Abstract
BackgroundGlobally, there is an increasing prevalence of high blood pressure (HBP) among adults and youth. However, the mechanisms of how the risk factors (physical inactivity and obesity) relate with blood pressure (BP) are not well known especially among the urban poor youth in low and middle income countries. Meanwhile childhood and adolescent physical inactivity and obesity, particularly in conditions of poverty, predispose individuals to cardiovascular diseases (CVDs) in later life. The aim of this study was to assess the BP levels and to examine its associations with physical activity (PA) and body mass index (BMI) amongst urban poor youth in Accra, Ghana.MethodsWe studied 201 youth aged 15–24 years in three urban poor communities in Accra, Ghana. Height, weight and BP were measured in all subjects. PA levels were assessed using the Edulink Urban Health and Poverty project questionnaire. Multiple linear regression analysis was used to determine the factors influencing BP levels.ResultsThe proportion of pre-hypertension and hypertension among the youth was 32.3% and 4%, respectively. The rates of pre-hypertension (42.0 vs. 24.8) and hypertension (6.8 vs. 1.8) were higher in males than in females. More than three-quarters (84.1%) of the youth were not physically active. Females were more physically inactive compared to the males (94.7% vs. 70.5%). The average BMI was 22.8 kg/m2. For overweight (17.7 vs. 6.8) and obesity (13.3 vs. 2.3), females had higher rates than males. BMI was positively related to systolic BP, and significantly associated with systolic BP (β = 1.4, p < 0.000 and β = 0.8, p < 0.000; respectively for male and female youth) compared to diastolic BP. Youth with low PA had raised BP.ConclusionThe positive association of BMI and BP in the study communities suggests the need for health measures to tackle their increase and related public health consequences. Further studies on BP and other risk factors among the youth of rural populations and other developing countries will be important to stall the rising prevalence and implications for adult morbidity and mortality.
Highlights
There is an increasing prevalence of high blood pressure (HBP) among adults and youth
Females had higher body mass index (BMI) than the males (23.6 kg/m2 and 21.7 kg/m2; p < 0.050 respectively) and a higher proportion of female youth were overweight or obese compared to male youth (17.7% vs 6.8% and 13.3% vs 2.3% respectively)
The male youth were found to have higher prevalence of prehypertension and hypertension than their female peers. This is consistent with studies of some developed countries, where cases of stroke and other cardiovascular disease (CVD) are reported mostly among males due to their higher risk status for HBP compared to females [32,33,34]
Summary
There is an increasing prevalence of high blood pressure (HBP) among adults and youth. It has been projected that in the decade, there will be a worldwide increase (15%) in death rates from cardiovascular diseases (CVDs): Africa will record over 20% increase [7] This will make CVD the most common cause of death compared to communicable diseases and it is projected to affect the younger age population especially in most low Afrifa–Anane et al BMC Public Health (2015) 15:269 and middle-income countries (LMIC) [8]. Most of these deaths will be attributed to HBP [9,10]. A rural–urban study in Ghana suggests a prevalence of 27%, each for both rural men and women and 33.4% and 28.9% for urban men and women respectively [13]
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