Logistics Regression Analysis of Risk Factors Associated with Hypertension in Kumasi Metropolis, Ghana
Hypertension is one of the most important chronic non-communicable diseases with increasing prevalence worldwide. The objective of this study was to develop a regression model of hypertension using binary logistic regression based on data from the cardiac clinic of the Komfo Anokye teaching hospital (KATH) Kumasi. Data from a total of 300 patients were studied. The demographic characteristics of the patients as well as the significant risk factors associated with hypertension were examined. The patients were aged between 17-88 years with a mean age (± standard deviation) of approximately 40 (±15.8) years. There were more females (60%) than males (40%). Educational level; primary education (19.6%), tertiary education (10.73%), alcohol intake (11.89%), sex (0.45%), age (44.65%), body mass index (BMI) (14.7%), family history of hypertension (3.3%) and Islamic religious affiliation (6.12%) were significantly associated with high probability of an individual developing hypertension in Kumasi metropolis. Conclusion: increasing age, female gender, family history of hypertension, increasing BMI, high alcohol intake and lower educational level were significantly associated with high probability of an individual developing hypertension in Kumasi metropolis.
Hypertension, Significant Risk Factors of Hypertension, Body Mass Index, Marginal Effect, Binary Logistic Regression
[1]
Adamson, S., and Muula, L. M., (2007). Cigarette Smoking prevalence among school – going Adolescent in two African capital cities: Kampala Uganda and Lilongwe Malawi.
[2]
Addae, S. (1996). History of Western Medicine in Ghana 1880 – 1960. Durham: Durham Academic press.
[3]
Adu, K. O. (2015). Determinants of household heads enrolment in National health insurance scheme in central region of Ghana. International Journal of Ecology and development, vol. 30 issue no.1.
[4]
Ahluwalia, I. B., Mock, K. A., Murphy, W., Mokdad, A. H., and Bales, V. S., (2003). State – specific prevalence of selected chronic Disease – Related Characteristics – Behavioral Risk Factor Surveillance System, 2001. MMWR (Surreal Summ) 52: 1 – 80.
[5]
Allied Dunbar National fitness Survey (1992). Health Education Authority and sports council London.
[6]
American Heart Association (2009). Heart Diseases and Stroke Statistics-2009 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 119.
[7]
American Heart Association Cardiovascular Disease, (2005). At website (http: llwww.americanheart.org).
[8]
Amoah A. G. B., (2003). “Hypertension in Ghana, a Cross-sectional Community Prevalence Study in Greater Accra”, Journal of Ethnicity and Disease, 13: 310-315.
[9]
Anon, Ghana (2003). Results from the Demographic and Health Survey Studies In Family Planning 2005 Jun: 36 (2): 158 – 62.
[10]
Antezance F. S., (1996). “Epidemiologic aspects of hypertension in the world”, at website www.gfmer.ch/TMCAH/hypertensions.
[11]
Bakx, C., Henk, J. M., Wil, H. J. M, Van Den Bosch, C. P., Van Schayck, Jan W., Van Ree Thien, T. and Van Weel, C. (1999). Development of Blood Pressure and the Incidence of Hypertension in Men and Women over an 18 Years Period: Results of the Nijmegen Cohert Study. J Clin Epidemial Vol P52-531.
[12]
Barlassina C., Lorna C., Luca B., Buzzi L., D’Anico M., Sciarrono T., and Bianchi G., (1997). “Genetic of renal mechanisms of primary hypertension”, the role of adducing Journal of Hypertension, 15: 1567-1571.
[13]
Betre, M., Kebede, D. And Kassaye, M. (1997). Modifiable Risk Factors for Coronary Heart Disease Among Young People in Addis Ababa. East Africa Med J 1997, 74(6): 376-81.
[14]
Boatayeb A., and Boutayeb S., (2005), “The burden of non-communication disease in developing countries”, International Journal Equity Health:.
