- Title
- Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study
- Creator
- Boateng, Godfred O.; Lartey, Stella T.; Baiden, Philip; Si, Lei; Biritwum, Richard Berko; Kowal, Paul; Magnussen, Costan G.; Ben Taleb, Ziyad; Palmer, Andrew J.; Luginaah, Isaac
- Relation
- Frontiers in Public Health Vol. 9, Issue 7 April 2021, no. 571110
- Publisher Link
- http://dx.doi.org/10.3389/fpubh.2021.571110
- Publisher
- Frontiers Research Foundation
- Resource Type
- journal article
- Date
- 2021
- Description
- 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.
- Subject
- elevated blood pressure; hypertension; multi-state model; transition probabilites; ACC/AHA 2017 hypertension guidelines; sub-Saharan Africa; SDG 17; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1477981
- Identifier
- uon:50071
- Identifier
- ISSN:2296-2565
- Language
- eng
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