Hypertension determinants among Ghanaians differ according to location of residence: RODAM study

Abstract

van den Born a,b , and Charles Agyemang a Objective: Hypertension prevalence is high among African migrants, but the determinants of hypertension in migrants in Europe in relation to the population in the country of origin still needs to be elucidated. Therefore, the aim of this study was to assess the determinants of hypertension in Ghanaians residing in Ghana and Europe. Methods:The current study used baseline data of 5659 participants, aged 25-70 years, of the Research on Obesity and Diabetes among African Migrants study. Multivariate logistic regression analysis was used to assess sociodemographic, lifestyle, psychosocial, anthropometric and health factors independently associated with hypertension in Ghanaians living in rural and urban Ghana, and Ghanaian migrants living in Europe.Results: Across all sites, older age (both sexes; odds ratio 1.07, 95% confidence interval 1.06-1.08) and diabetes (females only; 2.02, 1.54-1.67) were independently associated with hypertension. The other determinants of hypertension differed between geographical locations. Higher waist circumference (1.12, 1.05-1.20) was independently associated with hypertension in rural-Ghanaian males, as was higher body mass index (1.15, 1.03-1.28) in urban-Ghanaian males, higher waist circumference (1.04, 1.01-1.07) and diabetes (1.75, 1.17-2.63) in European-Ghanaian males. In European-Ghanaian females, high alcohol intake (1.88, 1.01 -3.53) and waist circumference (1.04, 1.02-1.06) were associated with hypertension, whereas in rural-Ghanaian females, a higher educational level (0.28, 0.08-0.98) was inversely associated with hypertension. Conclusion:The current study identified several modifiable determinants of hypertension in Ghanaians, with differences between populations residing in various geographical locations. This highlights the importance of development and implementation of context-specific interventions targeting these determinants to reduce the burden of hypertension among Ghanaian migrants and nonmigrants.

Cohort profile: Research on Obesity and Diabetes among African Migrants in Europe and Africa Prospective (RODAM-Pros) cohort study

“…23 24 The RODAM study has identified various cross-sectional factors associated with CVD risk factors. [25][26][27] In addition, the study has resulted in the first EWAS for type 2 diabetes in SSA, in which we identified several CpG sites that were differentially methylated between type 2 diabetes cases and controls at an epigenome-wide level. 28 In our study of epigenome-wide DNA methylation differences between migrant and non-migrant Ghanaians, we identified 13 differentially methylated positions and 3 differentially methylated regions between migrants and non-migrants, with DNA methylation differences ranging from 0.1 to 4.5%.…”

Risk Assessment Score and Chi-Square Automatic Interaction Detection Algorithm for Hypertension Among Africans: Models From the SIREN Study

“…Thirteen risk factors were initially assessed based on the literature review, 3,7,[23][24][25] clinical understanding of hypertension, and empirical evidence of factors associated with hypertension in the SIREN dataset. 7 Briefly, these factors were identified/ defined as follows: sex (male or female), age (<65 or ≥65) years, residence (rural or urban), formal education completed ("none" or "at least primary school"), physical inactivity (where the respondent was not involved in physical exercise including walking, swimming, gardening, jogging, playing football, and vigorous exercise for <4 hours/week 26 ), current alcohol use (self-reported; no or yes), current smoking (using any form of tobacco products for at least 12 months before the time of recruitment 19 ), adding salt at the table to ready-to-eat meals (self-reported; no or yes), anthropometric measurements (body mass index [BMI] and waist circumference [WC] measured by trained personnel using standard protocols), and family history of CVD (self-reported; no or yes).…”