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      Psychosocial factors and hypertension prevalence among Ghanaians in Ghana and Ghanaian migrants in Europe: The RODAM study

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          Abstract

          Despite progress made to prevent and control hypertension, its prevalence has persisted in many countries. This study examined the associations between psychosocial factors and hypertension among Ghanaian non-migrants and migrants. Data were drawn from the Research on Obesity and Diabetes among African Migrants (RODAM) project. Findings show that among migrant women, those who experienced periods of stress at home/work had higher odds of hypertension. Among non-migrants, women with depression symptoms were more likely to be hypertensive. Furthermore, there was a positive association between negative life events and hypertension among non-migrant men. The findings highlight the importance of psychosocial factors in addressing hypertension prevalence in Ghanaian populations.

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          The PHQ-9

          Kurt Kroenke, Robert L Spitzer, Janet B W Williams (2001)
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            Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis

            Pietro Modesti, Gianpaolo Reboldi, Francesco Cappuccio … (2016)
            Background People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU. Methods and Findings We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence. Conclusions 1) The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.
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              2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension.

              Judith Whitworth (2003)
              Hypertension is estimated to cause 4.5% of current global disease burden and is as prevalent in many developing countries, as in the developed world. Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range. Countries vary widely in capacity for management of hypertension, but worldwide the majority of diagnosed hypertensives are inadequately controlled. This statement addresses the ascertainment of overall cardiovascular risk to establish thresholds for initiation and goals of treatment, appropriate treatment strategies for non-drug and drug therapies, and cost-effectiveness of treatment. Since publication of the WHO/ISH Guidelines for the Management of Hypertension in 1999, more evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients. In high-risk patients there is evidence for lower thresholds. Lifestyle modification is recommended for all individuals. There is evidence that specific agents have benefits for patients with particular compelling indications, and that monotherapy is inadequate for the majority of patients. For patients without a compelling indication for a particular drug class, on the basis of comparative trial data, availability, and cost, a low dose of diuretic should be considered for initiation of therapy. In most places a thiazide diuretic is the cheapest option and thus most cost effective, but for compelling indications where other classes provide additional benefits, even if more expensive, they may be more cost effective. In high-risk patients who attain large benefits from treatment, expensive drugs may be cost effective, but in low-risk patients treatment may not be cost-effective unless the drugs are cheap.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Health Psychol Open
                Journal ID (iso-abbrev): Health Psychol Open
                Journal ID (publisher-id): HPO
                Journal ID (hwp): sphpo
                Title: Health Psychology Open
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 2055-1029
                Publication date (Electronic): 12 November 2019
                Publication date Collection: Jul-Dec 2019
                Volume: 6
                Issue: 2
                Electronic Location Identifier: 2055102919885752
                Affiliations
                [1 ]University of Ghana, Ghana
                [2 ]University College London, UK
                [3 ]Pennsylvania State University, USA
                [4 ]University of Amsterdam, The Netherlands
                [5 ]Utrecht University, The Netherlands
                [6 ]London School of Hygiene & Tropical Medicine, UK
                [7 ]Uganda Martyrs University, Uganda
                Author notes
                [*]Raphael Baffour Awuah, Regional Institute for Population Studies, University of Ghana, PO Box LG 96 Legon, Ghana. Email: ralph.awuah1@ 123456gmail.com
                Article
                Publisher ID: 10.1177_2055102919885752
                DOI: 10.1177/2055102919885752
                PMC ID: 6851611
                PubMed ID: 31763049
                SO-VID: 6db83893-b2f3-4e2d-862a-43ed7ddad511
                Copyright © © The Author(s) 2019
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Categories
                Subject: Report of Empirical Study
                Custom metadata
                cover-date July-December 2019

                Keywords: depression symptoms,hypertension,ghanaian migrants in europe,ghanaians in ghana,negative life events,stress
                Data availability:
                Keywords: depression symptoms, hypertension, ghanaian migrants in europe, ghanaians in ghana, negative life events, stress

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