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Sahatqija F, Hunsberger M, Cook S, Kholmatova K, Shapkina M, Malyutina S, Kudryavtsev AV. Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults. Int J Hypertens 2024; 2024:8542671. [PMID: 38567246 PMCID: PMC10985646 DOI: 10.1155/2024/8542671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes mellitus (DM). This study aimed to assess awareness of these three conditions among Russian adults (N = 3803) and the associated socio-demographic, lifestyle, and health characteristics. We used cross-sectional data from a randomly drawn population-based sample of Russians aged 35-69 years, who participated in the Know Your Heart (KYH) study conducted in Arkhangelsk and Novosibirsk between 2015-2018. Participants' self-reported awareness of hypertension, hypercholesterolemia, and DM was assessed against the measures at the KYH health check (blood pressure, cholesterol, HbA1c and/or use of medication for each condition). Prevalence estimates for the awareness were age- and sex-standardized to the Standard European Population. Socio-demographic, lifestyle, and health-related correlates of the awareness were investigated using logistic regression modelling. Among participants with hypertension (N = 2206), hypercholesterolemia (N = 3171), and DM (N = 329) recorded at a health check, 79%, 45%, and 61% self-reported these conditions, respectively. Higher awareness of hypercholesterolemia and hypertension was associated with older age, female sex, nonsmoking status, obesity, and history of CVD diagnoses. Low household income and history of CVD diagnoses were associated with being aware of DM. The awareness rates of hypertension were relatively high, whereas awareness rates of hypercholesterolemia and DM were relatively low. CVD prevention and early intervention could be improved in Russia through increasing the awareness of the risk factors.
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Affiliation(s)
- Filip Sahatqija
- Shalgrenska Academy, University of Gothenburg, Gothenburg 41390, Sweden
| | - Monica Hunsberger
- Shalgrenska Academy, University of Gothenburg, Gothenburg 41390, Sweden
| | - Sarah Cook
- School of Public Health, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
| | - Kamila Kholmatova
- International Research Competence Centre, Northern State Medical University, Arkhangelsk 163069, Russia
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø N-9037, Norway
| | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630089, Russia
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630089, Russia
- Department of Therapy, Haematology and Transfusiology, Novosibirsk State Medical University, Novosibirsk 630090, Russia
| | - Alexander V. Kudryavtsev
- International Research Competence Centre, Northern State Medical University, Arkhangelsk 163069, Russia
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø N-9037, Norway
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Sekyi E, Agyapong NAF, Eshun G. Food consumption by NOVA food classification, metabolic outcomes, and barriers to healthy food consumption among university students. Food Sci Nutr 2024; 12:1983-1994. [PMID: 38455168 PMCID: PMC10916562 DOI: 10.1002/fsn3.3894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 03/09/2024] Open
Abstract
The NOVA food classification system is a simple tool that can be used to assess the consumption levels of different categories of foods based on their level of processing. The degree to which food is processed has a significant impact on health outcomes. In Ghana, no study exists on the consumption of the different NOVA food groups among tertiary students and how it relates to their metabolic outcomes. This study assessed the frequency of food intake according to the NOVA classification and how they relate to body mass index, waist circumference, and blood pressure. The barriers to the consumption of healthy foods among students were also assessed. This was a cross-sectional study conducted among 352 students of the Takoradi Technical University. Questionnaire was used to obtain sociodemographic information as well as data on perceived barriers to healthy food consumption. Food frequency questionnaire was used to obtain data on dietary intake. The weight, height, waist circumference, waist-to-hip ratio, and blood pressure of all participants were measured. Chi-square was used to compare categorical variables between males and females and to determine the association between the frequency of food intake according to the NOVA classification and metabolic indicators. The prevalence of overweight and obesity was 23.8%. More than half (51.1%) of the students had elevated blood pressure. The majority of study participants (54.2%) had a high frequency of consumption of both unprocessed and ultra-processed foods. Male students who frequently consumed ultra-processed foods (1-6 times/day) had significantly high blood pressure. High consumption of both ultra-processed and unprocessed foods was also associated with elevated blood pressure among male students. Limited time to prepare healthy meals and the high cost of unprocessed foods were among barriers to which most students strongly agreed to. Establishment of canteens that provide affordable healthy foods, teaching students time management, and nutrition education can mitigate barriers to healthy food consumption.
