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Comparative Study
. 2013 Nov 14:9:59.
doi: 10.1186/1744-8603-9-59.

Rural and urban differences in blood pressure and pregnancy-induced hypertension among pregnant women in Ghana

Deborah van Middendorp, Augustinus ten Asbroek, Fred Yaw Bio, Anthony Edusei, Lyonne Meijjer, Sam Newton, Charles Agyemang  1
Affiliations
Comparative Study

Rural and urban differences in blood pressure and pregnancy-induced hypertension among pregnant women in Ghana

Deborah van Middendorp et al. Global Health. .

Abstract

Background: Globally, about 350.000 women die every year from pregnancy related causes and more than half of these deaths occur in sub-Saharan Africa (SSA). Approximately 12% of the maternal deaths are associated with hypertensive disorders in pregnancy such as pregnancy induced hypertension (PIH). However, very little is known about PIH and associated determinants in many SSA countries such as Ghana. We therefore sought to assess rural and urban differences in blood pressure (BP) and PIH among pregnant women in Ghana.

Methods: We conducted a cross-sectional study among 967 rural (677) and urban (290) pregnant women with a gestational age of more than 20 weeks. PIH was defined as a systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg.

Results: Women in urban Ghana had a higher mean systolic and diastolic BP than women in rural Ghana (105/66 mmHg versus 102/61 mmHg, p < 0.001 for both systolic and diastolic BP). The prevalence of PIH was also higher in urban Ghana (3.1%) than in rural Ghana (0.4%) (p = 0.014). The urban and rural difference in mean diastolic blood pressure persisted even after adjustments for the study characteristics in a linear regression model. In both rural and urban Ghana, BMI, heart rate and a family history of hypertension were independently associated with BP.

Conclusion: Our findings suggest higher mean BP levels and PIH in urban Ghana than in rural Ghana. BMI was independently related to high BP. Left unchecked, the increasing prevalence of overweight and obesity in Ghana will exacerbate PIH levels in Ghana.

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Figures

Figure 1
Figure 1
Mean systolic blood pressure by locality.
Figure 2
Figure 2
Mean diastolic blood pressure by locality.
Figure 3
Figure 3
Mean systolic blood pressures by age group and locality.
Figure 4
Figure 4
Mean diastolic blood pressures by age group and locality.
See this image and copyright information in PMC

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