Demographic and Clinical Characteristics of Hypertensive Patients Attending a Specialist Clinic in Techiman, Ghana
[1]
Emmanuel Acheamfour-Akowuah, Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
[2]
Isaac Kofi Owusu, Department of Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
[3]
Bernard C. Nkum, Department of Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Hypertension continues to emerge globally as one of the most dangerous cardiovascular disease risk factors. In developing countries, the prevalence of hypertension is increasing rapidly with varied clinical characteristics. This study was aimed to determine the demographic and clinical characteristics of hypertensive patients attending a Specialist Clinic in Techiman, Ghana. Three hundred and forty two (342) hypertensive patients were selected using simple random sampling. Structured questionnaires were used to collect socio-demographic characteristics and clinical data of the study participants. The patients were aged between 23 - 79 years with the mean age (± SD) of 46.9 (± 12.1) years. There were more females (62.28%; n=213) than males (37.72%; n=129). The mean systolic blood pressure (± SD) and the mean diastolic blood pressure (± SD) were 138.69 (±32.18) and 92.29 (±18.54) respectively. The pulse rate ranged between 45-162 beats/minute with the mean pulse rate (± SD) of 80.40 (± 0.89) beats/minute. More than two-third (70.6%) of the patients were farmers (37.1%) and traders (33.5%). High body mass index (BMI) (64%), dyslipidaemia (48.8%), and diabetes mellitus (24.5%) were the most frequently reported cardiovascular risk factors among the hypertensive patients. In conclusion, the most common cardiovascular risk factors seen in hypertensive patients attending a Specialist Clinic in Techiman, Ghana were high BMI, dyslipidaemia and diabetes mellitus. Early detection and control of these risk factors is important in the prevention of target organ complications in hypertension.
Blood Pressure, Hypertension, Cardiovascular Risk Factors, Diabetes Mellitus, Dyslipidaemia, BMI
[1]
Adedoyin RA, Mbada CE, Balogun MO, Martins T, Adebayo RA, Akintomide A, et al. Prevalence and pattern of hypertension in a semiurban community in Nigeria. Eur J Cardiovasc Prev Rehabil Off J Eur Soc Cardiol Work Groups Epidemiol Prev Card Rehabil Exerc Physiol 2008;15:683–7.
[2]
Amoah AGB. Hypertension in Ghana: a cross-sectional community prevalence study in greater Accra. Ethn Dis 2003;13:310–5.
[3]
Addo J, Smeeth L, Leon DA. Hypertension in sub-saharan Africa: a systematic review. Hypertension 2007;50:1012–8. doi:10.1161/HYPERTENSIONAHA.107.093336.
[4]
Murray CJ, Lopez AD. Global and regional cause-of-death patterns in 1990. Bull World Health Organ 1994;72:447–80.
[5]
Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997;349:1269–76. doi:10.1016/S0140-6736(96)07493-4.
[6]
World Bank. World Development Report 1993. Investing in Health. 1993.
[7]
Gwatkin DR, Heuveline P. Improving the health of the world’s poor. BMJ 1997;315:497.
[8]
Oo A. Epidemiology of cardiovascular disease in developing countries. J Hypertens Suppl Off J Int Soc Hypertens 1990;8:S233-8.
[9]
Sande MAB van der, Inskip HM, Jaiteh KO, Maine NP, Walraven GEL, Hall AJ, et al. Changing causes of death in the West African town of Banjul, 1942-97. Bull World Health Organ 2001;79:133–41. doi:10.1590/S0042-96862001000200008.
[10]
Ogah OS, Rayner BL. Recent advances in hypertension in sub-Saharan Africa. Heart 2013;99:1390–1397.
[11]
Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004;22:11–19.
[12]
Owusu IK. Causes Of Heart Failure As Seen In Kumasi Ghana. Internet J Third World Med 2007;4.
[13]
Plange-Rhule J, Phillips R, Acheampong JW, Saggar-Malik AK, Cappuccio FP, Eastwood JB. Hypertension and renal failure in Kumasi, Ghana. J Hum Hypertens 1999;13.
[14]
Amoah AGB, Kallen C. Aetiology of heart failure as seen from a National Cardiac Referral Centre in Africa. Cardiology 2000;93:11–18.
[15]
Seedat YK. Impact of poverty on hypertension and cardiovascular disease in sub-Saharan Africa. Cardiovasc J Afr 2007;18:316–20.
[16]
Singh RB, Suh IL, Singh VP, Chaithiraphan S, Laothavorn P, Sy RG, et al. Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention. J Hum Hypertens 2000;14:749–63.
[17]
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746–53.
[18]
Ezzati M, Vander Hoorn S, Lawes CMM, Leach R, James WPT, Lopez AD, et al. Rethinking the “Diseases of Affluence” Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development. PLoS Med 2005;2:e133. doi:10.1371/journal.pmed.0020133.
