Department of Public Health, Academic Medical Centre, University of Amsterdam, Netherlands PO Box 22660, Amsterdam, The Netherlands.
Global Health. 2013 Nov 14;9:59. doi: 10.1186/1744-8603-9-59.
Globally, about 350.000 women die every year from pregnancy related causes and more than half of these deaths occur in sub-Saharan Africa (SSA). Approximately 12% of the maternal deaths are associated with hypertensive disorders in pregnancy such as pregnancy induced hypertension (PIH). However, very little is known about PIH and associated determinants in many SSA countries such as Ghana. We therefore sought to assess rural and urban differences in blood pressure (BP) and PIH among pregnant women in Ghana.
We conducted a cross-sectional study among 967 rural (677) and urban (290) pregnant women with a gestational age of more than 20 weeks. PIH was defined as a systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg.
Women in urban Ghana had a higher mean systolic and diastolic BP than women in rural Ghana (105/66 mmHg versus 102/61 mmHg, p < 0.001 for both systolic and diastolic BP). The prevalence of PIH was also higher in urban Ghana (3.1%) than in rural Ghana (0.4%) (p = 0.014). The urban and rural difference in mean diastolic blood pressure persisted even after adjustments for the study characteristics in a linear regression model. In both rural and urban Ghana, BMI, heart rate and a family history of hypertension were independently associated with BP.
Our findings suggest higher mean BP levels and PIH in urban Ghana than in rural Ghana. BMI was independently related to high BP. Left unchecked, the increasing prevalence of overweight and obesity in Ghana will exacerbate PIH levels in Ghana.
全球每年约有 35 万名妇女死于与妊娠相关的原因，其中一半以上发生在撒哈拉以南非洲（SSA）。大约 12%的孕产妇死亡与妊娠期间的高血压疾病有关，如妊娠高血压（PIH）。然而，在加纳等许多 SSA 国家，人们对 PIH 及其相关决定因素知之甚少。因此，我们试图评估加纳农村和城市孕妇的血压（BP）和 PIH 差异。
我们对 967 名农村（677 名）和城市（290 名）妊娠 20 周以上的孕妇进行了横断面研究。PIH 的定义为收缩压≥140mmHg 和/或舒张压≥90mmHg。
加纳城市女性的平均收缩压和舒张压均高于加纳农村女性（105/66mmHg 与 102/61mmHg，收缩压和舒张压均<0.001）。加纳城市的 PIH 患病率也高于加纳农村（3.1%对 0.4%）（p=0.014）。即使在校正线性回归模型中的研究特征后，城乡加纳之间的平均舒张压差异仍然存在。在加纳农村和城市，BMI、心率和高血压家族史均与 BP 独立相关。
我们的研究结果表明，加纳城市的平均 BP 水平和 PIH 高于加纳农村。BMI 与高血压独立相关。如果不加控制，加纳超重和肥胖症的患病率不断增加，将加剧加纳的 PIH 水平。
