Background
Methods
Study Area
Data extraction
Results
Description of studies
Study references | Year of study | Location | Region | Population type | Participants | Sample size sex | Sample size residence | Response rate | Age in years | Prevalence ≥ 140/90 | Crude Prevalence ≥ 160/95 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Men | Women | Total | urban | rural | Range | mean | Men | Women | Total | Men | Women | Total | |||||||
1972/1973 | Accra-Tema | GAR | urban | public servants | 5520 | 1380 | 6900 | 91.0 | 15 -64 | nr | nr | nr | nr | 9.8 | 4.3 | 8.9 | |||
early 1973 | Danfa cluster of 20 villagesa
| GAR | rural | general pop. | 809 | 861 | 1670 | - | 1670 | 97.5 | 16 -75+ | nrk
| nr | nr | nr | 4.2 | 4.8 | 4.5 | |
Sept 1975 - May 1976 | Mamprobi, Accra | GAR | urban | general pop. | 1637 | 2108 | 3745 | 3745 | - | 73.0 | 15 -64 | nrl
| 28.5%m
| 23.2%m
| 25.5%m
| 16.1 | 10.8 | 13.1 | |
1981 | Mamprobi, Accra | GAR | urban | general pop. | nr | nr | 928 | 928 | - | 25.0 | 15 -64 | nr | nr | nr | nr | nr | nr | 13.0 | |
Hesse 1998 [30] | Mar - Jun 1995 | James Camp Prison in Accrab
| GAR | urban | Male Prison Officers; prisoners | 292g
| - | 292 | 292 | - | officers 81.4 prisoners 95.3 | Nr | officers = 39.8 ± 9.5; prisoners = 31.1 ± 10.3 | nr | nr | nr | officers = 36.4; prisoners = 2.9 | - | nr |
Amoah 2003 [33] | 1998 | 2 urban and 2 rural sites | GAR | Rural; urban | general pop. | 1860 | 2873 | 4733 | nr | nr | 75 | 25 - 102 | 44.3 ± 14.7 | 27.6 | 29.5 | 28.3 | 14.7 | 17.4 | 16.2 |
Addo et al 2006 [27] | 2001 | 4 sites, Ga districtc
| GAR | rural | general pop. | 107 | 255 | 362 | 0 | 362 | 60-80% of villages | 18 - 99 | 42.4 ± 18.6 | 24.1 | 25.9 | 25.4 | nr | nr | 15.2 |
Burket 2006 [35] | April 2002 | Liati and Tokor, Kpando district | VR | rural | general pop. | 66 | 221 | 287 | 0 | 287 | 99.0 | 17 -60+ | 41.8h
| 39.4 | 30.7 | 32.8 | nr | nr | nr |
June 2001 - June 2002 | 6 semi-urband and 6 rural | AR | Rural; semi-urban | general pop. | 385 | 628 | 1013 | 532 | 481 | 53.4 | 40 -75 | 54.7 ± 11.3 | 29.9 | 28.0 | 28.7 | nr | nr | nr | |
Escalona et al 2004 [18] | Oct 2000 - Sept 2002 | 6 sites, Accrae
| GAR | urban | general pop. | 257 | 341 | 598 | 598 | nr | nr | 15 - 65+ | nr | 27.6 | 26.1 | 26.8 | nr | nr | nr |
2003 | Accra Metropolis | GAR | urban | general pop. of women | 0 | 1328 | 1328 | 1328 | - | 41.5 | 18 -100 | 46.8 ± 18.0 | - | 48.0 | 48.0 | nr | nr | nr | |
2004 | Kumasi and 4 villages | AR | Rural; urban | general pop. | 787 | 644 | 1431 | 853 | 578 | 82-99 | 16 -50+ | 35.9 | 31.0 | 28.0 | 29.4 | nr | nr | nr | |
2005 | 7 ministries, Accraf
