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ToolsBoateng, Godfred O., Lartey, Stella T., Baiden, Philip, Si, Lei, Biritwum, Richard Berko, Kowal, Paul, Magnussen, Costan G., Ben Taleb, Ziyad, Palmer, Andrew J. and Luginaah, Isaac (2021) Measuring hypertension progression with transition probabilities: Estimates from the WHO SAGE longitudinal study. Frontiers in Public Health, 9. ISSN 2296-2565
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Abstract
This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic <80 mm Hg), stage 1 (systolic 130-139 mm Hg & diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg & diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: Study on global AGEing and adult health (SAGE) Waves 1 and 2 were supported by WHO and the US National Institute on Aging’s Division of Behavioral and Social Science Research (BSR) through Interagency Agreements (OGHA 04034785; YA1323-08-CN-0020; Y1-AG-1005-01) with WHO. Financial and in-kind support has come from the University of Ghana’s Department of Community Health. GB is supported by a Start-up fund at the University of Texas at Arlington. LS is supported by a National Health and Medical Research Council Early Career Fellowship (GNT1139826); AP is funded by the Centre of Excellence in Population Ageing Research, Australian Research Council (CE170100005); CM is funded by the National Heart Foundation of Australia Future Leader Fellowship (100849). IL is supported by Social Sciences and Humanities Research Council. |
| Uncontrolled Keywords: | aha 2017 hypertension guidelines,elevated blood pressure,hypertension,multi-state model,sub-saharan africa,transition probabilites,public health, environmental and occupational health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2739 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 18 Aug 2022 13:31 |
| Last Modified: | 06 Feb 2025 10:49 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/87458 |
| DOI: | 10.3389/fpubh.2021.571110 |
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