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Affiliation(s)
- Elizabeth Sekyi
- Department of Hospitality ManagementTakoradi Technical UniversityTakoradiGhana
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Guy Eshun
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
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Hooley B, Otchi EH, Mayeden S, Yawson AE, Awoonor-Williams K, Tediosi F. Examining the Utilization of Social Capital by Ghanaians When Seeking Care for Chronic Diseases: A Personal Network Survey. Int J Public Health 2023; 68:1605891. [PMID: 38179319 PMCID: PMC10764420 DOI: 10.3389/ijph.2023.1605891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives: With limited social security and health protection in Ghana, intergenerational support is needed by those living with NCDs, who incur recurrent costs when seeking NCD care. We measured the level of informal support received by NCD patients and identified factors that influence support provision. Methods: We surveyed 339 NCD patients from three hospitals in Ghana, who listed their social ties and answered questions about their relationship and support frequency. We analyzed the relationship between social support, demographic and health information, characteristics of social ties, and network characteristics. Results: Participants described 1,371 social ties. Nearly 60% of respondents reported difficulties in their usual work or household duties due to chronic illness, which was also the strongest predictor of support. Patients with higher wellbeing reported less social support, while older age and having co-habitant supporters were negatively associated with support, indicating caregiver burnout. Conclusion: Ghanaian NCD patients receive support from various caregivers who may not be able to handle the increasing healthcare and social needs of an aging population. Policies should therefore enhance resource pooling and inclusiveness for old age security.
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Affiliation(s)
- Brady Hooley
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Elom Hillary Otchi
- Korle Bu Teaching Hospital, Accra, Ghana
- Accra College of Medicine, Accra, Ghana
| | | | - Alfred Edwin Yawson
- Korle Bu Teaching Hospital, Accra, Ghana
- Medical School, University of Ghana, Accra, Ghana
| | - Koku Awoonor-Williams
- Department of Policy, Planning, Monitoring and Evaluation, Ghana Health Service, Accra, Ghana
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
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Fotouhi F, Shahidi A, Hashemi H, Saffarpour M, Yekta A, Esmaieli R, Esteki T, Derakhshan HB, Khabazkhoob M. Hypertension prevalence in Iran's elderly according to new criteria: the Tehran Geriatric Eye Study. J Diabetes Metab Disord 2023; 22:1489-1498. [PMID: 37975137 PMCID: PMC10638178 DOI: 10.1007/s40200-023-01272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 07/27/2023] [Indexed: 11/19/2023]
Abstract
Purpose To determine the prevalence of hypertension in a population above 60 years of age and its relationship with demographic and anthropometric factors. Methods A cross-sectional population-based study was conducted in 2019. Using a multistage random cluster sampling, 160 clusters were selected from 22 districts of Tehran. All participants were interviewed to collect demographic, anthropometric, and socioeconomic information. Then, systolic (SBP) and diastolic (DBP) blood pressures were measured under standard conditions twice, 10 min apart. A third measurement was performed if the two measurements showed a difference of ≥ 10 mmHg in SBP or ≥ 5 mmHg in DBP. Hypertension was defined as a SBP > 130 mmHg or a DBP > 80 mmHg (new criteria), being a known case of hypertension, or use of blood pressure lowering medications. Results Of 3791 invitees, 3310 participated in the study (87.3%). The mean age of the participants was 68.25 ± 6.54 years (60-97 years). The prevalence of hypertension was 81.08% (95% CI: 79.57-82.59) in the whole sample; 82.96% (95% CI: 81.02-84.91) in females, and 79.15% (95% CI: 76.6 -81.69) in males. The prevalence of hypertension ranged from 75.47% (95% CI: 72.65-78.29) in the age group 60-64 years to 88.40% (95% CI: 83.71-93.08) in the age group ≥ 80 years. The prevalence of hypertension unawareness was 32.84% (95% CI: 30.82-34.86). The highest and lowest prevalence of hypertension was seen in illiterate subjects (89.41%) and those with a university education (77.14%), respectively. According to the multiple logistic regression analysis, older age, lower education level, obesity and overweight, neck circumference, and diabetes were significantly associated with the prevalence of hypertension. Conclusion A significant percentage of Iranian elderly have hypertension and one of every 3 affected individuals is unaware of their disease. Considering the population aging in Iran, urgent and special attention should be paid to the elderly population. Caring for the elderly, informing families, and using non-traditional screening methods are recommended by families at the first level and policymakers at the macro level.
