Charles Agyemang1, Gertrude Nyaaba1, Erik Beune1, Karlijn Meeks1, Ellis Owusu-Dabo2, Juliet Addo3, Ama de-Graft Aikins4, Frank P Mockenhaupt5, Silver Bahendeka6, Ina Danquah7,8, Matthias B Schulze7, Cecilia Galbete7, Joachim Spranger9,10, Peter Agyei-Baffour2, Peter Henneman11, Kerstin Klipstein-Grobusch12,13, Adebowale Adeyemo14, Jan van Straalen15, Yvonne Commodore-Mensah16, Lambert T Appiah17, Liam Smeeth3, Karien Stronks1. 1. Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 2. School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3. Department of Noncommunicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 4. Regional Institute for Population Studies, University of Ghana, Legon, Ghana. 5. Charité -Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin, Humboldt Universitaet zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany. 6. MKPGMS -Uganda Martyrs University, Kampala, Uganda. 7. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal. 8. Charité -Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin, Humboldt Universitaet zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin. 9. Department of Endocrinology and Metabolism, Charité Centre for Cardiovascular Research, Charite -Universitaetsmedizin Berlin. 10. DZHK (German Centre for Cardiovascular Research), partner site Berlin and Berlin Institute of Health, Berlin, Germany. 11. Department of Clinical Genetics, Academic Medical Center, Amsterdam. 12. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 13. Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 14. Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA. 15. Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands. 16. Department of Community Public Health, Johns Hopkins School of Nursing, John Hopkins University, Baltimore, Maryland, USA. 17. Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Abstract
OBJECTIVES: Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. METHODS: A multicenter cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. RESULTS: The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio = 1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio = 2.21, 1.78-2.73; women, 51%; prevalence ratio = 1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio = 0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio = 0.59, 0.35-0.99), and London (36%; prevalence ratio = 0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure > 180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. CONCLUSION: Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts.Supplement Figure 1, http://links.lww.com/HJH/A831.
OBJECTIVES:Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. METHODS: A multicenter cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. RESULTS: The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio = 1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio = 2.21, 1.78-2.73; women, 51%; prevalence ratio = 1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio = 0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio = 0.59, 0.35-0.99), and London (36%; prevalence ratio = 0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure > 180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. CONCLUSION:Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts.Supplement Figure 1, http://links.lww.com/HJH/A831.
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Authors: Raphael Baffour Awuah; Ama de-Graft Aikins; F Nii-Amoo Dodoo; Karlijn Ac Meeks; Eric Jaj Beune; Kerstin Klipstein-Grobusch; Juliet Addo; Liam Smeeth; Silver K Bahendeka; Charles Agyemang Journal: Health Psychol Open Date: 2019-11-12
Authors: E S Jansen; C Agyemang; D Boateng; I Danquah; E Beune; L Smeeth; K Klipstein-Grobusch; K Stronks; K A C Meeks Journal: Public Health Date: 2021-07-04 Impact factor: 4.984