Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana-the RODAM study

Charles Agyemang, Gertrude Nyaaba, Erik Beune, Karlijn Meeks, Ellis Owusu-Dabo, Juliet Addo, Ama De Graft Aikins, Frank P. Mockenhaupt, Silver Bahendeka, Ina Danquah, Matthias B. Schulze, Cecilia Galbete, Joachim Spranger, Peter Agyei-Baffour, Peter Henneman, Kerstin Klipstein-Grobusch, Adebowale Adeyemo, Jan Van Straalen, Yvonne Commodore-Mensah, Lambert T. Appiah & 2 others Liam Smeeth, Karien Stronks

Research output: Contribution to journalArticle

Abstract

Objectives: Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. Methods: A multicenter cross-sectional study was conducted among Ghanaian adults (n=5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. Results: The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio=1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio=2.21, 1.78-2.73; women, 51%; prevalence ratio=1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio=0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio=0.59, 0.35-0.99), and London (36%; prevalence ratio=0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure>180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. Conclusion: Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts. Supplement Figure 1, http://links.lww.com/HJH/A831.

LanguageEnglish (US)
Pages169-177
Number of pages9
JournalJournal of Hypertension
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2018

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Ghana
Berlin
Hypertension
Therapeutics
Blood Pressure
Antihypertensive Agents
Prescriptions

Keywords

  • ethnic minority groups
  • Europe
  • Ghana
  • hypertension
  • hypertension therapy
  • migration
  • Research on Obesity and Diabetes among African Migrants study

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana-the RODAM study. / Agyemang, Charles; Nyaaba, Gertrude; Beune, Erik; Meeks, Karlijn; Owusu-Dabo, Ellis; Addo, Juliet; Aikins, Ama De Graft; Mockenhaupt, Frank P.; Bahendeka, Silver; Danquah, Ina; Schulze, Matthias B.; Galbete, Cecilia; Spranger, Joachim; Agyei-Baffour, Peter; Henneman, Peter; Klipstein-Grobusch, Kerstin; Adeyemo, Adebowale; Van Straalen, Jan; Commodore-Mensah, Yvonne; Appiah, Lambert T.; Smeeth, Liam; Stronks, Karien.

In: Journal of Hypertension, Vol. 36, No. 1, 01.01.2018, p. 169-177.

Research output: Contribution to journalArticle

Agyemang, C, Nyaaba, G, Beune, E, Meeks, K, Owusu-Dabo, E, Addo, J, Aikins, ADG, Mockenhaupt, FP, Bahendeka, S, Danquah, I, Schulze, MB, Galbete, C, Spranger, J, Agyei-Baffour, P, Henneman, P, Klipstein-Grobusch, K, Adeyemo, A, Van Straalen, J, Commodore-Mensah, Y, Appiah, LT, Smeeth, L & Stronks, K 2018, 'Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana-the RODAM study' Journal of Hypertension, vol. 36, no. 1, pp. 169-177. https://doi.org/10.1097/HJH.0000000000001520
Agyemang, Charles ; Nyaaba, Gertrude ; Beune, Erik ; Meeks, Karlijn ; Owusu-Dabo, Ellis ; Addo, Juliet ; Aikins, Ama De Graft ; Mockenhaupt, Frank P. ; Bahendeka, Silver ; Danquah, Ina ; Schulze, Matthias B. ; Galbete, Cecilia ; Spranger, Joachim ; Agyei-Baffour, Peter ; Henneman, Peter ; Klipstein-Grobusch, Kerstin ; Adeyemo, Adebowale ; Van Straalen, Jan ; Commodore-Mensah, Yvonne ; Appiah, Lambert T. ; Smeeth, Liam ; Stronks, Karien. / Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana-the RODAM study. In: Journal of Hypertension. 2018 ; Vol. 36, No. 1. pp. 169-177.
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abstract = "Objectives: Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. Methods: A multicenter cross-sectional study was conducted among Ghanaian adults (n=5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. Results: The age-standardised prevalence of hypertension was 22 and 28{\%} in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34{\%}; adjusted prevalence ratio=1.37, 95{\%} confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57{\%}; prevalence ratio=2.21, 1.78-2.73; women, 51{\%}; prevalence ratio=1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20{\%}; prevalence ratio=0.43 95{\%}, 0.23-0.82), Amsterdam (29{\%}; prevalence ratio=0.59, 0.35-0.99), and London (36{\%}; prevalence ratio=0.86, 0.49-1.51) than rural Ghanaians (59{\%}). Among women, no differences in hypertension control were observed. About 50{\%} of migrants to 85{\%} of rural Ghanaians with severe hypertension (Blood pressure>180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. Conclusion: Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts. Supplement Figure 1, http://links.lww.com/HJH/A831.",
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author = "Charles Agyemang and Gertrude Nyaaba and Erik Beune and Karlijn Meeks and Ellis Owusu-Dabo and Juliet Addo and Aikins, {Ama De Graft} and Mockenhaupt, {Frank P.} and Silver Bahendeka and Ina Danquah and Schulze, {Matthias B.} and Cecilia Galbete and Joachim Spranger and Peter Agyei-Baffour and Peter Henneman and Kerstin Klipstein-Grobusch and Adebowale Adeyemo and {Van Straalen}, Jan and Yvonne Commodore-Mensah and Appiah, {Lambert T.} and Liam Smeeth and Karien Stronks",
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T1 - Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana-the RODAM study

