Hypertension in Ghana: A cross-sectional community prevalence study in greater Accra

Objectives: To determine the prevalence of hypertension, and the extent to which it is treated and controlled, among adult Ghanaians. Design: 6300 adults, aged 25 years and older, were selected by random cluster sampling, using electoral enumeration areas and listings of adults. Setting: Three communities in the greater Accra region of Ghana. Subjects and Methods: A total of 4733 subjects (male to female ratio = 1:1.5) participated, representing a response rate of 75%. The analysis used the mean of 2 blood pressure readings, taken with a mercury sphygmomanometer after a 10-minute rest. Hypertension was defined as having blood pressure greater than or equal to140/90 mm Hg, or currently undergoing anti-hypertensive treatment. Results: The mean ages for males and females were 44.9 +/- 14.7 years, and 44.0 +/- 14.6 years, respectively. The crude prevalence of hypertension was 28.3%. The age-standardized prevalence, to the new standard world population, was 28.4%. Mean systolic and diastolic blood pressures increased with age. Of 1337 subjects with hypertension, 34% were aware of their condition, 18% were treated, and 4% were controlled (blood pressure <140/90 mm Hg). Conclusion: Hypertension is a major public health problem, and is associated with relatively low levels of awareness, drug treatment, and blood pressure control. Population-based prevention strategies, such as reduction in salt intake and integration of hypertension care into primary care, may prove beneficial; however, the determinants of hypertension remain to be ascertained.