[15]
Brent A., and Burket, (2006). “Blood Pressure Survey in two communities in the Volta Region, Ghana, West Africa”, Journal of Ethnicity and Disease 16: 292-294.
[16]
Buabeng, K. O, Matawe, L. and Plange, Rhule, J. (2004). Unaffordable Drug Prices: The Major Cause of Noncompliance With Hypertension Medication in Ghana. http://www.ualberta.calcsps/Jpps7(3).matowe/hypertension.htm.6th November 2012.
[17]
Campbell, N. R., Ashley, M. J., Curruthers, S. G., Lacoucrere, Y. and Mokay, D. W., (1999). Lifestyle Modification To Prevent And Control Hypertension.
[18]
Canadian Fitness and Lifestyle Research Institute (1998). Physical Inactivity Crises of Children and Youth Continue to Worsen. February 2, 1998.
[19]
Cappuccio F. P., Micah F. B., Emmett L., (2004). Prevalence, detection, management and control of hypertension in Ashanti, Ghana, West Africa. Journal of Hypertension, 43: 1017-1021.
[20]
Carrtero O. A., and Oparil S. (2000). Essential Hypertension Part I definition and etiology.
[21]
Castalli W. P., (1984). Epidemiology of coronary heart disease, the Framingham study America. Journal of Medicine 76: 4-12.Centre for Disease Control and Prevention (2001). Increasing Physical Activity: A Report on Recommendations of the Task Force On Community Preventive Services. Morbidity and Mortality Weekly Report 50:1-16.
[22]
Chobanian A. N., Bakris G. L, Black H. R, Cashman W. C., Green L. H., Izzo J. L., (2003). The seventh report of the Joint National committee on the prevention Detection, Evaluation, and Treatment of High Blood Pressure. JNC report JAMA, 289: 5660-2572.
[23]
Coca A. M, Benetos A., Zhou Q., Champion A., Cooper-Dettoff R. M., Pepine C. J., (2008). Predicting stroke risk in hypertension patients with coronary artery disease. A report from the INVEST. Stoke 39:343-348.
[24]
Cunha, J. P. and Marks J. W., (2011). High Blood Pressure (Hypertension). Available: http://www.medicent.com/highbloodpressure/articlehtm. Accessed 23rd October 2013.
[25]
Durham Regional Hospital, (2004). "Blood pressure Just the fact”, http://www.duramregional.org/healthlibrary/consumethealth/bloodpressure.
[26]
Elley C. R., and Arroll, (2002). Review: aerobic exercise reduces systolic and diastolic blood pressure in adults. ACPJ Club. 137: 109-118.
[27]
Emmanuel, R., Abdurahman, A., Adamson, S. M., (2007). Prevalence And Determinants Of Adolescent Tobacco Smoking In Addis Ababa, Ethiopia, BMC Public Health 2007; 7: 176.
[28]
Ezzati, M., and Lopez, A. D., (2000). Measuring the Accumulated Hazards Of Smoking: Global and Regional Estimates for 2000. 460. Tab control 2003 mar; 12: 79.
[29]
Frantz, J., Philips, J., and Amosun, S., (2003). Promotion of Physical Activity In South African Youth-Is It The Answer To The Public Health Burden of Chronic Diseases? African Journal or Physical, Health Education, Recreation and Dance 9(2): 200-207.
[30]
Ghananem H., Hadj F. A., (1997). Epidemiology of hypertension and other cardiovascular disease risk factors in the urban population of soussa, Tunisia. Eastern Mediterranean Health Journal 3:472-479.
[31]
Global Youth Tobacco Survey Collaborating Group (2003). Difference in Worldwide Tobacco. use by Gender: Findings From The Global Youth Tobacco Survey. J Sch Health, 73: 207-15.
[32]
Global Youth Tobacco Survey GYTS (2001). Report on the result of Global Youth Tobacco Survey in Kenya-2001. (http://www.cdcgov/tobacco/global/gits/reports/afro/2001kenya-report.htm).
