Prevalence of Cardiovascular Disease and Risk Factors in Ghana: A Systematic Review and Meta-analysis

Alfred Doku; Lawrence Sena Tuglo; Vincent Boima; Francis Agyekum; Pearl Aovare; Martha Ali Abdulai; Anthony Godi; Ron J.G. Peters; Charles Agyemang

doi:10.5334/gh.1307

Prevalence of Cardiovascular Disease and Risk Factors in Ghana: A Systematic Review and Meta-analysis

Volume 19 (2024): Issue 1

By: Alfred Doku , Lawrence Sena Tuglo , Vincent Boima , Francis Agyekum , Pearl Aovare , Martha Ali Abdulai , Anthony Godi , Ron J.G. Peters and Charles Agyemang

Open Access

|Feb 2024

Figures & Tables

PRISMA flow diagram of study search and selection procedures.

Table 1

Characteristics of the included studies.

STUDY	AUTHOR (PUBLICATION YEAR)	STUDY SETTING	STUDY DESIGN	REGION	DIAGNOSIS (CVD)	SAMPLE SIZE	DISEASED	PROPORTION
1	Sarfo et al., 2018 [24]	Hypertension and Diabetes Clinic	Prospective cohort study	More than one	Stroke	3220	54	1.68
2	Owusu et al., 2018 a [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Hypertensive heart disease	432	154	35.6
	Owusu et al., 2018 b [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Valvular heart disease	432	85	19.7
	Owusu et al., 2018 c [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Cardiomyopathies	432	80	18.5
	Owusu et al., 2018 d [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Arrhythmia	432	27	6.3
	Owusu et al., 2018 e [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Coronary artery disease	432	18	4.2
	Owusu et al., 2018 f [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Congenital heart disease	432	15	3.5
	Owusu et al., 2018 g [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Venous-thromboembolism	432	11	2.5
	Owusu et al., 2018 h [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Pulmonary hypertension	432	8	1.9
	Owusu et al., 2018 i [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Infective endocarditis	432	4	0.9
	Owusu et al., 2018 j [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Sickle cell heart disease	432	4	0.9
	Owusu et al., 2018 k [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Thyroid heart disease	432	3	0.7
	Owusu et al., 2018 m [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Pericardial disorders	432	3	0.7
	Owusu et al., 2018 n [25]	Cardiac Clinic	Cross-sectional study	Ashanti	Heart failure	432	3	0.7
3	Sarfo et al., 2016 [26]	Neurology Clinic	Cross-sectional study	Ashanti	Stroke	1812	1048	57.1
4	Hayfron-Benjamin et al., 2019 [27]	Community urban	Cross-sectional study	More than one	Peripheral artery disease	1419	126	8.93
4	Hayfron-Benjamin et al., 2019 [27]	Community Rural	Cross-sectional study	More than one	Peripheral artery disease	1017	76	7.52
5	Wiredu et al., 2001 [18]	Stroke Autopsy	Cross-sectional study	Greater Accra	Stroke	9760	1086	11.1
6	Amoah, 2000 a [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Hypertensive heart disease	708	133	18.8
	Amoah, 2000 b [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Rheumatic heart disease	708	123	17.4
	Amoah, 2000 c [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Cardiomyopathies	708	103	14.6
	Amoah, 2000 d [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Congenital heart disease	708	90	12.7
	Amoah, 2000 e [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Coronary artery disease	708	80	11.3
	Amoah, 2000 f [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pericardial disorders	708	56	7.9
	Amoah, 2000 g [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Infective endocarditis	708	32	4.5
	Amoah, 2000 h [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Arrhythmia	708	13	1.8
	Amoah, 2000 i [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pulmonary hypertension	708	12	1.7
	Amoah, 2000 j [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Thyroid heart disease	708	10	1.4
	Amoah, 2000 k [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Aortic aneurysm	708	8	1.1
	Amoah, 2000 m [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pulmonary embolism	708	6	0.9
	Amoah, 2000 n [33]	Cardiac Clinic	Cross-sectional study	Greater Accra	Thromboembolic pulmonary hypertension	708	5	0.7
7	Edingion, 1954 [19]	General Autopsy	Cross-sectional study	Greater Accra	CVD	3645	467	12.8
8	Agongo et al., 2022 [28]	Community Rural	Cross-sectional study	Northern	CVD	1839	29	1.6
9	Amoah et al., 2000 a [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Hypertensive heart disease	572	122	21.3
	Amoah et al., 2000 b [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Rheumatic heart disease	572	115	20.1
	Amoah et al., 2000 c [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Idiopathic cardiomyopathy	572	96	16.8
	Amoah et al., 2000 d [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Congenital heart disease	572	57	10
	Amoah et al., 2000 e [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Coronary artery disease	572	56	9.8
	Amoah et al., 2000 f [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pericardial disorders	572	44	7.7
	Amoah et al., 2000 g [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Infective endocarditis	572	25	4.4
	Amoah et al., 2000 h [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pulmonary hypertension	572	11	1.9
	Amoah et al., 2000 i [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Thyroid heart disease	572	10	1.8
	Amoah et al., 2000 j [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Arrhythmia	572	6	1
	Amoah et al., 2000 k [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Aortic aneurysm	572	6	1
	Amoah et al., 2000 m [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Thromboembolic pulmonary hypertension	572	4	0.7
	Amoah et al., 2000 n [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Pulmonary embolism	572	4	0.7
	Amoah et al., 2000 o [16]	Cardiac Clinic	Cross-sectional study	Greater Accra	Amyloid heart disease	572	3	0.5
10	Sanuade et al., 2019 [29]	Community Urban	Cross-sectional study	More than one	Stroke	4279	112	2.6
11	Sarfo et al., 2021 [30]	HIV Clinic	Prospective cohort study	Ashanti	CVD	255	5	1.96
12	Haddock et al., 1970 a [34]	Medical admission	Cross-sectional study	Greater Accra	Heart failure	5545	539	9.7
12	Haddock et al., 1970 b [34]	Medical admission	Cross-sectional study	Greater Accra	Stroke	5545	350	6.3
13	Sanuade et al., 2014 [20]	General autopsy	Cross-sectional study	Greater Accra	CVD	19289	4287	22.2
14	Sarfo et al., 2017 [17]	Neurology Clinic	Cross-sectional study	Ashanti	Stroke	934	607	65
15	Sarfo et al., 2015 [31]	General Admission	Cross-sectional study	Ashanti	Stroke	2000	19	1
	Sarfo et al., 2015 a [31]	General Admission	Cross-sectional study	Ashanti	Stroke	1132	569	50.3
	Sarfo et al., 2015 b [31]	General Admission	Cross-sectional study	Ashanti	Stroke	1132	382	33.7
	Sarfo et al., 2015 c [31]	General Admission	Cross-sectional study	Ashanti	Stroke	1132	181	16
16	Agyemang et al., 2012 a [32]	Medical Admission	Cross-sectional study	Ashanti	Stroke	1054	96	9.1
16	Agyemang et al., 2012 b [32]	Medical Admission	Cross-sectional study	Ashanti	Stroke	1054	139	13.2

