Prehypertension in the Ashanti region of Ghana, West Africa: an opportunity for early prevention of clinical hypertension

OBJECTIVE: To assess prehypertension among Ghanaian adults in the Ashanti region of Ghana, West Africa. DESIGN: Cross-sectional study. PARTICIPANTS: There were 1431 participants aged 18 years or more. Prehypertension was defined as blood pressure of 120-139/80-89 mmHg. MAIN OUTCOME MEASURES: Prehypertension. RESULTS: Overall, 31% of the study population were normotensive, 40% were prehypertensive and 29% were hypertensive. Prehypertension was more common in non-hypertensive males than non-hypertensive females (66% vs 49%, P <0.001). Prehypertension was also more common in those aged 35 years compared with those aged <35 years (P <0.001), and in overweight and obese people compared with people of normal weight (P=0.03). In a multivariate logistic regression model, male sex [odds ratio (OR) 2.36; 95% confidence interval (CI) 1.77-3.15; P <0.001], age 35-49 years (OR 1.56; 95% CI 1.12-2.18; P <0.01) and 50 years (OR 2.13; 95% CI 1.33-3.42; P=0.002)], overweight (OR 1.61; 95% CI 1.09-2.36; P=0.02) and obesity (OR 2.71; 95% CI 1.40-5.24; P=0.003) were independently associated with higher odds of prehypertension, whilst current smoking (OR 0.36; 95% CI 0.16-0.81; P=0.01) was associated with lower odds of prehypertension. CONCLUSION: Prehypertension is very common among non-hypertensive subjects in the Ashanti region of Ghana. As a large proportion of people with prehypertension will progress to clinical hypertension, targeting these people early with lifestyle modifications such as weight reduction may provide important long-term benefits