Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
J Hypertens. 2018 Jan;36(1):169-177. doi: 10.1097/HJH.0000000000001520.
Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana.
A multicenter cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI.
The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio = 1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio = 2.21, 1.78-2.73; women, 51%; prevalence ratio = 1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio = 0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio = 0.59, 0.35-0.99), and London (36%; prevalence ratio = 0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure > 180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site.
Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts.Supplement Figure 1, http://links.lww.com/HJH/A831.
高血压是非洲移民的主要负担，但在高收入国家的不同环境中，类似的非洲移民和非移民之间的高血压患病率、治疗和控制的差异程度尚未得到评估。我们评估了生活在三个欧洲城市（阿姆斯特丹、伦敦和柏林）的相对同质的非洲移民（加纳人）和生活在加纳农村和城市的非移民之间高血压患病率及其管理的差异。
对 25-70 岁的加纳成年人（n=5659）进行了一项多中心横断面研究。通过调整年龄、教育程度和 BMI 后使用患病率比进行了地点间比较。
加纳农村男性和女性的高血压标准化患病率分别为 22%和 28%。加纳城市的患病率较高[男性，34%；调整后的患病率比为 1.37，95%置信区间（CI）为 1.10-1.70]；而欧洲移民中的患病率更高，尤其是柏林（男性，57%；患病率比为 2.21，1.78-2.73；女性，51%；患病率比为 1.74，1.45-2.09），高于加纳农村。加纳移民的高血压知晓率和治疗率高于非移民加纳人。然而，柏林（男性，20%；患病率比为 0.43，95%CI 为 0.23-0.82）、阿姆斯特丹（男性，29%；患病率比为 0.59，95%CI 为 0.35-0.99）和伦敦（男性，36%；患病率比为 0.86，95%CI 为 0.49-1.51）的加纳男性移民的高血压控制率低于加纳农村地区（59%）。在女性中，未观察到高血压控制方面的差异。约 50%的移民和 85%的加纳农村严重高血压（血压＞180/110）患者未接受治疗。降压药物处方模式因地点而异。
与非移民加纳人相比，非洲移民的高血压患病率、知晓率和治疗水平普遍较高，但加纳男性移民的血压控制水平较低。需要进一步努力确定关键的潜在因素，以支持预防和管理工作。补充图 1，http://links.lww.com/HJH/A831。
