Risk Factors Associated with Hypertension among Adults in the Hohoe Municipality, Ghana

Background: Hypertension (HPT) is a major cause of morbidity and mortality worldwide and is increasingly becoming an important medical and public health issue. Identification of major risk factors, their prevention and control form the basis of the prevention of the disease. We set out to determine risk factors associated with HPT among adults in the Hohoe Municipality, Ghana.

Methods: A matched case control study was conducted in February 2016 using 65 cases of HPT recruited from the municipal hospital HPT clinic and 130 controls from communities of the cases to trace various exposures to hypertension. Information on the background characteristics, family history and lifestyle practices were collected using the WHO STEPWISE questionnaire. Blood pressure (ABP) and glucose levels were measured using a digital sphygmomanometer (Omron M3, HEM-7131-E) and glucometer (ONETOUCH UltraEasy). Weight, height, waist and hip circumference were measured with a digital weighing scale, Stadiometer and an inextensible tape measure respectively. Chi-square test and Odds Ratios were used to determine the relationships and associations between the dependent and independent variables at the 0.05 level.

Results: About 84% of the respondents were females, majority (72.3%) were between the ages of 45-74 years, 61% were married, 37.9% had no formal education and most (43.6%) were traders. There was no significant difference in background characteristics between the cases and controls. The odds of those with Diabetes developing HPT is 3.80 times higher compared to those without Diabetes [OR=3.80 (95% CI: 1.07-3.45); p=0.039]. The odds of developing HPT among those with Family history of HPT/Diabetes was 5 times more compared to those with no family history of HPT/Diabetes [OR=5.45 (95% CI: 0.28-1.02; p<0.001]. The odds of current consumers of alcohol developing HPT was 2 times higher compared to those who never consumed alcohol [OR=2.24 (95% CI: 0.99-5.06; p=0.052]. Palm oil consumption was 4.9 times higher among those with hypertension compared to vegetable oil [OR=4.90 (95% CI: 2.58-9.0; p<0.001], and those with hypertension were 1.5 times more likely to consume low salt, 2 times more likely to consume fruits 2 to 3 days a week and 3 times more likely to consume vegetables 2 to 3 days a week.

Conclusion: Alcohol consumption, diabetes and family history of hypertension were risk factors associated with hypertension. Those with hypertension were more likely to consume palm oil, take in less salt, eat more fruits and vegetables as a control measure based on dietary counselling at the hypertension clinic. Dietary counselling should not only be used as a tool for controlling hypertension but be extended to the general population as a preventive measure.