Prevalence, risk factors, and self-awareness for hypertension and diabetes: rural–urban and male–female dimensions from a cross-sectional study in Ghana

Ellahi B., DİKMEN D., Seyhan-Erdoğan B., KARABULUT Ö. F., Aitken A., Agbozo F., ...More

International Journal of Diabetes in Developing Countries, vol.43, no.5, pp.694-708, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 43 Issue: 5
  • Publication Date: 2023
  • Doi Number: 10.1007/s13410-022-01141-9
  • Journal Name: International Journal of Diabetes in Developing Countries
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database
  • Page Numbers: pp.694-708
  • Keywords: Elevated blood pressure, Elevated blood glucose, Non-communicable diseases, Adiposity, Body mass index, Urbanization, Undiagnosed
  • Hacettepe University Affiliated: Yes


© 2022, The Author(s), under exclusive licence to Research Society for Study of Diabetes in India.Background: Hypertension and diabetes remain the primary cause of non-communicable disease (NCD) related morbidity and mortality globally. Rural–urban transitions in developing countries might aggravate the risk factors and prevalence of these conditions. The study aims to determine prevalence, demographic, anthropometric, and diet-related predisposing factors for hypertension and diabetes among urban and rural dwellers and assess participants’ self-awareness of their hypertension and diabetes status. Methods: This cross-sectional survey involved 850 adult males and females age ≥ 18 years residing in urban and rural areas in the Hohoe Municipality of Ghana, randomly sampled using probability proportional to size. Data included demographic, anthropometric, physiologic (blood pressure, fasting blood glucose), and dietary information. Nutrient quantities were analysed using the Research to Improve Infant Nutrition and Growth (RIING) Nutrient Database Software. All other data was analysed in SPSS (v25). Risk factors for hypertension were estimated through ordinal logistic regression and the odds ratio (OR) with the corresponding 95% confidence level (CI) documented. Results: More females participated than males (58.4% vs 41.6%), similarly rural compared to urban inhabitants (53.5% vs 47.5%, p = 0.002) with a mean age of 47.3 ± 16.1 years. Females generally had higher adiposity, rural dwellers had higher BMI, whereas urban dwellers had higher waist and hip circumferences. Overall, 4.4% and 18.5% were diabetics and pre-diabetics, while 20.4% and 12.1% were overweight and obese respectively. Of the 36.8% hypertensives, only 18.2% were aware of their status, with significant male (40.3%) female (59.7%), and urban (43.5%) rural (56.6%) differences. Males had higher intakes of energy and nutrients of public health importance to hypertension, similar as rural inhabitants except for cholesterol. Advancing age (95% CI: 0.02.03–0.05), being male (OR: 1.56 95% CI:0.12–0.81), and increased BMI (95% CI: 0.01–0.11) were independently associated with hypertension. Conclusions: One third of the population were hypertensives but were unaware. Findings challenge the assumption of lower predisposition among rural inhabitants as we observe lifestyle habits consistent with increasing urbanisation. Efforts to mitigate rising NCD trend requires intensified community-based screening, awareness creation, and lifestyle interventions to improve diet, physical activity, and health seeking.