Ghana study links age, male sex and BMI to higher blood pressure categories

A cross-sectional AWI-Gen sub-study in Ghana’s Kassena-Nankana districts compared frequentist and Bayesian ordered probit models of blood pressure status. Researchers studied 2,010 adults aged 40–60 years, with 1,979 included in complete-case analyses. Blood pressure was classified using 2017 ACC/AHA thresholds, and models adjusted for demographic, lifestyle and exposure variables.

Overall, 46.1% had normal blood pressure, 12.4% had elevated blood pressure, 19.6% met stage 1 hypertension thresholds and 21.9% met stage 2 thresholds. Older age, male sex and higher BMI were associated with higher blood pressure categories in both models. Frequentist probit coefficients were 0.032 per year of age (95% CI 0.023–0.041), 0.279 for male sex (0.141–0.417) and 0.054 for BMI (0.039–0.069). These coefficients describe associations on the model’s latent scale, not changes in mmHg. Bayesian estimates were nearly identical, and model fit was comparable.

The findings document a substantial burden of elevated blood pressure in this middle-aged rural population. However, the sex association varied across severity thresholds, complicating interpretation of a single coefficient. Married status and pesticide exposure showed inverse associations, which should be treated as hypothesis-generating rather than protective effects. The cross-sectional design cannot establish causality, and the population’s restricted age range and location limit generalizability.