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

Abstract

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) In a recent study, the prevalence of hypertension was found to be 28% in North America and 44% in western Europe. 1 Until recently, hypertension was thought to be rare in rural Africa 3-4 ; on the other hand, hypertension and its complications, including stroke, heart failure, and renal failure, have been reported in blacks all over the world. Hypertension is now being widely reported in Africa and is the most common cause of cardiovascular disease on the continent. 5 It is also a major factor in the high mortality of adults in sub-Saharan Africa. 6 In Ghana, hypertensive renal disease is a common complication in both Kumasi and Accra. [7][8] In Ghana, earlier studies revealed a hypertension prevalence of 4.5% among rural dwellers and of 8% to 13% in the town. 9 This was part of an evaluation of the health burden of cardiovascular diseases in Accra and was to form the basis for setting up a hypertension control program. More recently, the prevalence of hypertension in urban Accra was found to be 28.3% (crude) and 27.3% (age-standardized). 10 Hypertension is becoming more common as urbanization increases, and this has been shown in several studies in Africa. 11 A number of studies of urban African populations have shown a positive correlation between blood pressure, age, and gender. The prevalence of hypertension in Accra was much higher in men than in women aged Ͻ40 years but similar above that age. 9 On the other hand, in a recent study prevalence was higher in women than in men. 10 In the developed world, the detection, treatment, and control of hypertension have been characterized by the "rule of halves," 12 although recent evidence suggests that there has been a general improvement. 13 However, in much of sub-Saharan Africa, due to scarce resources and inadequate healthcare provision, detection, treatment, and control are very poor. 9,10,14 The aim of our study was to assess the prevalence, detection, management, and control of hypertension among men and women living in rural and semi-urban villages in the Ashanti Region of Ghana, West Africa. 15 It was part of a community-based study of the prevention of hypertension and stroke in the same region.

Vieillissement et pathologies chroniques au Sénégal. Comparaison entre des populations vivant en milieu rural (Ferlo) et urbain (Dakar)

“…Enfin, concernant la connaissance, le traitement et le contrôle de l'HTA, les résultats obtenus par régression logistique sont en accord avec la littérature en ce qui concerne l'effet du sexe : en effet, les femmes sont significativement plus souvent au courant de leur statut d'hypertendue que les hommes et sont également plus souvent traitées, du fait de contacts plus fréquents avec les centres de santé [5]. En ce qui concerne la localisation géographique (Dakar vs. Ferlo), il apparaît que, quelles que soient les caractéristiques sociodémographiques des individus, les personnes habitant le Ferlo ont significativement moins de chances de se savoir hypertendues, d'être traitées et de voir leur tension contrôlée que les individus habitant Dakar.…”

All cause and cardiovascular mortality in African migrants living in Portugal: evidence of large social inequalities

“…Studies in the 1970s found low prevalence of hypertension (less than 10%) in rural areas of Ghana [9], Nigeria [10] and Lesotho [11], and recent studies in Cameroon [12] and Ghana [13] found that although prevalence may be rising in rural areas, it remains lower than in urban areas. Prevalence in west African origin Caribbean populations is intermediate between those in west Africa and the UK, suggesting that behavioural change associated with societal transition is a contributory factor [5,14].…”

Prevalence and Determinants of Masked Hypertension Among Black Nigerians Compared With a Reference Population

“…Most, [3][4][5][6] although not all, 7,8 cross-sectional data from different areas of sub-Saharan Africa [3][4][5][6] aimed at evaluating the burden of high blood pressure (BP) defined hypertension solely on the basis of clinic BP. This excludes a substantial number of individuals who have hypertension that is masked to conventional office measurement.…”