Forest plot for the prevalence of CVD in Ghana.

Table 2

Subgroup analysis regarding the prevalence of CVD in Ghana.

SUBGROUPS	POOLED PREVALENCE 95% CONFIDENCE INTERVAL (CI) (%)	HETEROGENEITY ACROSS THE STUDIES		HETEROGENEITY BETWEEN GROUPS (p-VALUE)
SUBGROUPS	POOLED PREVALENCE 95% CONFIDENCE INTERVAL (CI) (%)	I² (%)	p-VALUE	HETEROGENEITY BETWEEN GROUPS (p-VALUE)
Total	10.34[8.48, 12.20]	99.54	<0.001	<0.001
Study setting
Cardiac Clinic	6.55[5.45, 7.66]	97.41	<0.001	<0.001
Community Rural	4.51[–1.29-10.31]	97.80	<0.001
Community Urban	5.72[–0.48, 11.93]	98.42	<0.001
General Admission	25.22[3.23, 47.21]	99.82	<0.001
General Autopsy	17.51[8.3, 26.72]	99.55	<0.001
HIV Clinic	1.96[0.26, 3.66]
Hypertension and Diabetes Clinic	1.68[1.24, 2.12]
Medical Admission	9.46[6.87, 12.05]	95.82	<0.001
Neurology Clinic	60.98[53.24, 68.72]	93.93	<0.001
Stroke Autopsy	11.10[10.48, 11.72]
Study setting classification
Community-based	5.04[2.54, 7.53]	97.41	<0.001	0.001
Hospital-based	10.74[8.69, 12.79]	99.56	<0.001
Study design
Cross-sectional study	10.65[8.69, 12.62]	99.55	<0.001	<0.001
Prospective cohort study	1.70[1.27, 2.13]	0.00	0.755
Region
Ashanti Region	15.48[11.01, 19.94]	99.65	<0.001	<0.001
Greater Accra Region	7.86[5.47, 10.25]	99.48	<0.001
More than one region	5.03[2.72, 7.34]	97.54	<0.001
Northern Region	1.60[1.03, 2.17]
Diagnosis
Amyloid heart disease	0.50[–0.08, 1.08]			<0.001
Aortic aneurysm	1.05[0.49, 1.61]	0.00	0.861
Arrhythmia	2.70[0.63, 4.77]	89.1	<0.001
General CVD	9.65[–2.20, 21.49]	99.88	<0.001
Cardiomyopathies	16.33[12.53, 20.13]	65.48	<0.001
Congenital heart disease	8.68[2.89, 14.47]	95.20	<0.001
Coronary artery disease	8.39[3.86, 12.91]	92.05	<0.001
Heart failure	5.20[–3.62, 14.02]	99.61	<0.001
Hypertensive heart disease	25.08[16.11, 34.05]	94.88	<0.001
Idiopathic cardiomyopathy	16.80[13.74, 19.86]
Infective endocarditis	3.20[0.54, 5.86]	91.47	<0.001
Pericardial disorders	5.37[–0.14, 10.88]	97.14	<0.001
Peripheral artery disease	8.26[6.86, 9.64]	36.78	0.209
Pulmonary embolism	0.80[0.31, 1.29]	0.00	0.688
Pulmonary hypertension	1.81[1.18, 2.44]	0.00	0.954
Rheumatic heart disease	18.61[15.98, 21.23]	33.64	0.220
Sickle cell heart disease	0.90[0.01, 1.79]
Stroke	24.08[16.62, 27.53]	99.82	<0.001
Thromboembolic pulmonary hypertension	0.70[0.24, 1.16]	0.00	1.000
Thyroid heart disease	1.22[0.60, 1.85]	31.57	0.232
Valvular heart disease	19.70[15.95, 23.45]
Veno-thromboembolism	2.50[1.03, 3.97]

