Sex-Related Absolute and Relative Inequalities in Hypertension Prevalence Among Adults Aged 30-79 in Ghana, 1990-2019

Hypertension is a major contributor to cardiovascular diseases in Ghana. However, long-term sex-specific trends in crude and age-standardised rates remain underexplored. This study evaluates the sex-related inequalities in crude and age-standardised hypertension prevalence rates among adults aged 30-79 in Ghana from 1990 to 2019.

We used data from the World Health Organization's Global Health Observatory, which was available in the WHO's Health Equity Assessment Toolkit. Sex was the only stratifier available to examine disparities in hypertension prevalence. We analysed sex differences for both crude and age-standardised prevalence using four inequality indicators: Difference (D), Ratio (R), Population Attributable Fraction (PAF), and Population Attributable Ratio (PAR). We examined the absolute and relative disparities in hypertension prevalence between males and females.

In 1990, age-standardised prevalence was similar between women, 35.7% (95% CI: 22.0-50.8) and men, 34.7% (95% CI: 20.0-50.9), with a D of 1.0 and R of 1.0. By 2019, the prevalence among women increased slightly to 36.1% (95% CI: 26.6-46.3), whereas the prevalence among men declined markedly to 31.4% (95% CI: 22.0-41.2), resulting in an absolute difference of 4.7 and a sex ratio of 1.2. Relative inequality increased modestly from 1.0 in 1990 to 1.1 in 2019. PAF and PAR remained negative over the period, increasing from -1.7% and -0.6 in 1990 to -7.4% and -2.5 in 2019, respectively.

Over three decades, Ghana has experienced a widening sex disparity in age-standardised hypertension prevalence, with women consistently having a higher burden than men. Given that a substantial portion of the national burden of hypertension could be averted by closing this gap, urgent gender-responsive public health strategies are required to advance cardiovascular equity in Ghana.