Abstract
Studies using the revised hypertension classification are needed to better understand epidemiology of hypertension across full distribution. The sociodemographic, biological, and health behavior characteristics associated with different stages of hypertension in Ghana and South Africa (SA) were studied using global ageing and adult health (SAGE), WAVE 1 dataset. Blood pressure was assessed for a total of 7545 respondents, 2980 from SA and 4565 from Ghana. Hypertension was defined using JNC7 blood pressure classification considering previous diagnosis and treatment. Multivariate multinomial logistic regression analysis using Stata version 12 statistical software was done to identify independent predictors. The weighted prevalence of prehypertension and hypertension in Ghana was 30.7% and 42.4%, respectively, and that of SA was 29.4% and 46%, respectively, showing high burden. After adjusting for the independent variables, only age (OR = 1.32, 95% CI: 1.14–1.53), income (OR = 1.9, 95% CI: 1.04–3.47), and BMI (OR = 1.16, 95% CI: 1.1–1.22) remained independent predictors for stage 1 hypertension in Ghana, while, for SA, age (OR = 2.27, 95% CI: 1.53–3.36), sex (OR = 0.28, 95% CI: 0.08–1), and BMI (OR = 1.15, 95% CI: 1.07–1.25) were found to be independent predictors of stage 1 hypertension. Healthy lifestyle changes and policy measures are needed to promptly address these predictors.
Highlights
Worldwide prevalence estimates for hypertension may be as much as 1 billion individuals, and approximately 7.1 million deaths per year may be attributable to hypertension
The World Health Organization reports that suboptimal systolic blood pressure (SBP) >115 mmHg is responsible for 62 percent of cerebrovascular disease and 49 percent of ischemic heart disease (IHD), with little variation by sex [1]
Participants who have been diagnosed previously with high blood pressure or who were already taking treatment were excluded from analysis due to overlap and difficulty to stratify them into mutually exclusive hypertension stages
Summary
Worldwide prevalence estimates for hypertension may be as much as 1 billion individuals, and approximately 7.1 million deaths per year may be attributable to hypertension. The World Health Organization reports that suboptimal systolic blood pressure (SBP) >115 mmHg is responsible for 62 percent of cerebrovascular disease and 49 percent of ischemic heart disease (IHD), with little variation by sex [1]. The risk of developing these complications depends on the level of elevated blood pressure and has been seen in all age groups starting from blood pressure as low as SBP 115 and DBP of 75 [6]. Data from observational studies involving more than 1 million individuals have indicated that death from both IHD and stroke increases progressively and linearly from levels as low as 115 mmHg SBP and 75 mmHg. DBP upward especially in individuals ranging from 40 to 89 years of age, indicating need for new blood pressure classification [6]. The risk of coronary heart disease increased significantly in the high range prehypertension individuals (SBP 130–139 or DBP 85–89 mmHg) but not in the low range prehypertensive population (SBP from 120 to 129 or DBP 80 to 84 mmHg) [7]
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