Aheto Justice Moses K, Dagne Getachew A
Department of Biostatistics School of Public Health, College of Health Sciences, University of Ghana Accra Ghana.
College of Public Health, University of South Florida Tampa Florida USA.
Health Sci Rep. 2021 Dec 10;4(4):e453. doi: 10.1002/hsr2.453. eCollection 2021 Dec.
Hypertension is a major public health issue, an important risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programs and policies aimed at reducing the prevalence and its associated morbidity, disability, and mortality. This study attempts to develop multilevel regression, an in-depth statistical model to identify critical risk factors of hypertension.
This study used data on 4667 individuals aged ≥18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 conducted in 2014/2015. Multilevel regression modeling was employed to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (ie, SBP > 140 mmHg). Of the 4667, 27.3% were hypertensive. Final data on 4381 individuals residing in 3790 households were analyzed using multilevel models, and results were presented as adjusted odds ratios (aOR) and their associated 95% confidence intervals (CI).
Risk factors for hypertension identified were age (aOR) = 5.4, 95% CI: 4.11-7.09), obesity (aOR = 1.51, 95% CI: 1.19-1.91), marital status (aOR = 0.75, 95% CI: 0.64-0.89), perceived health state (moderate; aOR = 1.38, 95% CI: 1.15-1.65 and bad/very bad; aOR = 1.35, 95% CI: 1.0-1.83), and difficulty with self-care (aOR = 1.64, 95% CI: 1.1-2.44). We found unobserved significant differences in the likelihood of hypertension prevalence between different households.
Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability, and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message, and political will could be beneficial to the management and prevention of hypertension.
高血压是一个主要的公共卫生问题，是心血管疾病和中风的重要危险因素，尤其是在发病率仍高得令人无法接受的发展中国家。在非洲，高血压是心血管疾病和中风死亡的主要驱动因素。确定高血压的关键危险因素有助于制定有针对性的公共卫生计划和政策，以降低其患病率及其相关的发病率、残疾率和死亡率。本研究试图开发多水平回归模型，这是一种深入的统计模型，用于确定高血压的关键危险因素。
本研究使用了2014/2015年在加纳进行的具有全国代表性的世界卫生组织全球老龄化与成人健康研究（SAGE）第二轮中4667名年龄≥18岁个体的数据。采用多水平回归模型，根据收缩压（SBP）（即SBP>140 mmHg）确定高血压的关键危险因素。在这4667名个体中，27.3%患有高血压。使用多水平模型对居住在3790户家庭中的4381名个体的最终数据进行了分析，结果以调整后的比值比（aOR）及其相关的95%置信区间（CI）表示。
确定的高血压危险因素包括年龄（aOR = 5.4，95%CI：4.11 - 7.09）、肥胖（aOR = 1.51，95%CI：1.19 - 1.91）、婚姻状况（aOR = 0.75，95%CI：0.64 - 0.89）、自我感知健康状况（中等；aOR = 1.38，95%CI：1.15 - 1.65和差/非常差；aOR = 1.35，95%CI：1.0 - 1.83）以及自我护理困难（aOR = 1.64，95%CI：1.1 - 2.44）。我们发现不同家庭之间高血压患病率的可能性存在未观察到的显著差异。
解决肥胖问题，针对50岁以上人群进行特定干预，以及改善加纳人的整体健康状况，对于降低高血压患病率及其相关的发病率、残疾率和死亡率至关重要。通过饮食摄入进行生活方式改变、提供有强有力公共卫生信息支持的知识以及政治意愿，可能有助于高血压的管理和预防。
