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Intern Emerg Med. 2018 Sep;13(6):845-856. doi: 10.1007/s11739-018-1846-6. Epub 2018 Apr 17.

Ideal cardiovascular health among Ghanaian populations in three European countries and rural and urban Ghana: the RODAM study.

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Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana.
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
MKPGMS-Uganda Martyrs University, Kampala, Uganda.
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
Department of Endocrinology and Metabolism, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
Center for Cardiovascular Research (CCR), Charite-Universitaetsmedizin Berlin, Berlin, Germany.
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.


Cardiovascular health (CVH) is a construct defined by the American Heart Association (AHA) as part of its 2020 Impact Goal definition. CVH has, until now, not been evaluated in Sub-Saharan African populations. The aim of this study was to investigate differences in the prevalence of ideal CVH and its constituent metrics among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in three European countries. The AHA definition of CVH is based on 7 metrics: smoking, body mass index, diet, physical activity, blood pressure, total cholesterol, and fasting plasma glucose. These were evaluated among 3510 Ghanaian adults (aged 25-70 years) residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin) in the multi-centre RODAM study. Differences between groups were assessed using logistic regression with adjustments for gender, age, and education. Only 0.3% of all participants met all 7 metrics of the AHA's definition of ideal CVH. Compared to rural Ghana (25.7%), the proportions and adjusted odds ratio (OR) of individuals who had 6-7 CVH metrics in the ideal category were substantially lower in urban Ghana, (7.5%; OR 0.204, 95% CI 0.15-0.29), Amsterdam (4.4%; 0.13, 0.08-0.19), Berlin (2.7%; 0.06, 0.03-0.11), and London (1.7%; 0.04, 0.02-0.09), respectively. The proportion of ideal CVH for the various metrics ranged from 96% for all sites in the smoking metric to below 6% in the diet metric. The proportion of ideal CVH is extremely low in Ghanaians, especially among those living in urban Ghana and Ghanaian migrants in Europe.


Cardiovascular disease; Ethnic minority groups; Europe; Ghana; Ideal cardiovascular health; Migration; RODAM study; Sub-Saharan Africa

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