| GAR | urban | civil servants | 615 | 400 | 1015 | 1015 | nr | 82.7 | 25 -68 | 44.0 ± 10.1 | 31.7 | 28.0 | 30.2 | nr | nr | nr | |
Owiredu et al 2008 [19] | Aug - Oct 2005 | 3 Pentecostal churches, Kumasi | AR | urban | Church goers | 117 | 266 | 383 | 383 | - | Nr | 18 - 85 | 41.6 ± 13.4 | SBP = 12.0; DBP = 9.4 | SBP = 29.3; DBP = 25.6 | SBP = 24.0; DBP = 20.6 | nr | nr | nr |
Kunutsor & Powles 2009 [34] | Feb - Apr 2007 | Kassena-Nankana District | UER | rural | general pop. | 207 | 367 | 574 | - | 574 | 95.7 | 15 - 65 | 37.8 ± 14.1 | 19.2 | |||||
Mensa-Wilmot 2003 [26] | 2003 | Kassena-Nankana District | UER | rural | general pop. | 852 | 1166 | 2018 | - | 2018 | Nr | 15 -64 | 36.0 ± 14.6i
| SBP = 5.6; DBP = 7.2 | SBP = 3.8; DBP = 5.4 | SBP = 6.2; DBP = 4.5 | nr | nr | nr |
Akufo 2008 [25] | 2008 | Kumasi metropolis | AR | urban | factory workers | 251 | 49 | 300 | 300 | - | Nr | 17 -72 | 34.5j
| 22.7 | 18.4 | 22.0 | nr | nr | nr |
Blood pressure measurement
Study references | Personnel taking BP | No. of visits | Interval between visits | Frequency of readings per visit | Initial rest time (mins) | Interval between multiple readings | Reading used in analysis | cuff size | Posture | Part of body on which BP taken | Device |
---|---|---|---|---|---|---|---|---|---|---|---|
nr | 1 -2; If 2nd BP reading higher than that defined for age, BP re-taken at a later visit | 24 hours | 1 - 3 | nr | 10 mins | 1st or 3rd BP reading | nr | seated | right arm | manual | |
2 field staff | 1 | - | 3 | 5-10 | nr | Mean of three readings | 14 cm wide cuff | seated | right arm | manual | |
trained nurses | 1 | - | 1 - 3; BP repeated twice if BP > 160/95 mmHg | 5 | 10 mins | Initial BP | two cuff sizes 12 × 10 cm, 14 × 17 cm | seated | right arm | Manual | |
trained nurses | 1 | - | As in Ikeme et al 1978[21] | 5 | nr | nr | two cuff sizes 12 × 10 cm, 14 × 17 cm | seated | right arm | manual | |
Hesse 1998 [30] | 4 medical officers | 1 - 2; BP re-taken at a later visit if BP > 140/90 mmHg | 1 month | 3 | 5 | 30 secs | Mean of latter 3 readings | appropriate cuff size | seated | right arm | manual |
Amoah 2003 [33] | 3 nurses | 1 | - | 2 | ≥ 10 | 1 min | Mean of two readings | appropriate cuff size | seated | right arm | manual |
Addo et al 2006 [27] | 2 nurses | 1 | - | 2 | ≥ 10 | 1 min | Mean of 2 readings | appropriate cuff size | seated | Right arm | manual |
Burket 2006 [35] | Nurses, confirmed by physician if raised BP | 1 | - | 1 - 2; BP repeated only if 1st reading is raised | nr | On average, 26.5 mins | nr | nr | seated | arm | manual |