[19]
Bosu WK. Epidemic of hypertension in Ghana: a systematic review. BMC Public Health 2010;10:418. doi:10.1186/1471-2458-10-418.
[20]
Cappuccio FP, Micah FB, Emmett L, Kerry SM, Antwi S, Martin-Peprah R, et al. Prevalence, detection, management, and control of hypertension in Ashanti, West Africa. Hypertension 2004;43:1017–22. doi:10.1161/01.HYP.0000126176.03319.d8.
[21]
Norman R, Gaziano T, Laubscher R, Steyn K, Bradshaw D, South African Comparative Risk Assessment Collaborating Group. Estimating the burden of disease attributable to high blood pressure in South Africa in 2000. South Afr Med J Suid-Afr Tydskr Vir Geneeskd 2007;97:692–8.
[22]
Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation 2005;112:3562–3568.
[23]
Whitworth JA. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003;21:1983–1992.
[24]
Scott RC. The electrocardiographic diagnosis of left ventricular hypertrophy. Am Heart J 1960;59:155–156.
[25]
Addo J, Amoah AG, Koram KA. The changing patterns of hypertension in Ghana: a study of four rural communities in the Ga District. Ethn Dis 2006;16:894–899.
[26]
Ogah OS, Okpechi I, Chukwuonye II, Akinyemi JO, Onwubere BJ, Falase AO, et al. Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review. World J Cardiol 2012;4:327.
[27]
Muxfeldt ES, Nogueira A da R, Salles GF, Bloch KV. Demographic and clinical characteristics of hypertensive patients in the internal medicine outpatient clinic of a university hospital in Rio de Janeiro. São Paulo Med J Rev Paul Med 2004;122:87–93. doi:/S1516-31802004000300003.
[28]
Yadav S, Boddula R, Genitta G, Bhatia V, Bansal B, Kongara S, et al. Prevalence & risk factors of pre-hypertension & hypertension in an affluent north Indian population. Indian J Med Res 2008;128:712–20.
[29]
Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension 2001;37:1199–208.
[30]
Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995;25:305–13.
[31]
Isezuo AS, Njoku CH. Blood pressure control among hypertensives managed in a specialised health care setting in Nigeria. Afr J Med Med Sci 2003;32:65–70.
[32]
Owusu IK. Electrocardiographic Left Ventricular Hypertrophy In Patients Seen With Hypertensive Heart Failure. Internet J Third World Med 2007.
[33]
Ejike CECC, Ugwu CE, Ezeanyika LUS, Olayemi AT. Blood pressure patterns in relation to geographic area of residence: a cross-sectional study of adolescents in Kogi state, Nigeria. BMC Public Health 2008;8:411. doi:10.1186/1471-2458-8-411.
[34]
Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995;25:305–13.
[35]
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003;42:1206–1252.
[36]
Psaty BM, Furberg CD, Kuller LH, Cushman M, Savage PJ, Levine D, et al. Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality: the cardiovascular health study. Arch Intern Med 2001;161:1183–1192.
[37]
Ike SO, Onwubere BJC. The relationship between diastolic dysfunction and level of blood pressure in Blacks. Ethn Dis 2003;13:463–9.
[38]
Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N. Epidemiology of hypertension in low-income countries: a cross-sectional population-based survey in rural Uganda. J Hypertens 2011;29:1061–8. doi:10.1097/HJH.0b013e3283466e90.
[39]
Shey Wiysonge CU, Ngu Blackett K, Mbuagbaw JN. Risk factors and complications of hypertension in Yaounde, Cameroon. Cardiovasc J South Afr Off J South Afr Card Soc South Afr Soc Card Pract 2004;15:215–9.
[40]
El-Shafei SA, Bassili A, Hassanien NM, Mokhtar MM. Genetic determinants of essential hypertension. J Egypt Public Health Assoc 2002;77:231–46.
[41]
Ibekwe R. Modifiable risk factors of hypertension and socio-demographic profile in Oghara, Delta State; prevalence and correlates. Ann Med Health Sci Res 2015;5:71. doi:10.4103/2141-9248.149793.
[42]
Sowers JR, Haffner S. Treatment of cardiovascular and renal risk factors in the diabetic hypertensive. Hypertension 2002;40:781–8.
[43]
Wilson PW, Kannel WB, Silbershatz H, D’Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med 1999;159:1104–9.
[44]
Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000;342:905–12. doi:10.1056/NEJM200003303421301.
[45]
Viera AJ, Kshirsagar AV, Hinderliter AL. Lifestyle modification advice for lowering or controlling high blood pressure: who’s getting it? J Clin Hypertens Greenwich Conn 2007;9:850–8.
