title: Relationship between psychosocial stress and hypertension among Ghanaians in Amsterdam, the Netherlands--the GHAIA study.
abstract: BACKGROUND
  Hypertension is highly prevalent among recent sub-Saharan African (SSA) migrants in western countries and some tend to associate their hypertension to psychosocial stress. However data on the relationship between hypertension and psychosocial stress among SSA migrants are rare. We assessed the relationship between psychosocial stress and hypertension among the largest SSA migrant population (Ghanaians) in Amsterdam, the Netherlands.
  
  
  METHODS
  Data were obtained from structured interviews along with medical examination among 212 participants from a cross-sectional study: the GHAIA study in 2010 in Amsterdam. Blood pressure was measured with a validated Oscillometric automated digital blood pressure device. Psychosocial stress was assessed by questionnaires on perceived discrimination, depressive symptoms and financial problems. Binary logistic regression was used to study associations between psychosocial stress and hypertension.
  
  
  RESULTS
  The overall prevalence of hypertension was 54.7%. About two thirds of the study population experienced a moderate (31%) or high (36%) level of discrimination. 20.0% of the participants had mild depressive symptoms, whilst 9% had moderate depressive symptoms. The prevalence of financial stress was 34.8%. The psychosocial stresses we assessed were not significantly associated with hypertension: adjusted odds ratios comparing those with low levels and those with high levels were 0.99 (95% CI, 0.47-2.08) for perceived discrimination, 0.81 (95% CI, 0.26-2.49) for depressive symptoms and 0.71 (95% CI, 0.37-1.36) for financial stress, respectively.
  
  
  CONCLUSIONS
  We did not find evidence for the association between psychosocial stress and hypertension among recent SSA migrants. More efforts are needed to unravel other potential factors that may underlie the high prevalence of hypertension among these populations.
authors.forename: Bernard
authors.initials: B
authors.lastname: Agyei
authors.forename: Mary
authors.initials: M
authors.lastname: Nicolaou
authors.forename: Linda
authors.initials: L
authors.lastname: Boateng
authors.forename: Henriette
authors.initials: H
authors.lastname: Dijkshoorn
authors.forename: Bert-Jan
authors.initials: BJ
authors.lastname: van den Born
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl.
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000208:ethnology; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000209:etiology*; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D036301:Qualitative Research; D013315:Stress, Psychological / Q000150:complications* / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000523:psychology; D055815:Young Adult