Brent A Burket1. 1. Margaret Marquart Catholic Hospital, Kpando, V/R, Ghana, West Africa. burketthoene@yahoo.com
Abstract
BACKGROUND: The prevalence of hypertension appears to be increasing in the developing world. A study published in 2003 showed a crude prevalence of 28.3% in the capital city of Accra, Ghana. The prevalence of hypertension in many rural areas of the developing world is not known. OBJECTIVES: 1) To survey two rural populations for hypertension; 2) to identify factors that may be associated with hypertension; 3) to assess the level of control of hypertension. STUDY DESIGN/SETTING/PARTICIPANTS: 287 volunteers surveyed during market day in two villages in the Volta region of Ghana. Blood pressures were obtained after obtaining demographic and historical information. All individuals age > or = 17 were included in the analysis. Hypertension was defined as a blood pressure > or = 140/90 mm Hg on two separate occasions. RESULTS: The prevalence of hypertension in the populations surveyed was 32.8%. Factors associated with hypertension that reached statistical significance (P<.05) included family history of hypertension, consumption of akpeteshie, location of blood pressure assessment, and consumption of non-smoked fish (inverse association). More than 80% of those with a history of hypertension had an elevated blood pressure at the time of screening. CONCLUSIONS: The proportion of hypertension in the rural populations surveyed is higher when compared to true prevalence studies and is most likely due, in part, to selection biases. The low hypertension control rates identified in people with a history of hypertension would need to be considered when determining whether to expand hypertension screening programs or to improve access to treatment for those with known hypertension in these resource-limited areas.
BACKGROUND: The prevalence of hypertension appears to be increasing in the developing world. A study published in 2003 showed a crude prevalence of 28.3% in the capital city of Accra, Ghana. The prevalence of hypertension in many rural areas of the developing world is not known. OBJECTIVES: 1) To survey two rural populations for hypertension; 2) to identify factors that may be associated with hypertension; 3) to assess the level of control of hypertension. STUDY DESIGN/SETTING/PARTICIPANTS: 287 volunteers surveyed during market day in two villages in the Volta region of Ghana. Blood pressures were obtained after obtaining demographic and historical information. All individuals age > or = 17 were included in the analysis. Hypertension was defined as a blood pressure > or = 140/90 mm Hg on two separate occasions. RESULTS: The prevalence of hypertension in the populations surveyed was 32.8%. Factors associated with hypertension that reached statistical significance (P<.05) included family history of hypertension, consumption of akpeteshie, location of blood pressure assessment, and consumption of non-smoked fish (inverse association). More than 80% of those with a history of hypertension had an elevated blood pressure at the time of screening. CONCLUSIONS: The proportion of hypertension in the rural populations surveyed is higher when compared to true prevalence studies and is most likely due, in part, to selection biases. The low hypertension control rates identified in people with a history of hypertension would need to be considered when determining whether to expand hypertension screening programs or to improve access to treatment for those with known hypertension in these resource-limited areas.