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. 2020 Dec 15;9(24):e017492.
doi: 10.1161/JAHA.120.017492. Epub 2020 Dec 7.

Cardiometabolic Risk Factors and Preclinical Target Organ Damage Among Adults in Ghana: Findings From a National Study

Jie Li  1   2 , Isaac Kofi Owusu  3   4 , Qingshan Geng  5 , Aba Ankomaba Folson  6 , Zhichao Zheng  7 , Yaw Adu-Boakye  4 , Xinran Dong  8 , Wen-Chih Wu  2   9 , Francis Agyekum  6 , Hongwen Fei  7 , Harold Ayetey  10 , Mulan Deng  11 , Fred Adomako-Boateng  12 , Zuxun Jiang  7 , Braimah Baba Abubakari  13 , Zhao Xian  14 , Forster Nketiah Fokuoh  15 , Lambert Tetteh Appiah  4 , Simin Liu  2 , Chunying Lin  5
Affiliations

Cardiometabolic Risk Factors and Preclinical Target Organ Damage Among Adults in Ghana: Findings From a National Study

Jie Li et al. J Am Heart Assoc. .

Abstract

Background Although sub-Saharan Africa has a high prevalence of cardiovascular diseases (CVDs), there remains a lack of systematic and comprehensive assessment of risk factors and early CVD outcomes in adults in sub-Saharan Africa. Methods and Results Using a stratified multistage random sampling method, we recruited 1106 men and women, aged >18 years, from the general population in Ghana to participate in a national health survey from 2016 to 2017. In Ghanaian adults, the age-standardized prevalence of known CVD risk factors was 15.1% (95% CI, 12.9%-17.3%) for obesity, 6.8% (95% CI, 5.1%-8.5%) for diabetes mellitus, 26.1% (95% CI, 22.9%-29.4%) for hypertension, and 9.3% (95% CI, 7.1%-11.5%) for hyperuricemia. In addition, 10.1% (95% CI, 7.0%-13.2%) of adults had peripheral artery disease, 8.3% (95% CI, 6.7%-10.0%) had carotid thickening, 4.1% (95% CI, 2.9%-5.2%) had left ventricular hypertrophy, and 2.5% (95% CI, 1.5%-3.4%) had chronic kidney disease. Three CVD risk factors appeared to play prominent roles in the development of target organ damage, including obesity for peripheral artery disease (odds ratio [OR], 2.22; 95% CI, 1.35-3.63), hypertension for carotid thickening (OR, 1.92; 95% CI, 1.22-3.08), and left ventricular hypertrophy (OR, 5.28; 95% CI, 2.55-12.11) and hyperuricemia for chronic kidney disease (OR, 5.49; 95% CI, 2.84-10.65). Conclusions This comprehensive health survey characterized the baseline conditions of a national cohort of adults while confirming the prevalence of CVD risk factors, and early CVD outcomes have reached epidemic proportions in Ghana. The distinct patterns of risk factors in the development of target organ damage present important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.

Keywords: Ghana; adults; cardiovascular disease; risk factors; target organ damage.

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Conflict of interest statement

In the design and conduct of the Ghana Heart Study, Dr. Liu served as Chief Scientific Consultant for Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences.

Figures

Figure 1
Figure 1. Association between body mass index (BMI) and ankle‐brachial index (ABI) among adults who participated in GHS (Ghana Heart Study), 2016 to 2017.
A, Association of BMI with ABI in all population. B, Association of BMI with ABI in men. C, Association of BMI with ABI in women. Restricted cubic splines with 3 knots were used for association analysis with adjustment for age, sex, ethnicity, living area, education, smoking, and physical activity. Histogram represents the distribution of BMI in the study population.
Figure 2
Figure 2. Association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with carotid intima‐media thickness (CIMT) among adults who participated in GHS (Ghana Heart Study), 2016 to 2017.
A, Association of SBP with CIMT in all population. B, Association of SBP with CIMT in men. C, Association of SBP with CIMT in women. D, Association of DBP with CIMT in all population. E, Association of DBP with CIMT in men. F, Association of DBP with CIMT in women. Restricted cubic splines with 3 knots were used for association analysis with adjustment for age, sex, ethnicity, living area, education, smoking, physical activity, and body mass index. Histogram represents the distribution of SBP/DBP in the study population.
Figure 3
Figure 3. Association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with left ventricular mass index (LVMI) among adults who participated in GHS (Ghana Heart Study), 2016 to 2017.
A, Association of SBP with LVMI in all population. B, Association of SBP with LVMI in men. C, Association of SBP with LVMI in women. D, Association of DBP with LVMI in all population. E, Association of DBP with LVMI in men. F, Association of DBP with LVMI in women. Restricted cubic splines with 3 knots were used for association analysis with adjustment for age, sex, ethnicity, living area, education, smoking, physical activity, and body mass index. Histogram represents the distribution of SBP/DBP in the study population.
Figure 4
Figure 4. Association of uric acid with estimated glomerular filtration rate (eGFR) among adults who participated in GHS (Ghana Heart Study), 2016 to 2017.
A, Association of uric acid with eGFR in all population. B, Association of uric acid with eGFR in men. C, Association of uric acid with eGFR in women. Restricted cubic splines with 3 knots were used for association analysis with adjustment for age, sex, ethnicity, living area, education, smoking, physical activity, and body mass index. Histogram represents the distribution of plasma uric acid levels in the study population.
See this image and copyright information in PMC

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