Silent Crisis: Epidemic Hypertension in Rural West Africa

Williams, Emmanuel Ato

doi:10.4172/2167-1095.1000147

Cited by 3 publications

(5 citation statements)

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“…In addition, factors like changes in diet, lifestyle, and the rising prevalence of obesity may contribute to finding a higher prevalence of hypertension in this study ( 12 ). Although the finding is in line with a study conducted in a rural community of Barekese in Ghana, where 438 adults aged ≥ 35 had a prevalence rate of 50.9% ( 26 ). However, a systematic review and a meta-analysis on the prevalence of adult hypertension in Ghana conducted by Bosu and Bosu ( 27 ) found a 27.0% pooled prevalence of hypertension which is relatively lower than the findings of this study but similar to that of Nigeria (28.9%) ( 28 ), Cameroon (30.9%) ( 29 ), Sub-Saharan Africa (30.0%) ( 30 ), Ethiopia (19.6%) ( 31 ), and of 44 developing countries (17.5%) ( 32 ).…”

Section: Discussionsupporting

confidence: 90%

The prevalence of hypertension and its associated risk factors among older adults in Ghana

Dai

Addai-Dansoh

Nutakor

et al. 2022

Front. Cardiovasc. Med.

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BackgroundHypertension is a worldwide health issue that primarily affects the elderly in our society. However, in comparison to the developed world, the prevalence of hypertension is higher in Sub-Saharan Africa.ObjectiveThis paper examines the prevalence of hypertension and its associated risk factors among older adults in Ghana.MethodsUsing the World Health Organization’s study on global AGEing and adult health (WHO SAGE) Wave 1 cross-sectional data collected via in-person structured interviews; paper and pencil interviews (PAPI) from ten administrative regions of Ghana using stratified multistage cluster design from respondents aged 50+ grouped by decade, this study analyzed a nationally representative sub-sample of 3,997 respondents employing binary logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to estimate risk factors associated with hypertension (blood pressure ≥ 130/80 mm/Hg).ResultsThere was a 53.72% hypertension prevalence rate among older adults. Hypertension prevalence tends to increase with increasing age. The prevalence of hypertension was associated with residency (B = −0.18, OR = 0.84, p < 0.017), with urban residents being more at risk of hypertension than rural residents. The prevalence of hypertension increased with overweight (B = 0.66, OR = 1.94, p < 0.001) and obesity (B = 0.82, OR = 2.28, p < 0.001). The amount of fruit and vegetable intake was insignificant but had an inverse relationship with hypertension prevalence.ConclusionThis study has shown that demographic and lifestyle factors significantly affect and explain the hypertension risk among older adults. Medical factors, such as chronic diseases, were largely insignificant and accounted for less hypertension prevalence. Therefore, when interpreting test findings in clinical practice, such as hypertension, it is essential to consider demographic and lifestyle factors. In addition, health policies and primary interventions that seek to improve the standard of living, lifestyle, and wellbeing of older adults need to be critically considered moving forward to lower hypertension prevalence among older adults in Ghana.

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Section: Discussionsupporting

confidence: 90%

The prevalence of hypertension and its associated risk factors among older adults in Ghana

Dai

Addai-Dansoh

Nutakor

et al. 2022

Front. Cardiovasc. Med.

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“…The first of these studies in 425 adults aged ≥35 years reported a prevalence of hypertension of 44.7% [ 130 ]. Concerned about this high prevalence in the rural community, the investigators repeated the study the following year in 438 adults aged ≥35 years and confirmed their earlier study with an even higher prevalence of 50.9% [ 131 ]. Then, in 2012, the investigators conducted another study in the same community, this time sampling 845 adults aged ≥18 years and found a prevalence of isolated systolic hypertension of 30.6%.…”

Section: Discussionmentioning

confidence: 56%

“…Inspired by this observation, we described an ‘epidemic of hypertension’ in our systematic review of 2010 [ 12 ]. Since then, a rural epidemic of hypertension [ 131 ] and a national epidemic of obesity in Ghana have been described [ 18 ]. Of particular concern is our finding that the urban-rural gap in the prevalence of hypertension has become blurred and that the high prevalence has persistent over four decades.…”

Section: Discussionmentioning

confidence: 99%

“…The narrowing urban-rural gap in the prevalence of hypertension may be due to changing lifestyles with a lower physical activity and a shift from traditional diets rich in fibre to energy-dense processed foods high in fat, sugar and salt [ 40 , 166 ]. With up to half of adults in some rural communities in Ghana living with hypertension [ 131 ] and about one-quarter living with overweight or obesity [ 18 ], cardiovascular risk should be now considered more pervasive in Ghana and resource planning and allocation adjusted accordingly.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence, awareness and control of hypertension in Ghana: A systematic review and meta-analysis

