Abstract
Cardiovascular health (CVH) is a construct defined by the American Heart Association (AHA) as part of its 2020 Impact Goal definition. CVH has, until now, not been evaluated in Sub-Saharan African populations. The aim of this study was to investigate differences in the prevalence of ideal CVH and its constituent metrics among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in three European countries. The AHA definition of CVH is based on 7 metrics: smoking, body mass index, diet, physical activity, blood pressure, total cholesterol, and fasting plasma glucose. These were evaluated among 3510 Ghanaian adults (aged 25–70 years) residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin) in the multi-centre RODAM study. Differences between groups were assessed using logistic regression with adjustments for gender, age, and education. Only 0.3% of all participants met all 7 metrics of the AHA’s definition of ideal CVH. Compared to rural Ghana (25.7%), the proportions and adjusted odds ratio (OR) of individuals who had 6–7 CVH metrics in the ideal category were substantially lower in urban Ghana, (7.5%; OR 0.204, 95% CI 0.15–0.29), Amsterdam (4.4%; 0.13, 0.08–0.19), Berlin (2.7%; 0.06, 0.03–0.11), and London (1.7%; 0.04, 0.02–0.09), respectively. The proportion of ideal CVH for the various metrics ranged from 96% for all sites in the smoking metric to below 6% in the diet metric. The proportion of ideal CVH is extremely low in Ghanaians, especially among those living in urban Ghana and Ghanaian migrants in Europe.
Highlights
Cardiovascular diseases (CVD), especially ischaemic heart disease and stroke, are the leading cause of morbidity and mortality worldwide [1]
The results of the regression analysis showed that in comparison with rural Ghanaians and after adjustment for age, gender and education level, urban Ghanaians had 80% lower odds of having 6 or more components of ideal cardiovascular health (Table 3)
Compared to rural Ghanaians, Ghanaian migrants residing in Amsterdam, Berlin, and London had lower odds of having ≥ 6 components of ideal Cardiovascular health (CVH) after adjustment for age, gender, and education level
Summary
Cardiovascular diseases (CVD), especially ischaemic heart disease and stroke, are the leading cause of morbidity and mortality worldwide [1]. Ethnic minority populations in Europe appear to exhibit higher rates of CVD and its associated risk factors such as type 2 diabetes and obesity, than the European host populations [4]. Low- and middle-income countries (LMICs) are experiencing a steep surge in CVD prevalence, while already contributing 80% to the global burden of CVD [5]. This high CVD burden in LMICs is associated with changes in living and work environments following urbanisation, increasingly sedentary lifestyle, westernised diet as well as increased rates in diabetes, obesity, and smoking [6]
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