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Affiliation(s)
- Farid Fotouhi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Shahidi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mahshid Saffarpour
- Department of Restorative Dentistry, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roghayeh Esmaieli
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taraneh Esteki
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoon Bana Derakhshan
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Anesthesiology and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lamloum D, Fassio F, Osetinsky B, Tediosi F. Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis. Int J Public Health 2023; 68:1606428. [PMID: 37901590 PMCID: PMC10600349 DOI: 10.3389/ijph.2023.1606428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Objective: High blood pressure is the leading risk factor for cardiovascular disease. The hypertension care cascade (HCC) is increasingly being used to evaluate the effectiveness of interventions. This systematic review aims to examine HCC in low-income settings. Methods: The search strategy included articles published between January 2010 and April 2023. We excluded studies with incomplete HCC, on fragile patients or aged <18 years, reviews. We used the MOOSE guideline. Five researchers retrieved data on the survey year, country, population, HCC and diagnostic methods for hypertension. We used JBI Critical Appraisal Tools for quality assessment. Results: Ninety-five articles were analyzed. Average hypertension prevalence was 33% (95% CI: 31%-34%), lower in LICs than in LMICs (25% vs. 34%). The overall mean awareness of hypertension was 48% (95% CI: 45%-51%), its treatment was 35% (95% IC: 32%-38%) and its control 16% (95% CI: 14%-18%). In almost all steps, percentages were lower in LICs and in Sub-Saharan Africa. Conclusion: Trends in HCC vary between countries, with poorer performance in LICs. This review highlights the need for interventions tailored to low-income settings in order to improve hypertension care.
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Affiliation(s)
- Demetrio Lamloum
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Federico Fassio
- Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Brianna Osetinsky
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Haung Z, Hong SA. Prevalence and factors associated with treatment and control of hypertension among adults with hypertension in Myanmar. Int Health 2023; 15:207-215. [PMID: 35851920 PMCID: PMC9977219 DOI: 10.1093/inthealth/ihac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/03/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Due to a dearth in the number of studies conducted in low- and middle-income countries, this study aimed to identify the prevalence and determinants of the treatment and control of hypertension among patients with hypertension in Myanmar. METHODS This community-based cross-sectional study was conducted among 410 adults who were registered for hypertensive treatment in health centers in Myitkyina Township, Kachin State, Myanmar. Multiple logistic regression was used to identify the associated factors. RESULTS The prevalence of treatment and control of hypertension was 48.1% and 20.5%, respectively. The factors associated with treatment were age (OR=2.60 for 46-60 y and OR=2.29 for 61-70 y compared with 30-45 y), ethnicity (OR=1.87), monthly family income (OR=1.90), comorbidity (OR=2.33), knowledge (OR=2.63) and adherence to physical activity (OR=1.86). Controlled hypertension was associated with age (OR=3.03 for 46-60 y and OR=2.27 for 61-70 y compared with 30-45 y), education (OR=1.81), comorbidity (OR=1.67) and adherence to medication (OR=3.45). CONCLUSIONS The prevalence of treated and controlled hypertension was relatively low in this study. To improve the prevalence of hypertension treatment and control in this study population, effective and culturally sensitive intervention programs under universal health coverage should be established with an emphasis on individuals with lower educational attainment and younger ages.
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Affiliation(s)
- Ze Haung
- Township Department of Public Health, Myitkyina Township, Kachin State, Myanmar
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phuthamonthon, Nakhon Pathom 73170, Thailand
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Dai B, Addai-Dansoh S, Nutakor JA, Osei-Kwakye J, Larnyo E, Oppong S, Boahemaa PY, Arboh F. The prevalence of hypertension and its associated risk factors among older adults in Ghana. Front Cardiovasc Med 2022; 9:990616. [PMID: 36606290 PMCID: PMC9807661 DOI: 10.3389/fcvm.2022.990616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background Hypertension 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. Objective This paper examines the prevalence of hypertension and its associated risk factors among older adults in Ghana. Methods Using 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). Results There 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. Conclusion This 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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Affiliation(s)
- Baozhen Dai
- Department of Labor and Social Security, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Stephen Addai-Dansoh
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu, China,*Correspondence: Stephen Addai-Dansoh,
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Jeremiah Osei-Kwakye
- School of Computer Science and Telecommunications Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Ebenezer Larnyo
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Stephen Oppong
- Department of Agriculture Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Priscilla Yeboah Boahemaa
- Department of Accounting and Finance, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francisca Arboh
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu, China
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Awareness, treatment, and practices of lifestyle modifications amongst diagnosed hypertensive patients attending the tertiary care hospital of Karachi: A cross-sectional study. Ann Med Surg (Lond) 2022; 82:104587. [PMID: 36268382 PMCID: PMC9577521 DOI: 10.1016/j.amsu.2022.104587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/31/2022] [Accepted: 09/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Methods Results Conclusion Data regarding the awareness of lifestyle modifications in the general hypertensive population of Pakistan is scarce. Out of 425 hypertensive patients, 70.7% had uncontrolled hypertension. Age and female gender were the only risk factors significantly associated with uncontrolled hypertension. Most of the patients are on treatment and still not controlled, and thus could be considered under treatment. Interventions should be considered and implemented to potentially increase the control rates.
