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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A community programme to reduce salt intake and blood pressure in Ghana [ISRCTN88789643]
BMC Public Health, Volume 6, Article 13, Year 2006
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Description
Background: In Africa hypertension is common and stroke is increasing. Detection, treatment and control of high blood pressure (BP) is limited. BP can be lowered by reducing salt intake. In Africa salt is added to the food by the consumer, as processed food is rare. A population-wide approach with programmes based on health education and promotion is thus possible. Methods: We carried out a community-based cluster randomised trial of health promotion in 1,013 participants from 12 villages (628 women, 481 rural dwellers); mean age 55 years to reduce salt intake and BP. Average BP was 125/74 mmHg and urinary sodium (UNa) 101 mmol/day. A health promotion intervention was provided over 6 months to all villages. Assessments were made at 3 and 6 months. Primary end-points were urinary sodium excretion and BP levels. Results: There was a significant positive relationship between salt intake and both systolic (2.17 mmHg [95% CI 0.44 to 3.91] per 50 mmol of UNa per day, p < 0.001) and diastolic BP (1.10 mmHg [0.08 to 1.94], p < 0.001) at baseline. At six months the intervention group showed a reduction in systolic (2.54 mmHg [-1.45 to 6.54]) and diastolic (3.95 mmHg [0.78 to 7.11], p = 0.015) BP when compared to control. There was no significant change in UNa. Smaller villages showed greater reductions in UNa than larger villages (p = 0.042). Irrespective of randomisation, there was a consistent and significant relationship between change in UNa and change in systolic BP, when adjusted for confounders. A difference in 24-hour UNa of 50 mmol was associated with a lower systolic BP of 2.12 mmHg (1.03 to 3.21) at 3 months and 1.34 mmHg (0.08 to 2.60) at 6 months (both p < 0.001). Conclusion: In West Africa the lower the salt intake, the lower the BP. It would appear that a reduction in the average salt intake in the whole community may lead to a small but significant reduction in population systolic BP. © 2006 Cappuccio et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Cappuccio, Francesco Paolo
United Kingdom, Coventry
Warwick Medical School
Kerry, Sally
United Kingdom, London
St George’s, University of London
Micah, Frank B.
Ghana, Kumasi
Komfo Anokye Teaching Hospital
Plange-Rhule, Jacob
Ghana, Kumasi
Komfo Anokye Teaching Hospital
Eastwood, John B.
United Kingdom, London
St George’s, University of London
Statistics
Citations: 171
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1186/1471-2458-6-13
ISSN:
14712458
e-ISSN:
14712458
Research Areas
Food Security
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Study Locations
Multi-countries
Ghana
Participants Gender
Female