Doctors, nurses, clerks | 1 | - | 3 | ≥ 5 | 1 min | Mean of 2nd and 3rd readings | appropriate cuff size | seated | arm | electronic OMRON HEM705CP | |
Escalona et al 2004 [18] | Nurses | 1 | - | nr | nr | nr | nr | nr | seated | arm | Manual |
2 trained nurses | 1 | - | 2 | nr | nr | nr; both readings had to be raised | two cuff sizes | 1303 seated 1253 supine | arm | Manual | |
Trained staff | 1 | - | 2 | 5 | ≥ 5 mins | Mean of two readings | appropriate cuff size | seated | right arm | electronic - Omron M5-I | |
Addo et al 2008 [31] | Trained interviewers | 1 - 2, BP repeated at a later visit if initially > 140/90 mmHg without treatment | 3 weeks | 1-3 | ≥ 10 | 1 min | Mean of 2nd & 3rd readings | appropriate cuff size | Seated with feet flat on floor | right arm | electronic - Omron M5-I |
Owiredu et al 2008 [19] | Trained personnel | 1 | - | 2 | > 5 | 5 mins | Mean of two readings | nr | seated | Left arm | Manual |
Kunutsor & Powles 2009 [34] | 6 trained personnel | 1 - 2 BP re-taken in consenting sub-sample at a later visit | 2 weeks | 1 - 2 | nr | nr | Mean of two readings | nr | seated | right arm | electronic - OMRON MX3 Plus |
Mensa-Wilmot 2003 [26] | nurses | 1 | - | 3 | ≥ 5 | ≥ 5 mins | Mean of 2nd and 3rd readings | nr | seated | wrist | electronic OMORON R5-I wrist digital |
Akufo 2008 [25] | Nurse and 2 field assistants | 1 | - | 3 | ≥ 30 | 5 mins | Mean of the 3 readings | nr | seated | right arm | electronic OMRON M4-I digital |
Prevalence of hypertension
Study references | Population type | Mean Age in years | Prevalence ≥140/90 | Crude Prevalence ≥160/95 | Mean systolic BP | Mean diastolic BP | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
urban | rural | urban | rural | Male | Female | Total | Male | Female | Total | |||
Urban public servants | nr | 8.0 | nr | 8.0 | - | |||||||
rural | nrk | nr | nr | - | 4.5 | 123.8 ± 19.7 | 122.0 ± 21.0 | 122.5 | 69.2 ± 13.5 | 68.8 ± 12.7 | 69 | |
urban | nrl | 25.5 | - | 13.1 | - | 127.7 ± 18.7 | 124.6 ± 20.2 | 125.9 ± 9.6 | 80.5 ± 13.0 | 78.9 ± 13.9 | 79.6 ± 13.6 | |
urban | nr | nr | nr | 13.0 | - | 133.6 ± 19.9 | 136.7 ± 22.9 | 135.2 ± 21.4 | 85.5 ± 11.3 | 86.1 ± 13.4 | 85.8 ± 12.4 | |
Hesse 1998 [30] | Urban Prison | officers = 39.8 ± 9.5; prisoners = 31.1 ± 10.3 | nr | nr | officers = 36.4; prisoners = 2.9 | - | officers = 140.9 ± 25.1; prisoners = 123.3 ± 14.4 | - | nr | officers = 91.3 ± 16.7; prisoners = 77.2 ± 10.4 | - | nr |
Amoah 2003 [33] | Rural; urban | 44.3 ± 14.7 | nr | nr | nr | nr | 129.0 ± 22.2 | 128.9 ± 26.7 | 128.9 ± 25.0 | 75.1 ± 13.0 | 74.7 ± 14.1 | 74.9 ± 13.7 |
