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

Autor:	Aheto JMK; Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.; WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom.; College of Public Health, University of South Florida, Tampa, Florida, United States of America., Gates T; College of Public Health, University of South Florida, Tampa, Florida, United States of America., Babah R; Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana., Takramah W; Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Apr 26; Vol. 3 (4), pp. e0001613. Date of Electronic Publication: 2023 Apr 26 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001613
Abstrakt:	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. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Aheto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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