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Amponsem-Boateng C, Oppong TB, Zhang W, Boakye-Yiadom J, Wang L, Acheampong K, Opolot G. Screening of hypertension, risks, knowledge/awareness in second-cycle schools in Ghana. A national cross-sectional study among students aged 12-22. J Hum Hypertens 2022; 36:405-415. [PMID: 33790406 DOI: 10.1038/s41371-021-00502-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12-22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.
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Affiliation(s)
- Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Timothy Bonney Oppong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Weidong Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | | | - Lianke Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kwabena Acheampong
- Department of Epidemiology and Health Statistics, Central South University, Changsha, PR China
| | - Godfrey Opolot
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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Appiah EO, Agyekum SB, Ninon AP, Appiah C. Non-pharmacologic hypertension management barriers and recommendations by hypertensive patients at Pentecost Hospital, Madina. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000085. [PMID: 36962265 PMCID: PMC10022142 DOI: 10.1371/journal.pgph.0000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/15/2021] [Indexed: 06/18/2023]
Abstract
The number of hypertension cases keeps rising worldwide. Africa is not exempted from the prevalence of hypertension. The Sub-Saharan region over the years has been recording high numbers of hypertension cases due to low consciousness, poor management and lack of control of urbanization. However, it has been established that hypertension as a condition can be managed by controlling familiar risk factors such as alcohol consumption, tobacco use, physical inactivity and intake of an unhealthy diet. The researchers, therefore, intend to explore the non-pharmacologic hypertension management barriers and recommendations by hypertensive patients at Pentecost Hospital, Madina. The researchers employed the qualitative exploratory-descriptive design using a purposive sampling technique to select 20 participants between the ages of 35-65, who met the inclusion criteria. Using a semi-structured interview guide, participants were engaged in 30-60 minutes of face-to-face interviews. The demography of the participants revealed that 60% (12) were females, and 40% (8) were also males. Participants reported that they visit the clinic once a week with a budget of hundred Ghana Cedis to five hundred Ghana Cedis (100-500 GHS). Two main themes and 7 subthemes emerged from the study analysis. The barriers identified include financial constraints, difficulty adjusting to lifestyle changes, personal factors (laziness, forgetfulness, stress), lack of motivation, and busy work schedules and limited time. Recommendations were also made to overcome the barriers which include follow ups by health care professionals, and advice to hypertensive and non-hypertensive patients. In conclusion, the study found that adherence to non-pharmacologic management of hypertension is greatly influenced by one's finances, some personal factors and external influences. Hence, it is necessary address these factors and also to ensure effective follow-ups and reminders in order to improve adherence to the non-pharmacologic management of hypertension. Further studies can also be conducted to address other obstacles to non-pharmacologic hypertension management.
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Affiliation(s)
- Evans Osei Appiah
- School of Nursing and Midwifery, Department of Midwifery, Valley View University, Accra, Ghana
| | - Susana Boateng Agyekum
- Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | - Amertil P. Ninon
- Dean of Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | - Cyndi Appiah
- Assistant Lecturer, Ghana Christian University College, Accra, Ghana
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Harrison MA, Marfo AFA, Opare-Addo MNA, Ankrah DNA, Acheampong F, Nelson F, Buabeng KO. Anti-hypertensive medication access and affordability and their association with blood pressure control at a teaching hospital in Ghana. Pan Afr Med J 2021; 39:184. [PMID: 34584609 PMCID: PMC8449564 DOI: 10.11604/pamj.2021.39.184.27977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction many hypertensive patients require two or more anti-hypertensive drugs, but in low- and middle-income countries there may be challenges with medication access or affordability. The objective of this study was to determine accessibility and affordability of anti-hypertensive medicines and their association with blood pressure (BP) control among hypertensive patients attending the Korle-Bu teaching hospital (KBTH) polyclinic. Methods a cross-sectional study was conducted among 310 systematically sampled hypertensive patients attending the KBTH Polyclinic in Ghana. A structured questionnaire was used to obtain data on patient demographics and clinical characteristics, prices, availability and mode of payment of generic anti-hypertensive medicines. Results fifty-nine patients (19.4%) made out-of-pocket payments. At the private pharmacy and hospital, 123 (40.5%) and 77 patients (25.3%) respectively could not afford four anti-hypertensive medicines. Medicines availability at KBTH was 60%. Continuous access to BP drugs at KBTH was 14.8%. Overall access was 74.9% (SD ± 41.3). Out-of-pocket affordability of the medicines was positively correlated with BP control (R=0.12, p=0.037). Obtaining medicines via health insurance only was more likely to result in BP control than making any out-of-pocket payments (OR= 2.185; 95% CI, 1.215 - 3.927). Access at KBTH was more likely to result in BP control (OR=1.642; 95% C.I, 0.843 - 3.201). Conclusion there were access challenges although most patients obtained BP medication free. Out-of-pocket affordability is a challenge for some hypertensive patients. Access to affordable BP medication can improve BP control. These findings provide an impetus for urgently evaluating access to affordable anti-hypertensive medicines in other hospitals in Ghana.