[33]
Greene, W. H. (2003). Econometric analysis. New Jersey: Prentice Hall Inc.
[34]
Greenland P., Knoll M. D., Stamler J., Neaton J. D., Dyer A. R., Garside D. B et al (2003). Major risk factor as antecedents of fatal and nonfatal coronary heart disease events. JAMA, 290-891.
[35]
Gregory Y. H. L., (2000). Target organ Damage and prothrombotic state in Hypertension.36: 975-977.
[36]
Gujarati, D. N. (2002). Basic Econometrics. McGraw-Hill College.
[37]
Hajjar, I., & Kitchen, T. A. (2003). Trends in Prevalence Awareness, Treatment, and Control Of Hypertension In The United States 1986-200. JAMA 290-206.
[38]
Hatmi Z. N., Tahvildari S., and Mottag A. G. (2007). Prevalence of coronary artery disease risk factors in Iran: a population based survey. BMC Cardiovascular Disorder 7:32.
[39]
Hsia J., Margolis K. L., Eaton C. B., (2007). Prehypertension and Cardiovascular disease risk in the Women's Health Initiative. Circulation 115: 855-860.
[40]
Hublet, A., De Bacquer, D., Valinaa, R., Godeau, E., Schmind, H., and Rehav, G. (2006). Smoking Trends Among Adolescents From 1990 To 2002 In Ten European Countries And Canada. BMC Public Health 2006, 6: 280.
[41]
Juliet, A., Lium, S., and David, A. L., (2006). Smoking Patterns in Ghanaian Civil Servants: Changes Over Three Decades.
[42]
Kannel W. B., (1990). Bishop lecture: Contribution of the Framingham study to preventive cardiology. J Am coll of cardiol 15: 206-11.
[43]
Kannel, W. B., (1996). Blood Pressure as A Cardiovascular Risk Factor: Prevention And Treatment. JAMA. 275: 1571-6.
[44]
Kearney P. M., Whelton M., Reynolds K., Meintner P., Whelton P. K., He J., (2005). Global burden of hypertension: analysis of worldwide data. Lancet, 365:217-223.
[45]
Kirstie, J., Edwards, R., Mugusi, F., Whiting, D., and Unwin N., (2001). Tobacco Smoking In Tanzania, East Africa. Population Based Smoking Prevalence Using A Expired Alvedar Carbon Monoxide As A Validation Tool.
[46]
Laragh, J. H., Sealey, J. E., Benin Angiotensin Aldosterone Systeand. The Renal Regulation Of Sodium, Potassium, And Blood Pressure Homoeostasis In Windhager EE (Ed). Handbook Of Physiology, Sect 8, and Renal Physiology Oxford University Press New York 1991: Pp. 1409-1541.
[47]
Lifton R. P., (1995). Genetic Determinants of Human Hypertension Proc Nat AcadSci USA. 92: 8545-51.
[48]
Lifton, R. P., (1996). Molecular Genetics of Human Blood Pressure Variation Science. 276: 676-80.
[49]
Mackey, J. and Ericksen, M. (2002). Tobacco Atlas World Health Organization (WHO).
[50]
Maher, D., Smeeth and Sekajugo, J. (2010). Health Transition In Africa: Practical Policy Proposals for Primary Care.
[51]
Mba. C. J and Aboh I., (2006). Prevalence and Management of Malaria in Ghana: A case study of Volta Region. University of Ghana, Legon.
[52]
Melander O. (2001). Genetic factors in Hypertension. What is known and what does it mean?, Blood pressure 10:254-270.
[53]
Ministry Of Social Affairs and Health (2007). Alcohol responsible For Up To 15% of early death
[54]
Mittal, B. V., and Singh A. K. (2010). Hypertension in the developing world: challenges and Opportunities. American Journal Of Kidney Diseases Vol 55, No.3 590-598.
