Multilevel modelling, prevalence and predictors of hypertension in Ghana: Evidence from Wave 2 of the World Health Organization’s Study on Global AGEing and adult health.

Background Hypertension is a major public health issue, a critical risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programmes and policies aimed at reducing the prevalence and its associated morbidity, disability and mortality. This study attempts to develop multilevel regression, an in-depth statistical model to identify critical risk factors of hypertension. Methods This study used data on 4381 individuals aged ≥18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2. Multilevel regression modelling was employed to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (i.e. SBP>140mmHg). Results The data on 4381 individuals were analysed out of which 27.3% were hypertensive. Critical risk factors for hypertension identified were age, obesity, marital status, health state and difficulty with self-care. Strong unobserved household-level residual variations were found. Conclusion Hypertension remains high in Ghana. Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message and political will could be beneficial to the management and prevention of hypertension.