Epidemiology of Hypertension Stages in Two Countries in Sub-Sahara Africa: Factors Associated with Hypertension Stages

Studies using the revised hypertension classification are needed to better understand epidemiology of hypertension across full distribution. The sociodemographic, biological, and health behavior characteristics associated with different stages of hypertension in Ghana and South Africa (SA) were studied using global ageing and adult health (SAGE), WAVE 1 dataset. Blood pressure was assessed for a total of 7545 respondents, 2980 from SA and 4565 from Ghana. Hypertension was defined using JNC7 blood pressure classification considering previous diagnosis and treatment. Multivariate multinomial logistic regression analysis using Stata version 12 statistical software was done to identify independent predictors. The weighted prevalence of prehypertension and hypertension in Ghana was 30.7% and 42.4%, respectively, and that of SA was 29.4% and 46%, respectively, showing high burden. After adjusting for the independent variables, only age (OR = 1.32, 95% CI: 1.14-1.53), income (OR = 1.9, 95% CI: 1.04-3.47), and BMI (OR = 1.16, 95% CI: 1.1-1.22) remained independent predictors for stage 1 hypertension in Ghana, while, for SA, age (OR = 2.27, 95% CI: 1.53-3.36), sex (OR = 0.28, 95% CI: 0.08-1), and BMI (OR = 1.15, 95% CI: 1.07-1.25) were found to be independent predictors of stage 1 hypertension. Healthy lifestyle changes and policy measures are needed to promptly address these predictors.