Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Medicine, SUNY Upstate Medical University, New York, USA.
J Glob Health. 2020 Dec;10(2):020408. doi: 10.7189/jogh.10.020408.
We estimated the prevalence and socio-demographic risk factors of hypertension among Ghanaian adults as per the Joint National Committee 7 and the 2017 American College of Cardiology/American Hypertension Association hypertension thresholds used for diagnosis and treatment.
This cross-sectional analysis included 12 151 adults (8295 females and 3856 males) aged 18 years or older who participated in the 2014 Ghana Demographic and health Survey. Multiple logistic regression models were applied to obtain risk factors associated with hypertension as per both guidelines.
Overall, 30.43% (n = 3698) and 11.48% (n = 1395) respondents had hypertension as per the 2017 ACC/AHA and JNC7 guidelines, respectively. The following factors were significant according to the 2017 ACC/AHA guideline: 55-64 years (adjusted odds ratio (aOR) = 6.42, 95% confidence interval (CI): 4.70-8.77), 45-54 years (aOR = 5.72, 95% CI = 4.70-6.85), 3544 years (aOR = 3.91, 95% CI = 3.33-4.59), and 25-34 years (aOR = 2.05, 95% CI = 1.77-2.37) age groups. Males (aOR = 1.39, 95% CI = 1.23-1.53), and urban residents (aOR = 1.18, 95% CI = 1.05-1.38). All the above risk factors were significant according to the JNC7 guideline too. Factors positively associated with only the 2017 ACC/AHA guideline included: middle income (aOR = 1.20, 95% CI = 1.02-1.42) and richest (aOR = 1.36, 95% CI = 1.10-1.69) wealth quintiles, whereas manual (aOR = 1.37, 95% CI = 1.02-1.86) was positively associated with the JNC7 guidelines only.
We conclude that adopting the ACC/AHA guidelines would lead to a substantial increase in the prevalence of hypertension among Ghanaian adults, thus, hypertension prevention and control should be prioritized.
我们根据联合国家委员会第 7 版（JNC7）和 2017 年美国心脏病学会/美国高血压协会（ACC/AHA）用于诊断和治疗的高血压阈值，估计了加纳成年人高血压的患病率和社会人口学危险因素。
这项横断面分析包括了 12151 名年龄在 18 岁及以上的成年人（女性 8295 名，男性 3856 名），他们参加了 2014 年加纳人口与健康调查。我们应用多因素逻辑回归模型，根据这两个指南，获得与高血压相关的危险因素。
根据 2017 年 ACC/AHA 指南，总体上有 30.43%（n=3698）和 11.48%（n=1395）的受访者患有高血压。根据 2017 年 ACC/AHA 指南，以下因素具有统计学意义：55-64 岁（调整后的优势比（aOR）=6.42，95%置信区间（CI）：4.70-8.77）、45-54 岁（aOR=5.72，95%CI=4.70-6.85）、35-44 岁（aOR=3.91，95%CI=3.33-4.59）和 25-34 岁（aOR=2.05，95%CI=1.77-2.37）年龄组。男性（aOR=1.39，95%CI=1.23-1.53）和城市居民（aOR=1.18，95%CI=1.05-1.38）。所有这些危险因素根据 JNC7 指南也具有统计学意义。仅与 2017 年 ACC/AHA 指南相关的正相关因素包括：中等收入（aOR=1.20，95%CI=1.02-1.42）和最富有（aOR=1.36，95%CI=1.10-1.69）财富五分位数，而体力劳动（aOR=1.37，95%CI=1.02-1.86）仅与 JNC7 指南相关。
我们的结论是，采用 ACC/AHA 指南将导致加纳成年人高血压患病率的大幅增加，因此，应优先考虑高血压的预防和控制。
