Food Insecurity and Blood Pressure in West Africans with Chronic Kidney Disease

Background/aims: Food insecurity, limited/uncertain access to adequate food, is a growing concern, especially in low- and middle-income countries, where it may exacerbate chronic kidney disease (CKD). Evidence on the relationship between food insecurity and blood pressure (BP) in West African CKD populations remains scarce. This study aimed to (1) assess food insecurity prevalence in West African CKD populations; (2) identify associated sociodemographic factors; and (3) examine its association with systolic BP (SBP) and diastolic BP (DBP). Methods: We conducted a cross-sectional analysis using data from the Diet, CKD, and Apolipoprotein L1 (DCA) Study and an ancillary study to the Human Heredity and Health in Africa (H3 Africa) Kidney Disease Research Network in Nigeria and Ghana. Food insecurity was assessed using a validated single-question survey, and BP was measured by trained study coordinators during in-person study visits after 5 min of seated rest using an automated device. We used the average of three blood pressure readings taken at the specific visit for the analyses. Prevalence estimates were calculated by region, and associations with BP were analyzed using mixed effects linear regression with clinical site as a random effect. Results: Among 617 CKD participants, 27% (n = 169) reported food insecurity. Prevalence was highest in South-East (67%) and South-West Nigeria (28%) compared to Central Nigeria (2%) and Greater Accra Region, Ghana (13%). Overall, food insecurity was not significantly associated with BP. However, stratified analysis showed that among females, food insecurity was associated with higher diastolic BP (β = 4.86, 95% CI: 0.92, 8.84, p = 0.02). Conclusion: Food insecurity was not directly associated with either SBP or DBP in the DCA participants; however, the elevated DBP among food-insecure females suggests potential indirect effects on disease progression.

Duke Scholars

Author Rasheed Adebayo Gbadegesin Pediatrics, Nephrology