Bosu

Bosu²

2021

PLoS ONE

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Background Hypertension is a major health problem in Ghana, being a leading cause of admissions and deaths in the country. In the context of a changing food and health policy environment, we undertook a systematic review (PROSPERO registration number: CRD42020177174) and a meta-analysis of the prevalence of adult hypertension, and its awareness and control in Ghana. Methods We searched major databases including PubMed, Embase as well as Google Scholar and online digital collections of public universities of Ghana to locate relevant published and unpublished community-based articles up till April 2020. Findings Eighty-five articles involving 82,045 apparently-healthy subjects aged 15–100 years were analyzed. In individual studies, the prevalence of hypertension, defined in most cases as blood pressure ≥ 140/90 mmHg, ranged from 2.8% to 67.5%. The pooled prevalence from the meta-analysis was 27.0% (95% CI 24.0%-30.0%), being twice as high in the coastal (28%, 95% CI: 24.0%-31.0%) and middle geo-ecological belts (29%, 95% CI: 25.0%-33.0%) as in the northern belt (13%, 95% CI: 7.0%-21.0%). The prevalence was similar by sex, urban-rural residence or peer-review status of the included studies. It did not appear to vary over the study year period 1976–2019. Of the subjects with hypertension, only 35% (95% CI: 29.0%-41.0%) were aware of it, 22% (95% CI: 16.0%-29.0%) were on treatment and 6.0% (95% CI: 3.0%-10.0%) had their blood pressure controlled. Sensitivity analyses corroborated the robust estimates. There was, however, high heterogeneity (I2 = 98.7%) across the studies which was partly explained by prevalent obesity in the subjects. Conclusion More than one in four adults in Ghana have hypertension. This high prevalence has persisted for decades and is similar in rural and urban populations. With the low awareness and poor control of hypertension, greater investments in cardiovascular health are required if Ghana is to meet the global target for hypertension.

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“…The burden is not peculiar to urban areas as studies in rural areas in sub-Saharan Africa have also revealed a high rate. (21)(22)(23) Reports have shown that urban populations consistently have higher prevalence of hypertension than their rural counterparts in almost all studies that covered both area (15). This observation has been suggested to be linked with increased levels of obesity, salt and fat intake from increased consumption of processed foods, and engaging in jobs with minimal physical activity and smoking.…”

Section: P R E V a L E N C E O F H Y P E R T E N S I O Nmentioning

confidence: 99%

Review of Hypertension in sub-Saharan Africa

Nkyi

2017

Afri Jour Cur Med Res

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The prevalence of hypertension in sub-Saharan Africa is high and it is the main driver for cardiovascular diseases in the region. Cardiovascular diseases are associated with high morbidity and mortality worldwide. The high prevalence of hypertension in sub-Saharan Africa (SSA) can be attributed to rural-urban migration, high salt intake, smoking of tobacco and inadequate exercise. Awareness and control of hypertension is generally low with women having better control rates as compared to men. Untreated hypertension is associated with stroke, myocardial infarction and renal failure. The management of hypertension in the sub region is a major challenge due to financial constraints and inadequate resources. Hypertension is struggling to gain priority as a major health threat as infectious diseases like Human Immunodeficiency virus (HIV), tuberculosis (TB) and malaria are the main focus of most public health institutions. Hypertension is largely preventable and can be easily controlled using evidence based practices such as regular exercises, decreasing salt intake, cessation of smoking and alcohol intake and the usage of antihypertensives.Non-communicable diseases such as hypertension are rapidly overtaking communicable diseases in the sub-Saharan region and pose a major health threat. There is a need to prioritize cardiovascular diseases with a focus on pragmatic prevention and control of hypertension in order to decrease the burden of the disease in the region.

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Silent Crisis: Epidemic Hypertension in Rural West Africa

Abstract: The Barekese sub-district of Ghana is a rural community near Kumasi, Ghana's second largest city, where investigators have previously identified a high burden of hypertension along with poor

Cited by 3 publications

References 26 publications

The prevalence of hypertension and its associated risk factors among older adults in Ghana

The prevalence of hypertension and its associated risk factors among older adults in Ghana

Prevalence, awareness and control of hypertension in Ghana: A systematic review and meta-analysis

Review of Hypertension in sub-Saharan Africa

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