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Affiliation(s)
- Mark Amankwa Harrison
- Pharmacy Department, Korle Bu Teaching Hospital, Accra, Ghana.,Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Afia Frimpomaa Asare Marfo
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mercy Naa Aduele Opare-Addo
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Frempomaa Nelson
- Pharmacy Department, Korle Bu Teaching Hospital, Accra, Ghana.,Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwame Ohene Buabeng
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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12
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Blood Pressure Control, Accessibility, and Adherence to Antihypertensive Medications: Patients Seeking Care in Two Hospitals in the Ashanti Region of Ghana. Int J Hypertens 2021; 2021:9637760. [PMID: 34327016 PMCID: PMC8302388 DOI: 10.1155/2021/9637760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/23/2021] [Accepted: 07/09/2021] [Indexed: 11/18/2022] Open
Abstract
Hypertension is the second leading cause of death in Ghana, partly accounting for two-thirds of all medical admissions and more than 50% of deaths. This study aimed to comparatively evaluate adherence and accessibility to antihypertensive medications at two different levels of healthcare facilities in Kumasi, Ghana, and determine factors associated with medicine accessibility and adherence. A cross-sectional study involving outpatient department (OPD) hypertensive patients, 143 at KNUST Hospital (UHS) and 342 at Komfo Anokye Teaching Hospital (KATH), was conducted using a semistructured questionnaire. Correlations were drawn to evaluate the effect of accessibility and adherence on blood pressure control. A face-to-face interview was also conducted with relevant stakeholders involved in procurement of medicines. Blood pressure was uncontrolled in 50.4% (n = 72) of participants at UHS and 52.9% (n = 181) at KATH. With respect to medicine accessibility, 98.8% (n = 338) and 42.9% (n = 61) received at least one medication from the hospital pharmacy of KATH and UHS, respectively. Using MARS-10, 49.2% (n = 70) and 52.9% (n = 181) were nonadherent in UHS and KATH, respectively. There was a significant association between adherence and BP control at both UHS (p=0.038) and KATH (p=0.043). At UHS, there was a significant association between accessibility to medicines at the hospital and BP control (p=0.031), whilst at KATH, no significant association was observed (p=0.198). Supply chain practices and delays in payment by the NHIA affected accessibility to antihypertensive medications. Blood pressure control was inadequate among participants in both facilities. Accessibility to medicines was better at the tertiary facility compared to the secondary facility. Increased accessibility and adherence to antihypertensives were related to blood pressure control in both facilities. Good supply chain practices and prompt payment by the National Health Insurance Authority would enhance accessibility to antihypertensive medications.
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Abstract
PURPOSE OF REVIEW Hypertension (HTN) is the most prevalent risk factor for cardiovascular disease (CVD) worldwide, affecting 1.39 billion people. This review discusses recent literature regarding the global burden of HTN and emerging concepts in prevalence, treatment, and control in different regions around the globe. RECENT FINDINGS Community-based interventions and telemedicine may be useful in increasing access to care and identifying/assisting patients with HTN, especially in populations with geographical and economic barriers to healthcare. Home blood pressure monitoring is beneficial for HTN control in diverse regions. Polypills have proven benefits to decrease HTN and CVD risk. Continuation of treatment with angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers in high risk COVID-19 patients appears appropriate. SUMMARY Extensive research demonstrates that early screening/treatment, lifestyle modification, and pharmacotherapy are essential to control HTN worldwide. This review highlights recent research and novel concepts on effective interventions being used globally.
