Cardiometabolic risk factors and preclinical target organ damage among adults in Ghana: Findings from a national study

Abstract

Background: Sub Saharan Africa (SSA) has the highest prevalence of cardiovascular diseases (CVD). Nevertheless, very few studies have directly examined the development of and risk factors for CVD among Africans. Objective: To examine CVD risk factors and outcomes particularly in the early stage of CVD development among adults in Ghana. Methods: Using a stratified multistage random sampling method, 1,106 participants were recruited as a nationally representative sample of the general population ≥18 years in Ghana from 2016 to 2017. For each participant, we measured CVD risk factors and preclinical target organ damage (TOD) for CVD development. Results: The prevalence of CVD risk factors was 21.1% for obesity, 10.8% for diabetes, 55.4% for hypertension, 37.3% for dyslipidemia, 12.8% for hyperuricemia, and 39.3% for hsCRP>3 mg/L in the recruited population. The prevalence of preclinical TOD was 8.6% for peripheral artery disease (PAD), 14.7% for carotid thickening, 5.9% for left ventricular hypertrophy (LVH), and 4.4% for chronic kidney disease (CKD). Three CVD risk factors appeared to play most prominent roles in TOD development, including obesity for PAD (OR 1.88, 95% CI 1.13, 3.09), hypertension for carotid thickening (OR 1.57, 95% CI 0.99, 2.54) and LVH (OR 6.25, 95% CI 2.98, 14.50), and hyperuricemia for CKD (OR 5.56, 95% CI 2.79, 11.15). Conclusions: The prevalence of CVD risk factors and early outcomes have reached epidemic proportions among Ghanaian adults. The distinct patterns of risk factors in the development of TOD presents important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.

Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey

“…These results are consistent with reports from a Ghanaian study [55]. Cigarette smoking was generally uncommon in our study, but the impact of "Shesha pipe smoking" among young age must be evaluated.…”

“…In this study, elevated TG (22.1%) was the most prominent form of dyslipidemia, followed by an elevated LDL-C and HDL-C, with women having the highest prevalence of all measures of dyslipidaemia in comparison to men. This observed pattern of dyslipidaemia prevalence in our study is similar to a survey conducted in Ghana [55] but inconsistent with results documented by Asiki and team [56] and Gebreegziabiher et al [57], where the most prevalent dyslipidaemia markers were HDL-C, TC and LDL-C. Despite the observed disparities in the different measures of dyslipidaemia, studies have reported a high prevalence of all forms of dyslipidaemia among women [58][59][60][61].…”

Hyperuricaemia and its association with other risk factors for cardiovascular diseases: A population‐based study

“…Cardiovascular diseases are one of the most important causes of death in the world, and their pathogenesis is such that they are affected by several risk factors such as obesity, diabetes and hypertension. 1 Increased serum uric acid levels can lead to endothelial dysfunction resulting in atherosclerosis by releasing reactive oxygen species and is reported as one of the risk factors for cardiovascular diseases. 2 In the process of purine decomposition, uric acid is the final product.…”

Blood pressure variability and target organ damage regression in hypertension

“…It should be pointed out, however, that other unhealthy factors besides high BP such as ethnicity, age, gender, type 2 diabetes mellitus, obesity, sleep apnea syndrome, and renal disease contribute to the development of HMOD and cardiovascular events. 4 Moreover, it deserves to be emphasized that BP is dynamic physiologic variable characterized by large short-and long-term variations (ie, beat-to-beat, over 24 hours, day-to-day, and visit-to-visit). From a physiological point of view, these BP changes substantially reflect an adaptive response to a variety of physical and mental stimuli aimed at preserving the cardiovascular homeostasis.…”

“…Although cardiac and extracardiac complications of hypertension increase markedly with exposure to increasing BP load, the prognostic value of BP values routinely assessed in clinical practice still remains unsatisfactory regardless of the methods used. It should be pointed out, however, that other unhealthy factors besides high BP such as ethnicity, age, gender, type 2 diabetes mellitus, obesity, sleep apnea syndrome, and renal disease contribute to the development of HMOD and cardiovascular events 4 . Moreover, it deserves to be emphasized that BP is dynamic physiologic variable characterized by large short‐ and long‐term variations (ie, beat‐to‐beat, over 24 hours, day‐to‐day, and visit‐to‐visit).…”