Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies

  • Frederieke Sophie Diemer
  • Marieke Brigitte Snijder
  • Charles Agyemang
  • Yentl Christina Haan
  • Fares Aziz Karamat
  • Gert Alexander van Montfrans
  • Glenn Paul Oehlers
  • Ronaldus Joannes Gerardus Peters
  • Lizzy Maritza Brewster
  • Karien StronksEmail author


We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18–70 years), respectively. Groups were formed based on country and self-defined ethnicity, and stratified by sex. Age-adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated for hypertension prevalence, awareness, treatment, and control. Subsequently, we focused on hypertension prevalence and adjusted for risk factors for hypertension: BMI and waist circumference (model 2), educational level, physical activity, and smoking (model 3). After adjustment for age, no significant differences in hypertension prevalence, awareness, treatment, and control between countries were seen in men. However, women in Suriname were more often hypertensive with lower levels of awareness and control than those in The Netherlands (African: OR 1.54 [95% CI 1.19, 2.00]; South-Asian: 1.90 [1.35, 2.67]; awareness: 0.62 [0.43, 0.88] in African women; control: 0.48 [0.28, 0.84] in South-Asian women). Higher hypertension prevalence was explained by differences in BMI and waist circumference in African women (adjusted OR 1.26 [0.96, 1.65]) and by education, physical activity, and smoking in South-Asian women (adjusted OR 1.29 [0.87, 1.89]). Particularly, women in Suriname bear a relatively high hypertension burden with lower levels of awareness and control. As the higher hypertension prevalence was mainly explained by lifestyle-related risk factors, health promotion interventions may reduce the hypertension burden in Suriname.


Hypertension Prevalence Awareness Treatment Control Ethnicity 



The HELISUR study is conducted by the Academic Hospital Paramaribo with no external funding. The HELIUS study is conducted by the Academic Medical Center Amsterdam and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, The Netherlands Organization for Health Research and Development, the European Commission, and the European Fund for the Integration of non-EU immigrants (EIF). We are most grateful to the participants, research assistants, interviewers, and other staff who have taken part in gathering the data of these two studies.

Author contributions

FSD drafted the manuscript. MBS, KS, and LMB made substantial contributions in the interpretation of the data and in revising the manuscript. All authors critically reviewed the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study protocols were approved by the respective ethic committees of both research institutes and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participants gave written informed consent prior to the enrolment in the studies.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2020

Authors and Affiliations

  • Frederieke Sophie Diemer
    • 1
    • 2
  • Marieke Brigitte Snijder
    • 5
  • Charles Agyemang
    • 5
  • Yentl Christina Haan
    • 3
  • Fares Aziz Karamat
    • 3
  • Gert Alexander van Montfrans
    • 4
  • Glenn Paul Oehlers
    • 1
  • Ronaldus Joannes Gerardus Peters
    • 2
  • Lizzy Maritza Brewster
    • 6
    • 7
    • 8
  • Karien Stronks
    • 5
    Email author
  1. 1.Department of CardiologyAcademic Hospital ParamariboParamariboSuriname
  2. 2.Department of CardiologyAmsterdam UMC, Univ of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Vascular MedicineAmsterdam UMC, Univ of AmsterdamAmsterdamThe Netherlands
  4. 4.Department of Internal MedicineAmsterdam UMC, Univ of AmsterdamAmsterdamThe Netherlands
  5. 5.Department of Public Health, Public Health Research InstituteAmsterdam UMC, University of AmsterdamAmsterdamThe Netherlands
  6. 6.The Amsterdam Institute for Global Health and Development (AIGHD)AmsterdamThe Netherlands
  7. 7.Creatine Kinase FoundationAmsterdamThe Netherlands
  8. 8.Department of Public HealthAnton de Kom University of SurinameParamariboSuriname

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