Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods

Elevated blood pressure is the leading cause of cardiovascular diseases related mortality and a major contributor to non-communicable diseases globally, especially in sub-Saharan Africa where about 74.7 million people live with hypertension. In Ghana, hypertension is epidemic with prevalence of over...

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Main Authors: Justice Moses K. Aheto, Tracy Gates, Rahmatu Babah, Wisdom Takramah
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132648/?tool=EBI
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author Justice Moses K. Aheto
Tracy Gates
Rahmatu Babah
Wisdom Takramah
author_facet Justice Moses K. Aheto
Tracy Gates
Rahmatu Babah
Wisdom Takramah
author_sort Justice Moses K. Aheto
collection DOAJ
description Elevated blood pressure is the leading cause of cardiovascular diseases related mortality and a major contributor to non-communicable diseases globally, especially in sub-Saharan Africa where about 74.7 million people live with hypertension. In Ghana, hypertension is epidemic with prevalence of over 30% and experiencing continuing burden with its associated morbidity and mortality. Using the 2014 Ghana Demographic and Health Survey, we analyzed data on 4744 women aged 15–49 years residing in 3722 households. We employed univariate and multivariate response multilevel linear regression models to analyze predictors of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Geospatial maps were produced to show the regional distribution of hypertension prevalence in Ghana. Stata version 17 and R version 4.2.1 were used to analyze the data. Of the 4744 woman, 337 (7.1%) and 484 (10.2%) were found to be hypertensive on SBP and DBP, respectively. A combined prevalence of 12.3% was found. Older ages 25–34 (OR 2.45, 95%CI: 1.27, 3.63), 35–44 (OR 8.72, 95%CI: 7.43, 10.01), 45–49 (OR 15.85, 95%CI: 14.07, 17.64), being obese (OR 5.10, 95%CI: 3.62, 6.58), and having no education (OR -2.05, 95%CI: -3.40, -0.71) were associated with SBP. For DBP, we found the associated factors to be older ages 25–34 (OR 3.29, 95%CI: 2.50, 4.08), 35–44 (OR 6.78, 95%CI: 5.91, 7.64), 45–49 (OR 10.05, 95%CI: 8.85, 11.25), being obese (OR 4.20, 95%CI: 3.21, 5.19), and having no education (OR -1.23, 95%CI: -2.14, -0.33). Substantial residual household level differences in SBP (15%) and DBP (14%) were observed. We found strong residual correlation of SBP and DBP on individual women (r = 0.73) and household-level (r = 0.81). The geospatial maps showed substantial regional differences in the observed and reported hypertension prevalence. Interventions should be targeted at the identified high-risk groups like older age groups and those who are obese, and the high-risk regions.
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spelling doaj.art-049307bd04a0482681ce569850110d512023-09-03T10:52:04ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0134Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methodsJustice Moses K. AhetoTracy GatesRahmatu BabahWisdom TakramahElevated blood pressure is the leading cause of cardiovascular diseases related mortality and a major contributor to non-communicable diseases globally, especially in sub-Saharan Africa where about 74.7 million people live with hypertension. In Ghana, hypertension is epidemic with prevalence of over 30% and experiencing continuing burden with its associated morbidity and mortality. Using the 2014 Ghana Demographic and Health Survey, we analyzed data on 4744 women aged 15–49 years residing in 3722 households. We employed univariate and multivariate response multilevel linear regression models to analyze predictors of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Geospatial maps were produced to show the regional distribution of hypertension prevalence in Ghana. Stata version 17 and R version 4.2.1 were used to analyze the data. Of the 4744 woman, 337 (7.1%) and 484 (10.2%) were found to be hypertensive on SBP and DBP, respectively. A combined prevalence of 12.3% was found. Older ages 25–34 (OR 2.45, 95%CI: 1.27, 3.63), 35–44 (OR 8.72, 95%CI: 7.43, 10.01), 45–49 (OR 15.85, 95%CI: 14.07, 17.64), being obese (OR 5.10, 95%CI: 3.62, 6.58), and having no education (OR -2.05, 95%CI: -3.40, -0.71) were associated with SBP. For DBP, we found the associated factors to be older ages 25–34 (OR 3.29, 95%CI: 2.50, 4.08), 35–44 (OR 6.78, 95%CI: 5.91, 7.64), 45–49 (OR 10.05, 95%CI: 8.85, 11.25), being obese (OR 4.20, 95%CI: 3.21, 5.19), and having no education (OR -1.23, 95%CI: -2.14, -0.33). Substantial residual household level differences in SBP (15%) and DBP (14%) were observed. We found strong residual correlation of SBP and DBP on individual women (r = 0.73) and household-level (r = 0.81). The geospatial maps showed substantial regional differences in the observed and reported hypertension prevalence. Interventions should be targeted at the identified high-risk groups like older age groups and those who are obese, and the high-risk regions.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132648/?tool=EBI
spellingShingle Justice Moses K. Aheto
Tracy Gates
Rahmatu Babah
Wisdom Takramah
Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
PLOS Global Public Health
title Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
title_full Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
title_fullStr Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
title_full_unstemmed Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
title_short Joint modelling of systolic and diastolic blood pressure and its associated factors among women in Ghana: Multivariate response multilevel modelling methods
title_sort joint modelling of systolic and diastolic blood pressure and its associated factors among women in ghana multivariate response multilevel modelling methods
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132648/?tool=EBI
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