Systolic blood pressure and diastolic blood pressure. The Omron HEM-713C passed with a grade B for both systolic and diastolic blood pressures when using the British Hypertension Society protocol. It also passed both systolic and diastolic criteria for Association of the Advancement of Medical Instrumentation. The Omron HEM-713C compares well with the standard mercury manometer, we therefore recommend its use in both research and clinical applications which require blood pressure measurements.
The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on ... more The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on projections from a limited number of reports. In the absence of national health surveys in Zimbabwe, all data nationally generated between 1990 and 1997 were analyzed. From 1990 to 1997, prevalence rates (expressed per 100,000 people) of hypertension increased from 1000 to 4000, rates of diabetes increased from 150 to 550, and rates of cerebrovascular accidents (CVA) increased from 5 to 15. The case fatality rate (CFR) for CVA decreased substantially during the period of study, implying improved case management of the disease, while the CFR for most other diseases did not change significantly throughout the study period. The observation of increased prevalence of some NCDs during the study period was corroborated by findings from a blood pressure survey subsequently conducted in an urban environment of Zimbabwe, which revealed a hypertension (blood pressure > or =140/90 mm Hg) prevale...
Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise... more Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise high blood pressure has been observed to develop in some rural people who migrate to urban areas in developing countries like Zimbabwe. The pathogenesis of this urbanisation-related hypertension is still unknown. We therefore investigated aspects of insulin resistance in urbanisation-related hypertension in Zimbabwean blacks using oral glucose tolerance tests. Thirty normotensive subjects and 30 newly diagnosed hypertensive patients participated in this study. All subjects had blood pressures measured by random zero sphygmomanometry. Fasting blood samples were taken before a 75 g oral glucose load was given. Four other blood samples were subsequently collected at 30 minute intervals and determination of blood glucose and insulin levels was made. Fasting glucose (mmol/l) and fasting insulin (in microU/ml) levels were, respectively, 4.8 +/- 0.2 and 19 +/- 2 in hypertensive patients which ...
The World Health Organization Regional Office for Africa (WHO AFRO) commissioned a study to compi... more The World Health Organization Regional Office for Africa (WHO AFRO) commissioned a study to compile and analyze published reports on non-communicable diseases (NCDs) in Africa to build evidence on the burden of NCDs in the region. Anecdotally, little information or literature was available on this subject. The objective of the study was to establish the status of NCDs in Africa by using published sources of information. A literature search was done through MEDLINE/PubMed and Google to identify studies that reported on prevalence rates of NCD risk factors. The study confirmed that information on NCDs in Africa was lacking. The prevalence of hypertension was found to be rapidly increasing, from 3% in rural areas to > 30% in some urban settings. In some populations, hypertension prevalence rates were higher in women than in men while the opposite was true in others. Most people with hypertension were not aware of their condition, and of those who were on treatment, < 20% had opti...
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
This study examined the role of endothelin (ET), the thromboxane A2 (TXA2)-prostacyclin (PGI2) ra... more This study examined the role of endothelin (ET), the thromboxane A2 (TXA2)-prostacyclin (PGI2) ratio (TXA2/PGI2), plasma renin activity (PRA) and urinary aldosterone excretion (ALDO) in urban hypertensive patients and in the sodium pressor response in normotensives. Twenty-seven urban hypertensive patients and the same number of normotensive controls were studied on baseline diet, after 5 days of sodium restriction and after 5 days of sodium loading. Mean arterial blood pressure, plasma and ET values, PRA, TXA2/PGI2 and ALDO were assessed on each diet. The results showed that baseline PRA was suppressed in the hypertensive patients; this indicates that urbanisation-related hypertension is of the low renin type. ET levels and TXA2/PGI2 were higher in hypertensive than in normotensive subjects, suggesting an association between high blood pressure and these factors. Although the baseline PRA in hypertensives was suppressed, urinary ALDO was no different from that in the normotensive c...
A growing body of evidence suggests that low birth weight (LBW) offspring are associated with lon... more A growing body of evidence suggests that low birth weight (LBW) offspring are associated with long-term structural and functional changes in cardiovascular and neuroendocrine systems. We tested the hypothesis that muscle metaboreflex activation produces exaggerated responses in cardiac autonomic tone (represented by heart rate variability ratio) and cutaneous vascular sympathetic tone (represented by plethysmography pulse wave amplitude) in LBW compared to normal birth weight (NBW) young adults. We recruited 23 LBW (18 females and five males) and 23 NBW (14 females and nine males) University of Zimbabwe students with neonatal clinical cards as proof of birth weight at term. Resting electrocardiogram, pulse waves, and blood pressures were recorded. Participants then underwent a static/isometric handgrip exercise until fatigue and a post-exercise circulatory arrest period of 2 minutes. We observed (results mean ± standard deviation) a greater mean increase in heart rate variability ra...
To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory meth... more To compare the Omron HEM-713C automated blood pressure machine with the standard ausculatory method using a mercury manometer. Blood pressures of randomly selected subjects were measured using both the Omron HEM-713C and the mercury manometer. Dombotombo surburb in Marondera, Zimbabwe. One hundred and sixteen subjects 25 years and above (47 males and 69 females) randomly selected in Marondera. Systolic blood pressure and diastolic blood pressure. The Omron HEM-713C passed with a grade B for both systolic and diastolic blood pressures when using the British Hypertension Society protocol. It also passed both systolic and diastolic criteria for Association of the Advancement of Medical Instrumentation. The Omron HEM-713C compares well with the standard mercury manometer, we therefore recommend its use in both research and clinical applications which require blood pressure measurements.
Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise... more Insulin resistance has been associated with essential hypertension, obesity and old age. Likewise high blood pressure has been observed to develop in some rural people who migrate to urban areas in developing countries like Zimbabwe. The pathogenesis of this urbanisation-related hypertension is still unknown. We therefore investigated aspects of insulin resistance in urbanisation-related hypertension in Zimbabwean blacks using oral glucose tolerance tests. Thirty normotensive subjects and 30 newly diagnosed hypertensive patients participated in this study. All subjects had blood pressures measured by random zero sphygmomanometry. Fasting blood samples were taken before a 75 g oral glucose load was given. Four other blood samples were subsequently collected at 30 minute intervals and determination of blood glucose and insulin levels was made. Fasting glucose (mmol/l) and fasting insulin (in microU/ml) levels were, respectively, 4.8 +/- 0.2 and 19 +/- 2 in hypertensive patients which were significantly higher than 4.0 +/- 0.2 and 13 +/- 1.6 in normotensive patients (P &lt; 0.05). In addition the area under the insulin curve was significantly higher in hypertensive than in normotensive patients (P &lt; 0.05). These findings suggest that insulin resistance may play a role in urbanisation-related hypertension.
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Papers by Jephat Chifamba