Data from: Cardiovascular disease risk factors in Ghana during the rural-to-urban transition: a cross-sectional study

Populations in sub-Saharan Africa are shifting from rural to increasingly
urban. Although the burden of cardiovascular disease is expected to
increase with this changing landscape, few large studies have assessed a
wide range of risk factors in urban and rural populations, particularly in
West Africa. We conducted a cross-sectional, population-based survey of
3317 participants from Ghana (≥18 years old), of whom 2265 (57% female)
were from a mid-sized city (Sunyani, population ~250,000) and 1052 (55%
female) were from surrounding villages (populations <5000). We
measured canonical cardiovascular disease risk factors (BMI, blood
pressure, fasting glucose, lipids) and fibrinolytic markers (PAI-1 and
t-PA), and assessed how their distributions and related clinical outcomes
(including obesity, hypertension and diabetes) varied with urban residence
and sex. Urban residence was strongly associated with obesity (OR: 7.8,
95% CI: 5.3–11.3), diabetes (OR 3.6, 95% CI: 2.3–5.7), and hypertension
(OR 3.2, 95% CI: 2.6–4.0). Among the quantitative measures, most affected
were total cholesterol (+0.81 standard deviations, 95% CI 0.73–0.88), LDL
cholesterol (+0.89, 95% CI: 0.79–0.99), and t-PA (+0.56, 95% CI:
0.48–0.63). Triglycerides and HDL cholesterol profiles were similarly poor
in both urban and rural environments, but significantly worse among rural
participants after BMI-adjustment. For most of the risk factors, the
strength of the association with urban residence did not vary with sex.
Obesity was a major exception, with urban women at particularly high risk
(26% age-standardized prevalence) compared to urban men (7%). Overall,
urban residents had substantially worse cardiovascular risk profiles, with
some risk factors at levels typically seen in the developed world.