Addo et al 2006 [27] | rural | 42.4 ± 18.6 | - | 25.4 | nr | 15.2 | 125.4 ± 20.9 | 128.5 ± 27.6 | 127.5 ± 25.8 | 74.5 ± 14.2 | 73.9 ± 14.4 | 74.0 ± 14.3 |
Burket 2006 [35] | rural | 41.8 h | - | 32.8 | nr | nr | nr | nr | nr | nr | nr | nr |
Rural; semi-urban | 54.7 ± 11.3 | 32.9 | 24.1 | nr | nr | 126.3 ± 24.4 | 125.1 ± 27.0 | 125.5 ± 26.1 | 75.8 ± 13.7 | 73.5 ± 13.5 | 74.4 ± 13.6 | |
Escalona et al 2004 [18] | urban | nr | 26.8 | nr | nr | nr | nr | nr | nr | nr | nr | nr |
Urban women | 46.8 ± 18.0 | 48.0 | - | nr | nr | - | upright: 139.4 ± 27.5; supine 141.2 ± 28.0 mmHg | upright: 139.4 ± 27.5; supine 141.2 ± 28.0 mmHg | - | upright: 86.4 ± 15.1; supine 87.6 ± 15.3 mmHg | upright: 86.4 ± 15.1; supine 87.6 ± 15.3 mmHg | |
Rural; urban | 35.9 | 31.1 | 27.0 | nr | nr | nr | nr | nr | nr | nr | nr | |
Addo et al 2008 [31] | Urban civil servants | 44.0 ± 10.1 | 30.2 | - | nr | nr | 131.5 | 121.5 | 128.5 | 80.0 | 77.0 | 79.0 |
Owiredu et al 2008 [19] | Urban church attendees | 41.6 ± 13.4 | SBP = 24.0; DBP = 20.6 | - | nr | nr | 117.1 ± 15.7 | 126.4 ± 21.8 | 123.6 ± 20.5 | 72.9 ± 10.3 | 77.7 ± 13.5 | 76.2 ± 12.8 |
Kunutsor & Powles 2009 [34] | rural | 37.8 ± 14.1 | 19.2 | 124.3 ± 18.7 | 122.1 ± 22.0 | 122.9 ± 20.9 | 69.9 ± 12.1 | 72.1 ± 12.4 | 71.3 ± 12.3 | |||
Mensa-Wilmot 2003 [26] | rural | 36.0 ± 14.6i | nr | SBP = 6.2; DBP = 4.5 | nr | nr | mean SPB in 45+y group = 119.9 ± 17.6 | mean SPB in 45+y group = 116.1 ± 15.8 | All ages = 113; mean SPB in 45+y group = 117.6 ± 16.6 | Mean DPB in 45+y group = 78.3 ± 13.5 | Mean SPB in 45+y group = 74.5 ± 10.7 | All ages = 73.7; Mean DPB in 45+y group = 76.0 ± 18.0 |
Akufo 2008 [25] | urban factory workers | 34.5j | 22.0 | - | nr | nr | nr | nr | nr | nr | nr | nr |
Factors associated with hypertension
Study ref | Blood Pressure | 15-24 | 25-34 | 35-44 | 45-54 | 55-64 | 65-74 | 75 + | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M | F | T | M | F | T | M | F | T | M | F | T | M | F | T | M | F | T | M | F | T | ||
SBP | 120.9 | 113.8 | 117.2 | 122.1 | 113.4 | 117.3 | 121.7 | 118.1 | 119.8 | 120.3 | 127.4 | 123.7 | 127.8 | 130.8 | 129.2 | 130.2 | 133.5 | 131.9 | 143.4 | 151.6 | 147.2 | |
DBP | 60.6 | 62.7 | 61.7 | 69.1 | 64.0 | 66.3 | 71.5 | 70.5 | 71.0 | 72.7 | 75.8 | 74.2 | 74.3 | 75.8 | 75.0 | 74 | 74.1 | 74.1 | 76.1 | 78.1 | 77.0 | |
SBP | 116.4 ± 13.4 | 115.1 ± 13.2 | - | 117.6 ± 14.4 | 118.9 ± 15.5 | - | 126.9 ± 20.4 | 127.7 ± 23.2 | - | 137.8 ± 19.8 | 147.1 ± 31.1 | - | 149.1 ± 22.3 | 150.1 ± 24.5 | - | 153.5 ± 29.0 | 161.0 ± 29.8 | - | - | - | - | |
