LOGISTIC REGRESSION ANALYSIS OF FACTORS ASSOCIATED WITH HYPERTENSION PREVALENCE CASE STUDY: KOMFO ANOKYE TEACHING HOSPITAL (KATH), KUMASI,GHANA

ABSTRACT
Hypertension is one of the most important chronic non communicable diseases with increasing trend worldwide. According to Owusu et al (2012), hypertension topped the chart of cardiovascular risk prole in Kumasi Metropolis. This study therefore examines the factors associated with hypertension prevalence in Kumasi Metropolis. The study employed binary logistic regression model based on 2013 data from cardiac clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi Ghana. The sample size used for this study was 300 patients who visited cardiac clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi in 2013. The study found out that educational attainment, alcohol intake, gender, age, BMI, family history and religious aliation were signicant in explaining hypertension prevalence in Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana with these probabilities; 0.196(Primary), 0.1073(Tertiary), 0.1189, 0.0045, 0.4465, 0.147, 0.033 and 0.0612 respectively. This study recommended that Ghana health Service should intensify it education on the consequence of obesity and how to reduce weight. Also, Ghana Food and Drugs Board should regulate the rate at which alcoholic drinks are being advertised on our media and also use the media to educate the general public the side eects of alcoholic drinks. Last but not the least, there should be mass health education on the dangers, prevention and control of hypertension.


CHAPTER 1
INTRODUCTION
1.1       Background of the Study
The prevalence of risk factors for cardiovascular Diseases (CVD) is increasing worldwide. Obviously, this increase has been translated into mortality from CVD being the leading cause of death. Hypertension is a strong risk factor for cardiovascular as well as renal and neurological disorders. Recently, hypertension was identied as the most common risk factor for coronary heart diseases (Hajjar & Kitchen, 2003).

Approximately 15 to 37% of world's adults have hypertension, and in some population high blood pressure aects as many as 50% individuals older than 60 years. Worldwide hypertension is responsible for about 13% of all deaths (7.1 million people each year), 62% of strokes, and 49% of myocardial infarctions (American Heart Association, 2005).

Currently hypertension is classied into three categories. The rst category is Prehypertension. Previously, it was considered that systolic and diastolic pressure which varies between 120-139 and 80-89 mmHg respectively is high normal. The prevalence was more in male which is 39% compared to female 23% (Hosia et al.; 2007). Upon a report by Durham Regional Hospital (2004), American peoples that fall under this type of hypertension are almost 45 million. A person with prehypertension is three times more likely to have heart attack and 1.7 times to have heart related diseases compared to a normal individual (American Heart Association 2005)

Hypertension without any cause is the second category known as essential or primary hypertension and this account for 95% of a given total population (carretero and operil 2000). Often essential or primary hypertension is also termed clinically as idiopathic hypertension.

Essential hypertension is a silent killer because it goes unnoticed without any visible complications initially. If not treated, at a later stage it contributes to cardiovascular complications like stroke, angina and heart failure. People with primary hypertension usually seen with combined elevation of both systolic and diastolic pressure. The specic cause for the combined systolic and diastolic or isolated systolic hypertension is not known. Although there is no specic reason mentioned yet how primary hypertension develops several underlying factors may presumably be associated with it.

According to (Morton et al., 1962) genetic and environmental factors may contribute to primary hypertension even though there is no exact cause for the development of primary hypertension. It is believed that many genes come together to function as a network in order to determine genetic and environmental changes which is inherited from persons to persons (Melander, 2001). Some factors such as high dietary salt intake, heavy alcohol consumption, ethnicity impaired glucose tolerance, gender, age, and genetic disposition known as family history of hypertension are associated with high blood pressure.

The third category which is secondary hypertension, that is hypertension with the known cause. This type is less popular and account for about 5-10-% of the hypertensive total population (Onusku, 2003). This often associated with other diseases like renal artery, stenosis, chronic renal disease as well as pheochromocytoma (Saken and Kates 1997).

The reported prevalence of hypertension varies around the world, with the rate as low as 5.2% in rural North India and as high as 70.7% in Poland. Blood pressure variations also exist from within communities in the same country depending upon the economic development and auence. In economic developed countries, the prevalence of hypertension range between approximately 20 and 50%. Prevalence of hypertension in the Asia pacic region ranges from 5 to 47% in men and from 7 to 38% in women (WHO 2003). Cardiovascular disease illustrates this trend in transition from communicable to non communicable illness. Decreasing rates in western countries over the past 30-40 years have been attributed to heightened awareness and control of known risk factors.

According to WHO (2009), deaths due to non communicable diseases such as hypertension will rise by 17% over the next decade with the highest rise in the African region to the tune of 27% . The most cost eective mode of prevention is the primary prevention (Maher et al.,2003). In 2003, a cross-sectional study by Amoah et al. (2003) conducted in Ghana concluded that high prevalence in women (29.5%) compared to male (27.6%) and low of awareness.

In Ghana, the prevalence of hypertension in urban Accra was estimated to be 28.3% (Crade) and 27.3% (age-standardize) (Amoah, 2003). However, to a considerable extent the growth and effectiveness of reducing maternal death by means of prevent and treatment of hypertension has been effective even though it can be prevented.

Also, a study on the changing patterns of hypertension in four rural communities in Ghana showed prevalence of 25.4%. The study revealed that of those with hypertension only 32.3% had prior knowledge of their condition and less than half of these were on treatment (Addo et al., 2006). A survey conducted by Burket, (2006) on blood pressure in the Volta Region of Ghana reported a frequency of 32.8% for hypertension with percentages of male and female been 30.7% and 39.4% respectively. Cappucio et al., (2004) in their study in the Ashanti Region divulge a prevalence of hypertension of 28% for the Ashanti tribe in Ghana. According to the World Health Organization (WHO, 2008) African Regional Consultation Meeting report on global strategy on death, physical activity and health, the risk for non-communicable disease appears to be gaining importance in Ghana, with prevalence of high blood pressure estimated at 30-40% although prevalence data for survey are generally inadequate.

Knowledge on the pattern of this detrimental disease could help public health workers and government to organize education programs for citizen and cause of hypertension and its associated problem.

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Item Type: Ghanaian Project Material  |  Attribute: 56 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH50  |  Delivery: Within 30Mins.
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