Table 3

Risk factors of CVD in Ghana.

NUMBER	RISK FACTORS	STUDY	OR (95% CI)
1	Male gender	Sarfo et al., 2018 [24]	2.10 [1.21, 3.64]
		Wiredu et al., 2001 [18]	2.07 [1.75, 2.45]
		Agyemang et al., 2012 [32]	1.14 [0.98, 1.27]
		Overall, DL (I² = 93.8%, p < 0.001)	1.66 [1.02, 2.70]
2	Old age	Sarfo et al., 2018 [24]	1.28 [1.03, 1.60]
		Sarfo et al., 2015 [31]	1.31 [1.16, 1.47]
		Sarfo et al., 2017 [17]	1.41 [1.15, 1.73]
		Overall, DL (1² = 0.0%, p = 0.784)	1.32 [1.21, 1.45]
3	Unemployment	Sarfo et al., 2018 [24]	1.89 [1.11, 3.23]
		Sanuade et al., 2019 [29]	3.78 [2.02, 7.07]
		Overall, DL (I² = 63.3%, p = 0.099)	2.62 [1.33, 5.16]
4	Diabetes	Sanuade et al., 2019 [29]	3.95 [1.88, 8.30]
		Sarfo et al., 2017 [17]	2.24 [1.32, 3.80]
		Overall, DL (I² = 32.8%, p = 0.223)	2.79 [1.62, 4.81]
5	Hypertension	Sanuade et al., 2019 [29]	3.01 [1.77, 5.13]
		Sarfo et al., 2021 [30]	8.61 [1.32, 56.04]
		Overall, DL (I² = 10.5%, p = 0.290)	3.41 [1.75, 6.66]
6	Smoking	Sarfo et al., 2018 [24]	2.59 [1.18, 5.67]
7	Physical inactivity	Sarfo et al., 2018 [24]	1.81 [1.06, 3.10]
8	Divorced	Sanuade et al., 2019 [29]	2.47 [1.22, 4.97]
9	Rise in CD4 count	Sarfo et al., 2021 [30]	0.56 [0.35, 0.88]
10	Non-HDL-C	Agongo et al., 2022 [28]	1.58 [1.05, 2.39]
11	LDL-C/HDL-C levels	Agongo et al., 2022 [28]	1.26 [1.00, 1.59]

[i] OR: odds ratio; CD4: clusters of differentiation 4; HDL-C: high-density lipoprotein cholesterol; TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; DL: random-effects DerSimonian-Laird model.

Articles in this issue

DOI: https://doi.org/10.5334/gh.1307 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Apr 22, 2023

Accepted on: Feb 5, 2024

Published on: Feb 20, 2024

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

prevalence,

cardiovascular disease,

risk factors,

systematic review,

meta-analysis and Ghana

© 2024 Alfred Doku, Lawrence Sena Tuglo, Vincent Boima, Francis Agyekum, Pearl Aovare, Martha Ali Abdulai, Anthony Godi, Ron J.G. Peters, Charles Agyemang, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 19 (2024): Issue 1

Prevalence of Cardiovascular Disease and Risk Factors in Ghana: A Systematic Review and Meta-analysis

Figures & Tables

Figure 1

Table 1

Figure 2

Table 2

Table 3

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