Cardiovascular disease risk factors in Ghana during the rural-to-urban transition: A cross-sectional study

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dc.contributor.authorKodaman, N.
dc.contributor.authorAldrich, M.C.
dc.contributor.authorSobota, R.
dc.contributor.authorAsselbergs, F.W.
dc.contributor.authorPoku, K.A.
dc.contributor.authorBrown, N.J.
dc.contributor.authorMoore, J.H.
dc.contributor.authorWilliams, S.M.
dc.date.accessioned2017-10-25T19:29:58Z
dc.date.available2017-10-25T19:29:58Z
dc.date.issued2016
dc.description.abstractPopulations in sub-Saharan Africa are shifting from rural to increasingly urban. Although the burden of cardiovascular disease is expected to increase with this changing landscape, few large studies have assessed a wide range of risk factors in urban and rural populations, particularly in West Africa. We conducted a cross-sectional, population-based survey of 3317 participants from Ghana (≥18 years old), of whom 2265 (57% female) were from a mid-sized city (Sunyani, population ∼250,000) and 1052 (55% female) were from surrounding villages (populations <5000). We measured canonical cardiovascular disease risk factors (BMI, blood pressure, fasting glucose, lipids) and fibrinolytic markers (PAI-1 and t-PA), and assessed how their distributions and related clinical outcomes (including obesity, hypertension and diabetes) varied with urban residence and sex. Urban residence was strongly associated with obesity (OR: 7.8, 95% CI: 5.3-11.3), diabetes (OR 3.6, 95% CI: 2.3-5.7), and hypertension (OR 3.2, 95% CI: 2.6-4.0). Among the quantitative measures, most affected were total cholesterol (+0.81 standard deviations, 95% CI 0.73-0.88), LDL cholesterol (+0.89, 95% CI: 0.79-0.99), and t-PA (+0.56, 95% CI: 0.48-0.63). Triglycerides and HDL cholesterol profiles were similarly poor in both urban and rural environments, but significantly worse among rural participants after BMI-adjustment. For most of the risk factors, the strength of the association with urban residence did not vary with sex. Obesity was a major exception, with urban women at particularly high risk (26% age-standardized prevalence) compared to urban men (7%). Overall, urban residents had substantially worse cardiovascular risk profiles, with some risk factors at levels typically seen in the developed world.en_US
dc.identifier.other10.1371/journal.pone.0162753
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/22193
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.titleCardiovascular disease risk factors in Ghana during the rural-to-urban transition: A cross-sectional studyen_US
dc.typeArticleen_US

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