[55]
Morrison E., Fletcher C. D., Dunningom M. G., Allam B. F., (1991). Coronary heart and elderly people. BMJ. 303:1404-1409.
[56]
Morton D. S., Clark E. G., Gearing F. R., George A. P., (1962). Genetic factors in primary hypertension and coronary artery disease a reappraisal. Journal of chronic disease.15: 1093-1108.
[57]
National Institute of Health (1998). Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity.
[58]
Ndindjock, R., Gedeon, J., Mendis, S., Paccaud, F., and Bovet, P., (2011). Potential Impact of Single-Risk Factors versus Total Risk Management for The Prevention Of Cardiovascular Events In Seychelles Available: http://www.who.int/bulletin/volume/89/4/10-082370/en/accessed 15 march 2011Nieto, F. J., Alonso, J., Chambless, L. E., Zhong, M., and Ceraso, M. (1995). Population Awareness and Control Of Hypertension.
[59]
Nketiah-Amponsah, E. (2009). Demand for health insurance among women in Ghana: Cross-sectional evidence. International Research Journal of Finance and Economics, 33, 1450-2887.
[60]
Oke, D. A., and Bandele, E. O., (2004). Misconceptions of Hypertension. J. Nat. Med Association 97, 1221-12224.
[61]
Onusko E., (2003). Diagnosing Secondary Hypertension. Am Fam Physician 67:67-74.
[62]
Owusu I. K., (2007). Causes of Heart failures as seen in Kumasi, Ghana. The internet-Journal of third world medicine”. Volume 5, no. 1.
[63]
Owusu I. K., Adu-Boakye Y., & Boadi K. R. (2012). Cardiovascular Risk Profile of patient seen at a cardiac clinic in Kumasi, Ghana.
[64]
Owusu Isaac K., Christiana Aryee, William K. B. A. Owiredu, James Osei-Yeboah, Ellis Owusu-Dabo, Edwin F. Laing (2015). Analysis of Atherogenic and Anthropometric Profiles of Normotensive and Hypertensive Ghanaians in the Kumasi Metropolis. British Journal of Medicine & Medical Research 7(5): 378-397.
[65]
Pampel, F. C., (2002). Patterns of Tobacco Use In The Early Epidemic Stages: Malawian Zambia 2000-2002. Am J Pub. Health, 95: 1009-1015.
[66]
Parvez H., Kawar B., Nahas M. E., (2007). Obesity and diabetes in the developing world. A growing challenges. New England journal of medicine 356:213-215.
[67]
Peto, R., and Lopez, A. D., (2004). The Future Worldwide Health Effects of Current Smoking Patterns In Tobacco: Science, Policy and Public Health New York: Oxford University press 2004.
[68]
Pickering, G., (1986). High Blood Pressure. Churchill London.
[69]
Pindyck, R. S., & Rubinfeld, D. L. (1981). Econometric Models and Economic Forecasts. New York: McGraw-Hill, Inc.
[70]
Pobee, J. O. M., (2006). The Heart of the Matter Community Profile of Cardiovascular Diseases of A Sub-Saharan African Country 2006. Accra: Commercial Association Ltd.
[71]
Procor (2006). Charting the History of Hypertension In Ghana. Pobee J. O. M. An Interview By Dr Collins Kokuro Available: http://www.procor.org/advocacy/advocacyshow.accessed December 2010.
[72]
Qureshi A. I., Suri M. F.. Kirmoni J. F., Mohammed Y. (2005). Is Prehypertension a risk factor of cardiovascular disease stroke.
[73]
Rosenfeld J. B., Silverberg D. S., Viskoper R., (1985). Hypertension Control in the community. London, libbey (John) and company Ltd.
[74]
Rossi G., Sacchetto A., Pavan E., Pessina A. C., (1995). Hypertension cardiovascular disease and the renin-angiotensin system stroke, 26: 1700-1706.
