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. AppiahLiam 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.

Original languageEnglish (US)
Pages (from-to)169-177
Number of pages9
JournalJournal of hypertension
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

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

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Agyemang, C., Nyaaba, G., Beune, E., Meeks, K., Owusu-Dabo, E., Addo, J., Aikins, A. D. G., Mockenhaupt, F. P., Bahendeka, S., Danquah, I., Schulze, M. B., Galbete, C., Spranger, J., Agyei-Baffour, P., Henneman, P., Klipstein-Grobusch, K., Adeyemo, A., Van Straalen, J., Commodore-Mensah, Y., ... 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, 36(1), 169-177. https://doi.org/10.1097/HJH.0000000000001520