HYPERTENSION SUSCEPTIBILITY IN AFRICAN MIGRANTS: SOLVING THE PUZZLE THROUGH TRANSCONTINENTAL PROSPECTIVE COHORT STUDY DESIGN. THE RODAM-PROS STUDY

Abstract

Objective: Sub-Saharan African (SSA) migrants are disproportionately affected by hypertension, compared to the European-host population. Underlying reasons for the increased hypertension prevalence are still unclear, but suggest that rapid changes in lifestyle and environment after migration, in combination with genetic factors, might be responsible. The aim of the Research on Obesity and Diabetes among African Migrant prospective (RODAM-Pros) cohort study is to identify key changes in environmental exposures and epigenetic modifications driving the high prevalence of hypertension among African migrants. Design and method: The multicentre RODAM-Pros study included non-migrant Ghanaians residing in rural and urban Ghana, Ghanaians who migrated and are residing in Amsterdam (the Netherlands), and European-Dutch population who participated in baseline (2011-2015) and follow-up data collection (2019-2021). Data were collected on anthropometrics, blood pressure, biological samples, sociodemographic, health, lifestyle and environmental factors. Moreover, ∼1300 participants were included for DNA methylation analysis (Infinium® 850K DNA Methylation BeadChip) to assess methylation loci associated with incident hypertension in a nested case-control study. Results: In the follow-up data collection, 2165 Ghanaian participants (n = 638 from rural Ghana, n = 608 from urban Ghana, and n = 919 Ghanaian migrants in Amsterdam) and 2098 European-Dutch participants were included. The participation rates were 90.8 % in rural Ghana, 95.3% in urban Ghana, 52.7% among Amsterdam-Ghanaian and 67.2% among European-Dutch. Preliminary results show unstandardised prevalence rates of hypertension at follow-up of 43.3% in rural Ghana, 48.7% in urban Ghana, 60.1% in Amsterdam-Ghanaians, and 25.8% in European-Dutch. Unstandardised 5-year hypertension incidence rates were 18.5% in rural Ghana, 17.7% in urban Ghana, 14.1% in Amsterdam-Ghanaians, and 8.5% in European-Dutch. Conclusions: The preliminary findings show significant differences in hypertension prevalence and incidence rates among Ghanaians living in Ghana and in Europe. Future analysis are aimed to identify epigenetic and environmental determinants responsible for the increased prevalence of hypertension in SSA migrants. The findings from the RODAM-Pros study will be valuable for designing effective prevention and clinical management strategies to prevent the burden of hypertension and related complications, both in SSA and SSA migrants in Europe.