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Meta-Analysis
. 2021 Mar 5;16(3):e0248137.
doi: 10.1371/journal.pone.0248137. eCollection 2021.

Prevalence, awareness and control of hypertension in Ghana: A systematic review and meta-analysis

William Kofi Bosu  1 , Dary Kojo Bosu  2
Affiliations
Meta-Analysis

Prevalence, awareness and control of hypertension in Ghana: A systematic review and meta-analysis

William Kofi Bosu et al. PLoS One. .

Abstract

Background: Hypertension is a major health problem in Ghana, being a leading cause of admissions and deaths in the country. In the context of a changing food and health policy environment, we undertook a systematic review (PROSPERO registration number: CRD42020177174) and a meta-analysis of the prevalence of adult hypertension, and its awareness and control in Ghana.

Methods: We searched major databases including PubMed, Embase as well as Google Scholar and online digital collections of public universities of Ghana to locate relevant published and unpublished community-based articles up till April 2020.

Findings: Eighty-five articles involving 82,045 apparently-healthy subjects aged 15-100 years were analyzed. In individual studies, the prevalence of hypertension, defined in most cases as blood pressure ≥ 140/90 mmHg, ranged from 2.8% to 67.5%. The pooled prevalence from the meta-analysis was 27.0% (95% CI 24.0%-30.0%), being twice as high in the coastal (28%, 95% CI: 24.0%-31.0%) and middle geo-ecological belts (29%, 95% CI: 25.0%-33.0%) as in the northern belt (13%, 95% CI: 7.0%-21.0%). The prevalence was similar by sex, urban-rural residence or peer-review status of the included studies. It did not appear to vary over the study year period 1976-2019. Of the subjects with hypertension, only 35% (95% CI: 29.0%-41.0%) were aware of it, 22% (95% CI: 16.0%-29.0%) were on treatment and 6.0% (95% CI: 3.0%-10.0%) had their blood pressure controlled. Sensitivity analyses corroborated the robust estimates. There was, however, high heterogeneity (I2 = 98.7%) across the studies which was partly explained by prevalent obesity in the subjects.

Conclusion: More than one in four adults in Ghana have hypertension. This high prevalence has persisted for decades and is similar in rural and urban populations. With the low awareness and poor control of hypertension, greater investments in cardiovascular health are required if Ghana is to meet the global target for hypertension.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram showing study selection.
Fig 2
Fig 2. Map of Ghana showing regional distribution of number of studies and the prevalence of hypertension.
Fig 3
Fig 3. Forest plot of the prevalence of hypertension by geo-ecological belt of Ghana.
Fig 4
Fig 4. Trend in the prevalence of hypertension over study years 1976–2019.
Fig 5
Fig 5. Leave-one-out sensitivity plot on studies on prevalence of hypertension in Ghana.
Fig 6
Fig 6. Funnel plot of included studies on the prevalence of hypertension in Ghana.
Fig 7
Fig 7. Forest plot of prevalence of awareness of hypertension in Ghana.
See this image and copyright information in PMC

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