DBP | 74.9 ± 8.7 | 73.8 ± 8.2 | - | 76.6 ± 9.1 | 73.8 ± 11.4 | - | 83.6 ± 13.7 | 85.3 ± 13.6 | - | 88.9 ± 11.3 | 94.0 ± 17.0 | - | 95.1 ± 12.1 | 93.0 ± 12.9 | - | 93.7 ± 12.6 | 96.6 ± 17.4 | - | - | - | - | |
Amoah 2003 [33] | SBP | - | - | - | 120.7 ± 13.5 | 115.3 ± 15.3 | - | 123.1 ± 16.7 | 122.6 ± 20.0 | - | 131.7 ± 23.0 | 133.9 ± 26.3 | - | 144.0 ± 29.4 | 143.9 ± 28.2 | - | 128.1 ± 21.6 | 127.7 ± 25.7 | - | - | - | - |
DBP | - | - | - | 70.0 ± 9.7 | 68.2 ± 10.2 | - | 74.5 ± 12.5 | 74.3 ± 13.0 | - | 79.2 ± 13.9 | 78.7 ± 13.7 | - | 75.5 ± 13.3 | 79.8 ± 15.0 | - | 74.6 ± 12.7 | 74.2 ± 13.8 | - | - | - | - | |
SBP | - | - | - | - | - | - | 120.9 ± 18.6 | 108.7 ± 16.8 | - | 124.6 ± 22.2 | 122.8 ± 25.4 | - | 130.0 ± 25.5 | 129.7 ± 28.1 | - | 130.0 ± 30.0 | 138.1 ± 28.0 | - | - | - | - | |
DBP | - | - | - | - | - | - | 75.1 ± 13.9 | 67.7 ± 11.3 | - | 76.6 ± 13.6 | 74.3 ± 13.3 | - | 77.3 ± 14.4 | 75.6 ± 13.6 | - | 73.4 ± 12.9 | 75.2 ± 14.2 | - | - | - | - | |
Addo et al 2008 [31]d
| SBP | - | - | - | 125.0 | 113.5 | 119.0 | 127.5 | 117.5 | 125.0 | 135.5 | 130.8 | 134.0 | 140.3 | 131.8 | 137.0 | - | - | - | - | - | - |
DBP | - | - | - | 72.5 | 69.0 | 71.3 | 77.5 | 76.0 | 76.5 | 84.5 | 83.5 | 84.0 | 85.0 | 79.8 | 84.5 | - | - | - | - | - | - | |
Owiredu et al 2008 [19]e
| SBP | - | - | 109.5 ± 10.8 | - | - | 113.8 ± 11.6 | - | - | 121.7 ± 18.4 | - | - | 127.2 ± 18.8 | - | - | 139.1 ± 25.8 | - | - | 150.0 ± 20.6 | - | - | - |
DBP | - | - | 67.7 ± 7.7 | - | - | 70.8 ± 8.7 | - | - | 76.2 ± 12.8 | - | - | 80.1 ± 12.4 | - | - | 81.4 ± 15.5 | - | - | 85.7 ± 14.0 | - | - | - | |
Kunutsor & Powles 2009 [34] | SBP | 123.3 ± 13.0 | 113.5 ± 11.4 | 117.5 ± 13.0 | 124.1 ± 19.2 | 112.5 ± 11.0 | 116.7 ± 15.5 | 124.2 ± 16.2 | 123.1 ± 21.3 | 123.5 ± 19.3 | 124.4 ± 24.5 | 130.8 ± 25.9 | 129.0 ± 25.5 | 126.2 ± 23.7 | 134.0 ± 28.4 | 131.5 ± 27.1 | - | - | - | - | - | - |
DBP | 61.9 ± 6.6 | 65.6 ± 8.4 | 64.1 ± 7.9 | 69.9 ± 12.6 | 67.9 ± 9.2 | 68.6 ± 10.6 | 71.8 ± 9.9 | 76.1 ± 13.2 | 74.3 ± 12.1 | 75.5 ± 14.8 | 78.3 ± 13.7 | 77.5 ± 14.0 | 75.2 ± 12.2 | 74.0 ± 12.1 | 74.4 ± 12.1 | - | - | - | - | - | - |
Detection, treatment and control
Study ref | Total no. Hypertensives | Among total number of hypertensives: | Aware % | Treatment % | Control % | ||
---|---|---|---|---|---|---|---|
Awarea
| Treatmentb
| Controlc
| |||||
540 | 130 | 39 | 20 | 24.1 | 7.2 | 3.7 | |
Hesse 1998 [30] | 38 | 14 | 5 | 0 | 36.8 | 13.2 | 0.0 |
Amoah 2003 [33] | 1337 | 458 | 243 | 49 | 34.3 | 18.2 | 3.7 |
Addo et al 2006 [27] | 93 | 30 | 15 | 5 | 32.3 | 16.1 | 5.4 |
291 | 64 | 33 | 8 | 22.0 | 11.3 | 2.7 | |
421 | 143 | 118 | 26 | 34.0 | 28.0 | 6.2 | |
Addo et al 2008 [31] | 307 | 166 | 96 | 39 | 54.1 | 31.3 | 12.7 |