Hypertension determinants among Ghanaians differ according to location of residence: RODAM study

Abstract

OBJECTIVE: Hypertension prevalence is high among African migrants, but the determinants of hypertension in migrants in Europe in relation to the population in the country of origin still needs to be elucidated. Therefore, the aim of this study was to assess the determinants of hypertension in Ghanaians residing in Ghana and Europe. METHODS: The current study used baseline data of 5659 participants, aged 25-70 years, of the Research on Obesity and Diabetes among African Migrants study. Multivariate logistic regression analysis was used to assess sociodemographic, lifestyle, psychosocial, anthropometric and health factors independently associated with hypertension in Ghanaians living in rural and urban Ghana, and Ghanaian migrants living in Europe. RESULTS: Across all sites, older age (both sexes; odds ratio 1.07, 95% confidence interval 1.06-1.08) and diabetes (females only; 2.02, 1.54-1.67) were independently associated with hypertension. The other determinants of hypertension differed between geographical locations. Higher waist circumference (1.12, 1.05-1.20) was independently associated with hypertension in rural-Ghanaian males, as was higher body mass index (1.15, 1.03-1.28) in urban-Ghanaian males, higher waist circumference (1.04, 1.01-1.07) and diabetes (1.75, 1.17-2.63) in European-Ghanaian males. In European-Ghanaian females, high alcohol intake (1.88, 1.01-3.53) and waist circumference (1.04, 1.02-1.06) were associated with hypertension, whereas in rural-Ghanaian females, a higher educational level (0.28, 0.08-0.98) was inversely associated with hypertension. CONCLUSION: The current study identified several modifiable determinants of hypertension in Ghanaians, with differences between populations residing in various geographical locations. This highlights the importance of development and implementation of context-specific interventions targeting these determinants to reduce the burden of hypertension among Ghanaian migrants and nonmigrants.