Hypertension Prevalence and Determinants in Urban Coastal Communities in Ghana.

Background: The frequency of hypertension in Ghana has risen dramatically in recent decades. Inadequate diagnosis and inappropriate care of diagnosed cases has led to increased mortality and morbidity from poor blood pressure control and associated consequences, especially in areas with low socioeconomic status. This study aimed to assess the prevalence of hypertension and its determinants in underserved coastal communities in Ghana.

Methods: This screening survey is part of a quasi-experimental initiative in 8 coastal towns to detect hypertension patients and connect them to local care. The initial survey examined 10 000 consenting individuals aged 18 years and older in these localities. Poisson regression model was used to determine the associations of socioeconomic factors with hypertension occurrence.

Results: The median age of the study participants was 38 years, majority being women (65.3%). The overall age-standardized hypertension rate was 26.0% (95% CI: 25.1-26.9), with significant variability across subdistricts and communities ranging from 22.0% (95% CI: 20.1-23.8) in Ga South to 32.7% (95% CI: 30.2-35.2) in Krowor. The prevalence of hypertension decreased with increasing levels of monthly income with those earning GHC 1501-2000 having the lowest adjusted prevalence ratio (aPR, 0.64; 95% CI: 0.49-0.84). Besides age, female sex (aPR, 1.18; 95% CI: 1.08-1.28), being married (aPR, 1.19; 95% CI: 1.05-1.35), and alcohol consumption (aPR, 1.23; 95% CI: 1.13-1.35), were significantly associated with increased prevalence of hypertension.

Conclusion: The coastal communities in Ghana are highly affected by hypertension with a remarkably high prevalence in women. Tailored public health strategies such as education on lifestyle modification, creation of recreational areas, use of telemedicine and mobile applications for monitoring, and follow-up may help to decrease the risk of hypertension and its complications in these communities.