title: The changing patterns of hypertension in Ghana: a study of four rural communities in the Ga District.
abstract: OBJECTIVE
  To determine the prevalence, distribution and risk factors of hypertension among rural residents in Ghana.
  
  
  METHODS
  Cross sectional study in four rural communities in the Ga District of Ghana.
  
  
  METHODS
  All adults aged > or = 18 years in four rural communities were asked to participate. The average of two blood pressure readings taken with a mercury sphygmomanometer after 10 minutes of rest was used in the analysis. Hypertension was defined as blood pressure > or = 140/90 mm Hg.
  
  
  RESULTS
  362 subjects with a mean age of 42.4 +/- 18.6 years participated in the study. The prevalence of hypertension was 25.4%. Of those with hypertension, only 32.3% (n-30) had prior knowledge of their condition, and less than half of these (n=12) were on treatment. Of those on treatment 16.7% were well controlled (blood pressure < or = 140/90 mm Hg). The adjusted odds ratios for developing hypertension for overweight or obesity were 5.8 (95% confidence interval 1.4-24.3) and 6.9 (95% confidence interval 1.7-28.2), respectively. The adjusted odds ratio for hypertension for age groups 45-54, 55-64, and > or = 65 years were 31.9 (95% confidence interval 1.88-539.11), 31.8 (95% confidence interval 1.6-624.2), and 58.8 (95% confidence interval 2.9-1168.7), respectively. The adjusted odds ratio for hypertension with respect to smoking, alcohol consumption, job-related physical activity, family history, education, occupation, and diabetes status did not attain statistical significance.
  
  
  CONCLUSIONS
  Hypertension is now of public health significance in rural Ga District of Ghana. The high rate of hypertension was associated with low levels of awareness, drug treatment, and blood pressure control. Overweight and obesity are modifiable risk factors for hypertension that can be addressed through lifestyle interventions. Additionally, integrating hypertension care into primary care in rural health facilities may prove beneficial.
authors.affiliation: National Diabetes Management and Research Centre, Korle Bu Teaching Hospital, Korle Bu, Ghana. juliet.addo@lshtm.ac.uk
authors.forename: Juliet
authors.initials: J
authors.lastname: Addo
authors.forename: Albert G B
authors.initials: AG
authors.lastname: Amoah
authors.forename: Kwadwo A
authors.initials: KA
authors.lastname: Koram
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D050177:Overweight; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D019722:Sphygmomanometers