[75]
Russell, M., Cooper, M. L., Frone, M. R., and Welte, J. W., (1991). Alcohol Drinking Patterns and Blood Pressure. Am J Public Health 81(4): 452-457.
[76]
Saken R, and Kates G. (1997). During induced hypertension in infancy. The journal of pediatrics 95: 1077-1079.
[77]
Schofield, I., and Hazel, H. (1999). Healthy Ageing: Nursing Order People. Mosby International Ltd, Lynton House. 7-12 Tavistock Square, London, UK. 81-85Sheldon, G. S. High Blood Pressure (hypertension): Does Drinking Alcohol Affect Your Blood pressure? 2011. Stabouli, S., Papakatsika, S., and Kotsis, V. (2011). The Role of Obesity, Salt And Exercise On Blood Pressure In Children And Adolescents Vol. 9, No 6; 753-761.
[78]
Stamler J., (1985). The marked decline in coronary heart disease Mortality rates in the US 1968-1981. Summary of findings and possible explanation, cardiology 12: 11-22.
[79]
Statistics canada (2005). The Daily Statistics Canada Catalogue. no: 11-001-XIE.
[80]
Steckeling U. M., Stapptter M., Sharma A. M., Withehen H. U., Kraus P., Kupper B., (2004). HYDRA: Possible determinants of unsatisfactory hypertension control in Ghana Primary care patient Blood Pressure.13: 80-88Stone H, (2010).
[81]
Terry, D. F., Evans, J. C., Pencina, M. J., Murabito, J. M., Vasan, R. S., Wolf, P. A., and Benjamin, E. J. (2007). Characteristics of Framingham of Offspring Participant with Long-lived Parents. Archives of Internal Medicine 167, 438-444.Tousted, S., and Andrew Johnston, J. (2006). Cardiovascular Risk Associated With Smoking: A Review for Clinicions. Eur J. Cardiovasc Prev Rehabil, 13(4): 507-14.
[82]
Tuomilehto J., (1986). Decline in mortality from coronary heart disease in North Karelia and other parts of Finland Medical. Journal, 298: 1068-1071.
[83]
Van G. L., Merteus I., De Block C. (2006). Mechanisms linking obesity with cardiovascular disease Nature, 444:875-880.
[84]
Waller W. J., (1983). Changing US lifestyle and decline vascular Mortality a retrospective, new England Journal of Medicine 308:649-51.
[85]
Wang, P. S., Bahn, R. L., and Knight, E. (2002). Non-Compliance with Antihypertensive Medications: The Impact Of Depression Symptoms And Psychosocial Factors J. Gen International Med. 17: 504-511.
[86]
Wassertheil-Smoller, S., Anderson, G., Pasty, B. M., Black, H. R., and Manson, J. (2000). Hypertension And Its Treatment In Postmenopausal Women: Baseline Data from The Women’s Health Initiative Hypertension 36: 780- 89.
[87]
Wellington, E. (2002). Global Youth Tobacco Survey Fact Sheet, Ghana. Global Youth Tobacco Survey Collaboration Group.
[88]
Wolk R., Shamsuzzaman A. S., Somers V. K. (2003). Obesity, Sleep apnea and hypertension. Hypertension 42: 1067-1074.
[89]
World Health Organization, Ghana, (1996). Expert committee on hypertension control. Hypertension control report of WHO Expert committee, WHO Technical Report series 862:1-83.
[90]
World Health Organization, WHO, (2002). The world health report, reducing risk promoting Health Life Geneva
[91]
World Health Organization, WHO, (2003). International Society of Hypertension, ISH. Statement of management of hypertension, 12:1983-1992.
[92]
World Health Organization, WHO, (2008). Global strategy on diet physical activity and health. African Regional consultation meeting report Harare, Zimbabwe.
[93]
World Health Organization, WHO, (2009). Cardiovascular disease (CVDs).
[94]
Young L. H. (2011). Heart Disease in the Elderly.