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14
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Twumasi-Ankrah B, Poulter NR, Tannor EK, Adu-Boakye Y, Nyarko OO, Opoku G, Konadu SO, Aniagyei M, Ogah A, Baidoo TE, Mensah C, Clarke J, Beaney T, Myers-Hansen GA. May Measurement Month 2019: an analysis of blood pressure screening results from Ghana-Sub-Saharan Africa. Eur Heart J Suppl 2021; 23:B62-B65. [PMID: 34248431 PMCID: PMC8263074 DOI: 10.1093/eurheartj/suab023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Raised blood pressure (BP) remains the biggest single risk factor contributing to the global burden of disease and to global mortality. Although a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 7102 participants gave their consent and were screened during MMM 2019. After multiple imputation, of all 7102 participants 1836 (25.9%) had hypertension. Of all 1836 participants with hypertension, 36.5% were aware of their status and 30.0% were on anti-hypertensive medication. Of 550 participants on antihypertensive medications, 46.1% had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). Also, of all 1836 participants with hypertension, 13.8% had their BP controlled. Again, the proportion of participants with hypertension of those not receiving anti-hypertensive treatment was 1286 (19.6%). Data obtained from this project demonstrates that there is still a significant number of people with hypertension who are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the significance of BP screening campaigns as a tool to identify persons with elevated BP.
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Affiliation(s)
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Elliot K Tannor
- Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Adu-Boakye
- Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | | - Jonathan Clarke
- Department of Mathematics, Huxley Building, South Kensington Campus, Imperial College London, London SW7 2AZ, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Gustavus A Myers-Hansen
- Department of Virology, Noguchi Memorial Institute for Medical Research, Legon - Accra, Ghana.,Department of Biological Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Legon - Accra, Ghana
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15
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Menyanu EK, Corso B, Minicuci N, Rocco I, Russell JC, Ware LJ, Chidumwa G, Naidoo NN, Biritwum RB, Kowal PR, Schutte AE, Charlton KE. Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1-3. PLoS One 2021; 16:e0244807. [PMID: 33417616 PMCID: PMC7793275 DOI: 10.1371/journal.pone.0244807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023] Open
Abstract
The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11-12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization's Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants' BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.
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Affiliation(s)
- Elias K. Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Barbara Corso
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Nadia Minicuci
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Ilaria Rocco
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Joanna C. Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Glory Chidumwa
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nirmala N. Naidoo
- World Health Organization Data, Analytics and Delivery for Impact Division, Geneva, Switzerland
| | | | - Paul R. Kowal
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
- World Health Organization SAGE, Geneva, Switzerland
| | - Aletta E. Schutte
- School of Public Health and Community Medicine, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen E. Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
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16
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Twumasi-Ankrah B, Myers-Hansen GA, Adu-Boakye Y, Tannor EK, Nyarko OO, Boakye E, Lincoln MD, Quarshie GA, Deku EM, Galley ME, Beaney T, Ster AC, Xia X, Poulter N. May Measurement Month 2018: an analysis of blood pressure screening results from Ghana. Eur Heart J Suppl 2020; 22:H59-H61. [PMID: 32884472 PMCID: PMC7455267 DOI: 10.1093/eurheartj/suaa029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Elevated blood pressure (BP) is one of the leading risk factors for death and disability globally. It is also an important global health challenge because of its high prevalence and resulting morbidities. Albeit, a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 6907 participants were screened during MMM 2018. After multiple imputation, 2354 (34.1%) had hypertension. Of individuals not taking antihypertensive medications 1526 (25.1%) were hypertensive of whom 48.4% were aware of having it. Also, of individuals taking antihypertensive medications 432 (52.2%) had uncontrolled BP. Data obtained from this project demonstrates that a significant number of people with hypertension are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the effectiveness of BP screening campaigns as a tool to identify persons with elevated BP.
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Affiliation(s)
| | - Gustavus A Myers-Hansen
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- University of Ghana, Accra, Ghana
| | - Yaw Adu-Boakye
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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17
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Menyanu E, Baatiema L, Charlton K, Wilson M, Aikins ADG, Russell J. Towards Population Salt Reduction to Control High Blood Pressure in Ghana: A Policy Direction. Curr Dev Nutr 2020; 4:nzaa084. [PMID: 32851200 PMCID: PMC7438700 DOI: 10.1093/cdn/nzaa084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/16/2020] [Accepted: 05/13/2020] [Indexed: 01/29/2023] Open
Abstract
Although population salt reduction is considered a "best buy" in addressing hypertension and cardiovascular disease, Ghana shares a high hypertension burden with a seemingly high salt consumption. This article discusses best practices in reducing population salt intake and provides preliminary data on salt and potassium intake, as well as the process to develop a road map and identification of actions needed to support the development of a strategic national document towards salt reduction in Ghana. In February 2019, a 2-d stakeholder meeting was held with government agencies, researchers, nongovernmental organizations, civil society organizations, and international partners to deliberate on salt reduction strategies and interventions needed in the face of rising hypertension and other noncommunicable diseases (NCDs) in Ghana. Recommendations were developed from the stakeholder meeting and are being considered for inclusion in the revision of Ghana's national NCD policy.
