Cardiometabolic risk factors and preclinical target organ damage among adults in Ghana: Findings from a national study

Background: Sub Saharan Africa (SSA) has the highest prevalence of cardiovascular diseases (CVD). Nevertheless, very few studies have directly examined the development of and risk factors for CVD among Africans. Objective: To examine CVD risk factors and outcomes particularly in the early stage of CVD development among adults in Ghana. Methods: Using a stratified multistage random sampling method, 1,106 participants were recruited as a nationally representative sample of the general population ≥18 years in Ghana from 2016 to 2017. For each participant, we measured CVD risk factors and preclinical target organ damage (TOD) for CVD development. Results: The prevalence of CVD risk factors was 21.1% for obesity, 10.8% for diabetes, 55.4% for hypertension, 37.3% for dyslipidemia, 12.8% for hyperuricemia, and 39.3% for hsCRP>3 mg/L in the recruited population. The prevalence of preclinical TOD was 8.6% for peripheral artery disease (PAD), 14.7% for carotid thickening, 5.9% for left ventricular hypertrophy (LVH), and 4.4% for chronic kidney disease (CKD). Three CVD risk factors appeared to play most prominent roles in TOD development, including obesity for PAD (OR 1.88, 95% CI 1.13, 3.09), hypertension for carotid thickening (OR 1.57, 95% CI 0.99, 2.54) and LVH (OR 6.25, 95% CI 2.98, 14.50), and hyperuricemia for CKD (OR 5.56, 95% CI 2.79, 11.15). Conclusions: The prevalence of CVD risk factors and early outcomes have reached epidemic proportions among Ghanaian adults. The distinct patterns of risk factors in the development of TOD presents important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.