After conducting community-based tests, scientists have found alarming rates of undiagnosed organ damage among adults with high blood pressure (BP) and diabetes, underlining the need for regular prevention and screening.

This study, which involved scientists from Europe and Africa, aimed to determine the prevalence of target organ damage such as blindness, kidney failure, and damage of nerves among individuals with BP and/or diabetes during a survey in Lesotho in southern Africa. Their findings were published in the Journal of Epidemiology and Global Health on October 26, 2023.

Organ damage incidence
The researchers observed that although the entire study population had high rates of undiagnosed organ damage, which included retinopathy, renal impairment, and peripheral neuropathy, the chances of target organ damage were significantly higher in those with BP and/or diabetes than in those without either condition.

“The high rates of target organ damage among adults screened in the community indicate a looming epidemic of cardiovascular disease. These findings emphasize that in addition to the urgently needed prevention and care programs for cardiovascular risk factors such as elevated BP and diabetes, there is a pressing need to establish regular screening, patient education, and disease management programs for target organ damage in this setting,” warned the scientists.

As part of the household-based survey, 6,108 adults were screened from 120 randomly selected villages in the Lesotho districts of Mokhotlong and Butha-Buthe between November 2021 and August 2022.

Survey outcome
The survey outcomes revealed that among the participants with high BP, about one in three individuals had hypertensive retinopathy, whereas individuals with diabetes, regardless of their blood pressure levels, had a retinopathy prevalence of 14%.

Meanwhile, renal impairment prevalence was also higher among the study population with scientists stating to have found a high proportion of participants at high to very high risk of progression of renal impairment, in line with the results of another study in sub-Saharan Africa.

In the case of peripheral neuropathy, the survey results aligned with several other studies that have previously reported prevalence rates ranging from 15 to 27% among patients with diabetes. It's worth noting that the scientists evaluated peripheral neuropathy in individuals with diabetes, as it is one of the most common complications associated with the condition.

Prediction: looming epidemic
The scientists emphasized: “The high rates of target organ damage among adults screened in the community indicate a looming epidemic of cardiovascular disease. These findings emphasize that in addition to the urgently needed prevention and care programs for cardiovascular risk factors such as elevated BP and diabetes, there is a pressing need to establish regular screening, patient education, and disease management programs for target organ damage in this setting.”

Contributors to the study
Seasoned researcher, Prof. Maja Weisser contributed to the study. Maja is affiliated with Ifakara and the University of Basel, Switzerland. The study's lead author was Emmanuel Firima from the University of Basel. Other contributors are: Alain Amstutz and Niklaus Daniel Labhardt, Lucia Gonzalez, Eleonara Seelig, Tristan Lee, and Frédérique Chammartin and Thilo Burkard, also from the University of Basel. 

Other scientists who contributed to the study and publication are: Molulela Manthabiseng, Mamoronts'sane Sematle, Matumaole Bane, Makhebe Khomolishoele, Ikhetheleng Leisa, Lefokotsane Retselisitsoe, and Ravi Gupta from SolidarMed, Lesotho; Bailah Leigh from the University of Sierra Leone and Moazziz Ali Khan from Norges Blindeforbund, Norway.

Read the full publication here