AU - Agyemang, Charles

AU - Nyaaba, Gertrude

AU - Beune, Erik

AU - Meeks, Karlijn

AU - Owusu-Dabo, Ellis

AU - Addo, Juliet

AU - Aikins, Ama De Graft

AU - Mockenhaupt, Frank P.

AU - Bahendeka, Silver

AU - Danquah, Ina

AU - Schulze, Matthias B.

AU - Galbete, Cecilia

AU - Spranger, Joachim

AU - Agyei-Baffour, Peter

AU - Henneman, Peter

AU - Klipstein-Grobusch, Kerstin

AU - Adeyemo, Adebowale

AU - Van Straalen, Jan

AU - Commodore-Mensah, Yvonne

AU - Appiah, Lambert T.

AU - Smeeth, Liam

AU - Stronks, Karien

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. Methods: A multicenter cross-sectional study was conducted among Ghanaian adults (n=5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. Results: The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio=1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio=2.21, 1.78-2.73; women, 51%; prevalence ratio=1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio=0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio=0.59, 0.35-0.99), and London (36%; prevalence ratio=0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure>180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. Conclusion: Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts. Supplement Figure 1, http://links.lww.com/HJH/A831.

AB - Objectives: Hypertension is a major burden among African migrants, but the extent of the differences in prevalence, treatment, and control among similar African migrants and nonmigrants living in different contexts in high-income countries and rural and urban Africa has not yet been assessed. We assessed differences in hypertension prevalence and its management among relatively homogenous African migrants (Ghanaians) living in three European cities (Amsterdam, London, and Berlin) and nonmigrants living in rural and urban Ghana. Methods: A multicenter cross-sectional study was conducted among Ghanaian adults (n=5659) aged 25-70 years. Comparisons between sites were made using prevalence ratios with adjustment for age, education, and BMI. Results: The age-standardised prevalence of hypertension was 22 and 28% in rural Ghanaian men and women. The prevalence was higher in urban Ghana [men, 34%; adjusted prevalence ratio=1.37, 95% confidence interval (CI), 1.10-1.70]; and much higher in migrants in Europe, especially in Berlin (men, 57%; prevalence ratio=2.21, 1.78-2.73; women, 51%; prevalence ratio=1.74, 1.45-2.09) than in rural Ghana. Hypertension awareness and treatment levels were higher in Ghanaian migrants than in nonmigrant Ghanaians. However, adequate hypertension control was lower in Ghanaian migrant men in Berlin (20%; prevalence ratio=0.43 95%, 0.23-0.82), Amsterdam (29%; prevalence ratio=0.59, 0.35-0.99), and London (36%; prevalence ratio=0.86, 0.49-1.51) than rural Ghanaians (59%). Among women, no differences in hypertension control were observed. About 50% of migrants to 85% of rural Ghanaians with severe hypertension (Blood pressure>180/110) were untreated. Antihypertensive medication prescription patterns varied considerably by site. Conclusion: Hypertension prevalence, awareness, and treatment levels were generally higher in African migrants, but blood pressure control level was lower in Ghanaian migrant men compared with their nonmigrant peers. Further work is needed to identify key underlying factors to support prevention and management efforts. Supplement Figure 1, http://links.lww.com/HJH/A831.

KW - ethnic minority groups

KW - Europe

KW - Ghana

KW - hypertension

KW - hypertension therapy

KW - migration

KW - Research on Obesity and Diabetes among African Migrants study

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