Blood pressure control, glycemic control, and dyslipidemia among healthy adults in the Cape Coast metropolis, Ghana

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

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well as Google Scholar and online digital collections of public universities of Ghana to locate relevant published and unpublished community-based articles up till April 2020.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.

Arterial hypertension in the elderly accompanied in primary care: profile and associated factors

Abstract Objective: to analyze blood pressure control in elderly hypertensives accompanied by a Basic Health Unit of the Federal District, determining the sociodemographic profile and the associated risk factors. Method: this is a cross-sectional study with 133 elderly hypertensive patients. Variables related to sociodemographic factors, life habits, clinical factors and adherence to drug therapy were evaluated through the application of semistructured instruments and validated scales. Results with p <0.05 were considered significant. Results: the elderly presented controlled blood pressure (56.4%) predominantly. The majority of the participants were female and women also had a higher rate of uncontrolled blood pressure (86.2%). Older age was associated with higher blood pressure values (p = 0.031). Alcoholism (p = 0.020) and mean body mass index of 33.0 (p <0.000) were factors associated with hypertension adherence to therapy had more controlled values of systolic and diastolic blood pressure. Conclusion and implications for the practice: it was verified that there is a strong association between the risk factors discussed and the lack of control of the blood pressure of elderly hypertensive, especially with regard to advanced age, alcoholism, obesity and overweight, and it is necessary to reorient the planning and strategies of promotion of health and prevention of diseases directed at the elderly hypertensive in the scope of primary health care.