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Affiliation(s)
- Elias Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Leonard Baatiema
- Noncommunicable Diseases Support Center for Africa, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Karen Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Michael Wilson
- Noncommunicable Diseases Support Center for Africa, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ama De-Graft Aikins
- Noncommunicable Diseases Support Center for Africa, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joanna Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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18
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Tumwesigye NM, Mutungi G, Bahendeka S, Wesonga R, Katureebe A, Biribawa C, Guwatudde D. Alcohol consumption, hypertension and obesity: Relationship patterns along different age groups in Uganda. Prev Med Rep 2020; 19:101141. [PMID: 32685360 PMCID: PMC7358719 DOI: 10.1016/j.pmedr.2020.101141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/29/2022] Open
Abstract
Hypertension prevalence ratios don’t rise with age groups among frequent drinkers. Alcohol consumption pattern partly modifies the age-hypertension relationship. Alcohol consumption pattern does not modify obesity-age relationship.
The prevalence of non-communicable diseases including hypertension and obesity is rising and alcohol consumption is a predisposing factor. This study explored the effect of alcohol consumption patterns on the hypertension-age group and obesity-age group relationships. The data were extracted from the 2014 National NCD Survey of adults aged 18–69 years. Hypertension was defined as a condition of having systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg while obesity was defined as having a body mass index ≥30 kg/m2. Frequent alcohol consumption was measured as alcohol use ≥3 times a week. Multivariable log binomial regression analysis was used to assess independent relationship between the outcomes and alcohol consumption. The prevalences of hypertension, frequent alcohol consumption and obesity increased across age groups but were divergent towards last age group. Hypertension prevalence ratios were higher with higher age groups among moderate and nondrinkers but not among frequent drinkers. Alcohol drinking pattern modified the age hypertension relationship in a model with ungrouped age. The drinking pattern did not modify obesity-age relationship. Alcohol consumption pattern appeared to modify the hypertension-age group relationship. However, more research is needed to explain why prevalence ratios are higher with higher age groups among moderate drinkers and abstainers while they stagnate among the frequent drinkers. There was no evidence to show the effect of alcohol consumption on obesity-age group relationship.
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Affiliation(s)
| | - Gerald Mutungi
- Control of Non-communicable Diseases Desk, Ministry of Health, Kampala, Uganda
| | - Silver Bahendeka
- Department of Internal Medicine St. Francis Hospital Nsambya, Kampala, Uganda
| | - Ronald Wesonga
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Agaba Katureebe
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - Claire Biribawa
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
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19
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Abariga SA, Al Kibria GM, Albrecht JS. Impact of the 2017 American College of Cardiology/American Heart Association Guidelines on Prevalence of Hypertension in Ghana. Am J Trop Med Hyg 2020; 102:1425-1431. [PMID: 32228784 PMCID: PMC7253088 DOI: 10.4269/ajtmh.19-0272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 02/20/2020] [Indexed: 12/21/2022] Open
Abstract
We investigated the prevalence of hypertension in Ghana using the 2017 American College of Cardiology/American Heart Association (ACC/AHA) criteria and compared with prevalence estimates using the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) criteria. Among 13,220 Ghanaians aged 15-49 years, the prevalence of hypertension was 30.4% (95% CI: 29.3-31.6) based on the 2017 ACC/AHA guideline compared with 12.8% (95% CI: 12.0-13.6) when using the JNC7 guideline. The overall increase in prevalence was 17.6% (95% CI: 16.8-18.6). The increment in prevalence was 19.0% (95% CI: 17.5-20.7) among men and 17.7% (95% CI: 16.1-18.2) among women. People aged 40-49 years had the highest prevalence (51.1%; 95% CI: 49.0-53.3). We used multiple logistic regressions to obtain odds ratios. Urban dwelling, tertiary education, or being in higher wealth status was significantly associated with the odds of hypertension. The 2017 ACC/AHA guideline resulted in a significant increase in the prevalence of hypertension in Ghana. Scaling up of existing prevention and control strategies for hypertension such as health education through already established community health implementation and planning programs as well as improved screening and diagnostic protocols for hypertension should be prioritized.
