Hypertension in Ghana: a cross-sectional community prevalence study in greater Accra.

OBJECTIVES

To determine the prevalence of hypertension, and the extent to which it is treated and controlled, among adult Ghanaians.

DESIGN

6300 adults, aged 25 years and older, were selected by random cluster sampling, using electoral enumeration areas and listings of adults.

SETTING

Three communities in the greater Accra region of Ghana.

SUBJECTS AND

METHODS

A total of 4733 subjects (male to female ratio = 1:1.5) participated, representing a response rate of 75%. The analysis used the mean of 2 blood pressure readings, taken with a mercury sphygmomanometer after a 10-minute rest. Hypertension was defined as having blood pressure > or = 140/90 mm Hg, or currently undergoing anti-hypertensive treatment.

RESULTS

The mean ages for males and females were 44.9 +/- 14.7 years, and 44.0 +/- 14.6 years, respectively. The crude prevalence of hypertension was 28.3%. The age-standardized prevalence, to the new standard world population, was 28.4%. Mean systolic and diastolic blood pressures increased with age. Of 1337 subjects with hypertension, 34% were aware of their condition, 18% were treated, and 4% were controlled (blood pressure < 140/90 mm Hg).

CONCLUSION

Hypertension is a major public health problem, and is associated with relatively low levels of awareness, drug treatment, and blood pressure control. Population-based prevention strategies, such as reduction in salt intake and integration of hypertension care into primary care, may prove beneficial; however, the determinants of hypertension remain to be ascertained.