Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Burkina Faso.
Department of Paediatrics, St Dominic's Hospital, Akwatia, Ghana.
PLoS One. 2021 Mar 5;16(3):e0248137. doi: 10.1371/journal.pone.0248137. eCollection 2021.
Hypertension is a major health problem in Ghana, being a leading cause of admissions and deaths in the country. In the context of a changing food and health policy environment, we undertook a systematic review (PROSPERO registration number: CRD42020177174) and a meta-analysis of the prevalence of adult hypertension, and its awareness and control in Ghana.
We searched major databases including PubMed, Embase as well as Google Scholar and online digital collections of public universities of Ghana to locate relevant published and unpublished community-based articles up till April 2020.
Eighty-five articles involving 82,045 apparently-healthy subjects aged 15-100 years were analyzed. In individual studies, the prevalence of hypertension, defined in most cases as blood pressure ≥ 140/90 mmHg, ranged from 2.8% to 67.5%. The pooled prevalence from the meta-analysis was 27.0% (95% CI 24.0%-30.0%), being twice as high in the coastal (28%, 95% CI: 24.0%-31.0%) and middle geo-ecological belts (29%, 95% CI: 25.0%-33.0%) as in the northern belt (13%, 95% CI: 7.0%-21.0%). The prevalence was similar by sex, urban-rural residence or peer-review status of the included studies. It did not appear to vary over the study year period 1976-2019. Of the subjects with hypertension, only 35% (95% CI: 29.0%-41.0%) were aware of it, 22% (95% CI: 16.0%-29.0%) were on treatment and 6.0% (95% CI: 3.0%-10.0%) had their blood pressure controlled. Sensitivity analyses corroborated the robust estimates. There was, however, high heterogeneity (I2 = 98.7%) across the studies which was partly explained by prevalent obesity in the subjects.
More than one in four adults in Ghana have hypertension. This high prevalence has persisted for decades and is similar in rural and urban populations. With the low awareness and poor control of hypertension, greater investments in cardiovascular health are required if Ghana is to meet the global target for hypertension.
高血压是加纳的一个主要健康问题，是加纳住院和死亡的主要原因。在食品和健康政策环境不断变化的背景下，我们进行了一项系统评价（PROSPERO 注册号：CRD42020177174）和荟萃分析，以评估加纳成年人高血压的患病率及其知晓率和控制率。
我们检索了主要数据库，包括 PubMed、Embase 以及 Google Scholar 以及加纳公立大学的在线数字馆藏，以查找截至 2020 年 4 月的相关已发表和未发表的社区文章。
共分析了 85 篇涉及 82045 名年龄在 15-100 岁之间的貌似健康受试者的文章。在个别研究中，高血压的患病率定义为血压≥140/90mmHg，范围从 2.8%到 67.5%。荟萃分析的汇总患病率为 27.0%（95%CI 24.0%-30.0%），沿海（28%，95%CI：24.0%-31.0%）和中地理生态带（29%，95%CI：25.0%-33.0%）的患病率是北部带（13%，95%CI：7.0%-21.0%）的两倍。按性别、城乡居住或纳入研究的同行评审状态，患病率相似。它似乎没有随着 1976-2019 年的研究年份而变化。在患有高血压的患者中，只有 35%（95%CI：29.0%-41.0%）知道自己患有高血压，22%（95%CI：16.0%-29.0%）正在接受治疗，6.0%（95%CI：3.0%-10.0%）的血压得到控制。敏感性分析证实了这些稳健的估计。然而，研究之间存在很高的异质性（I2=98.7%），这部分归因于研究对象中普遍存在的肥胖。
加纳超过四分之一的成年人患有高血压。这种高患病率已经持续了几十年，在农村和城市人口中是相似的。鉴于高血压的知晓率低和控制率差，如果加纳要实现全球高血压目标，就需要对心血管健康进行更大的投资。
