Prevalence, Detection, Management and Control of Hypertension in Ashanti, West Africa

Abstract

Hypertension and stroke are important threats to the health of adults in sub-Saharan Africa. Nevertheless, detection of hypertension is haphazard and stroke prevention targets are currently unattainable. Prevalence, detection, management, and control of hypertension were assessed in 1013 men (nϭ385) and women (nϭ628), both aged 55 [SD 11] years, living in 12 villages in Ashanti, Ghana. Five hundred thirty two lived in semi-urban and 481 in rural villages. The participants underwent measurements of height, weight, and blood pressure (BP) and answered a detailed questionnaire. Hypertension was defined as BP Ն140 and/or Ն90 mm Hg or being on drug therapy. Women were heavier than men. Participants in semi-urban areas were heavier and had higher BP (129/76 [26/14] versus 121/72 [25/13] mm Hg; PϽ0.001 for both) than in rural areas. Prevalence of hypertension was 28.7% overall and comparable in men and women, but higher in semi-urban villages (32.9% [95% CI 28.9 to 37.1] versus 24.1% [20.4 to 28.2]), and increased with age. Detection rate was lower in men than women (13.9% versus 27.3%; Pϭ0.007). Treatment and control rates were low in both groups (7.8% and 4.4% versus 13.6% and 1.7%). Detection, treatment, and control rates were higher in semi-urban (25.7%, 14.3%, and 3.4%) than in rural villages (16.4%, 6.9%, and 1.7%). Hypertension is common in adults in central Ghana, particularly in urban areas. Detection rates are suboptimal in both men and women, especially in rural areas. Adequate treatment of high BP is at a very low level. There is an urgent need for preventive strategies on hypertension control in Ghana.

Prevalence of Hypertension among Urban Slum Dwellers in Lagos, Nigeria

“…The mean systolic blood pressure of 136.96±25.2 mmHg in this study was higher than the 121.5 mmHg that was observed about a decade ago in similar studies in Ghana 23 and Nigeria. 12 The increase can be attributed to the general increase in the rate of hypertension globally which may be related to the increase in the risk factors for the development of hypertension as a result of increasing urbanization.…”

“…Our study showed that the prevalence of hypertension was higher in males than females. This observation was also reported in other sudies 12,23 whereas some other studies actually found a higher prevalence in women. 24 However, this study showed that women had consistently higher age-specific prevalence of diastolic hypertension.…”

“…This low awareness has been well described in similar studies. 3,8,16,17,23 The low level of education, poverty, ignorance, lack of access to health information and health care services may be responsible for the low awareness. Hypertension is a disease that does not present with obvious signs and symptoms and therefore it is called the "silent killer".…”

Factors associated with hypertension awareness, treatment and control in rural Chinese

“…[6][7][8][9] Our study findings are consistent with several previous reports. Studies conducted in developing countries have consistently indicated that compared to their counterparts with a lower income, persons with a higher income have better access to health care and higher rates of awareness, treatment and control of hypertension.…”

Management of hypertension at the community level in Sub-Saharan Africa (SSA): towards a rational use of available resources

“…The particular context of SSA containing poverty and illiteracy contributes to the low awareness, control and treatment rate of hypertension (22). The limited resources devoted toward health care limit the number of health facilities added to the inexistence of health insurance scheme (23).…”