Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

A community programme to reduce salt intake and blood pressure in Ghana [ISRCTN88789643]

Cappuccio, FP; Kerry, SM; Micah, FB; Plange-Rhule, J; Eastwood, JB (2006) A community programme to reduce salt intake and blood pressure in Ghana [ISRCTN88789643]. BMC PUBLIC HEALTH, 6 (13). ISSN 1471-2458
SGUL Authors: Kerry, Sally Margaret Eastwood, John Bannister Plange-Rhule, Jacob

["document_typename_application/pdf; charset=binary" not defined] Published Version
Available under License St George's repository terms & conditions.

Download (270kB) | Preview


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.

Item Type: Article
Additional Information: Copyright: 2006 Cappuccio et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Adult, Aged, Blood Pressure, Blood Pressure Determination, Female, Ghana, Health Education, Health Promotion, Health Surveys, Humans, Male, Middle Aged, Program Evaluation, Sodium Chloride, Dietary, Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, SUB-SAHARAN AFRICA, DIETARY-SODIUM, CARDIOVASCULAR-DISEASE, DEVELOPING-COUNTRIES, OVERWEIGHT ADULTS, RANDOMIZED-TRIAL, HEART-DISEASE, GLOBAL BURDEN, WEST-AFRICA, WEIGHT-LOSS, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMC PUBLIC HEALTH
ISSN: 1471-2458
Related URLs:
24 January 2006Published
Web of Science ID: WOS:000235882600001
Publisher's version:

Actions (login required)

Edit Item Edit Item