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Affiliation(s)
- Samuel A. Abariga
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gulam Muhammed Al Kibria
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jennifer S. Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
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20
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Awuah RB, de-Graft Aikins A, Dodoo FNA, Meeks KA, Beune EJ, Klipstein-Grobusch K, Addo J, Smeeth L, Bahendeka SK, Agyemang C. Psychosocial factors and hypertension prevalence among Ghanaians in Ghana and Ghanaian migrants in Europe: The RODAM study. Health Psychol Open 2019; 6:2055102919885752. [PMID: 31763049 PMCID: PMC6851611 DOI: 10.1177/2055102919885752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Despite progress made to prevent and control hypertension, its prevalence has
persisted in many countries. This study examined the associations between
psychosocial factors and hypertension among Ghanaian non-migrants and migrants.
Data were drawn from the Research on Obesity and Diabetes among African Migrants
(RODAM) project. Findings show that among migrant women, those who experienced
periods of stress at home/work had higher odds of hypertension. Among
non-migrants, women with depression symptoms were more likely to be
hypertensive. Furthermore, there was a positive association between negative
life events and hypertension among non-migrant men. The findings highlight the
importance of psychosocial factors in addressing hypertension prevalence in
Ghanaian populations.
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Affiliation(s)
| | | | | | | | | | | | - Juliet Addo
- London School of Hygiene & Tropical Medicine, UK
| | - Liam Smeeth
- London School of Hygiene & Tropical Medicine, UK
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21
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Sanuade OA, Dodoo FNA, Koram K, de-Graft Aikins A. Prevalence and correlates of stroke among older adults in Ghana: Evidence from the Study on Global AGEing and adult health (SAGE). PLoS One 2019; 14:e0212623. [PMID: 30865654 PMCID: PMC6415815 DOI: 10.1371/journal.pone.0212623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/06/2019] [Indexed: 01/19/2023] Open
Abstract
This study examines the prevalence and correlates of stroke among older adults in Ghana. This cross-sectional study retrieved data from Wave 1 of the World Health Organization (WHO) Survey on Global Ageing and Adult Health (SAGE) conducted between 2007 and 2008. The sample, comprising 4,279 respondents aged 50 years and above, was analysed using descriptive statistics, cross tabulations and Chi-Square tests, and a multivariable binary logistic regression. Respondents ranged in age from 50 to 114 years, with a median age of 62 years. Stroke prevalence was 2.6%, with the correlates being marital status, level of education, employment status, and living with hypertension or diabetes. The results showed that being separated/divorced, having primary and secondary education, being unemployed and living with hypertension and diabetes, significantly increased the odds of stroke prevalence in this population. The results suggest that interventions to reduce stroke prevalence and impact must be developed alongside interventions for hypertension, diabetes and sociodemographic/economic factors such as marital status, level of education, and employment status.
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Affiliation(s)
| | | | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana., Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
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22
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Sanuade OA, Boatemaa S, Kushitor MK. Hypertension prevalence, awareness, treatment and control in Ghanaian population: Evidence from the Ghana demographic and health survey. PLoS One 2018; 13:e0205985. [PMID: 30403686 PMCID: PMC6221286 DOI: 10.1371/journal.pone.0205985] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/04/2018] [Indexed: 11/24/2022] Open
Abstract
Hypertension is a major cause of cardiovascular disease morbidity and mortality in Ghana. This study examines the prevalence, awareness, treatment and control of hypertension among Ghanaian aged 15–49 years. This cross-sectional study retrieved data from the 2014 Ghana Demographic and Health Survey (GDHS). The sample, comprising of 13,247 respondents aged 15–49 years, was analysed using descriptive statistics, Chi-Square tests, independent sample t-tests and binary logistic regressions. The overall prevalence of hypertension was 13.0% (12.1% for males and 13.4% for females). Among respondents who had hypertension, 45.6% were aware of their hypertension status; 40.5% were treating the condition while 23.8% had their blood pressure controlled (BP <140/90 mmHg). Socio-economic and demographic factors, health insurance coverage and recent visit to health facilities played significant roles in hypertension prevalence and awareness. While region of residence and health facility visits were predictors of hypertension treatment, age and region of residence predicted hypertension control in this population. This study suggests that in order to address the increasing burden of hypertension in Ghana, there should be an expansion of the National Health Insurance Scheme and development of measures to reduce health inequities. Also, some of the determining factors such as age, gender, marital status are similar to other cultures; therefore, existing interventions from those cultures could be adapted in addressing hypertension prevalence, awareness, treatment and control in Ghana.
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Affiliation(s)
| | - Sandra Boatemaa
- Centre for Complex Systems in Transitions, Stellenbosch University, Stellenbocsh, South Africa
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