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Charles Agyemang

Publications and source records attributed to Charles Agyemang.

11 recordsLinked to original sources
PubMed2026

A narrative review of what cohorts have taught us and how they have laid the foundation for much of our understanding of type 2 diabetes.

This narrative review provides a historical perspective on how observational research on type 2 diabetes has been developed and consolidated over the last 50 years and how well-designed cohort studies will provide us with knowledge for research and practice in the future and aid guideline development. We have included data from a large number of cohorts from every continent that have been used to study the development and/or progression of type 2 diabetes, including cohorts that are general population-based, disease-based, intervention-based and registry-based. We have structured the results from the past 50 years based on the following themes: diagnosis and screening, complications, risk factors and pathophysiology. We also discuss the strengths and weaknesses of observational research when compared with other research designs. Finally, we discuss the emerging and future directions for type 2 diabetes research using cohorts, which include novel developments, such as artificial intelligence, precision health and the exposome. We conclude that cohort research has significantly advanced our understanding of type 2 diabetes and aided guideline development, and complements experimental work, such as human randomised controlled trials and animal studies. Both approaches are essential and complementary in our pursuit to provide a more comprehensive understanding of the development and progression of type 2 diabetes, and to change dogma, practice and policies for better outcomes.

Humans↗
PubMed2006

Rural and urban differences in blood pressure and hypertension in Ghana, West Africa.

BACKGROUND: Hypertension, once rare in traditional African societies, is rapidly becoming a major public health problem. OBJECTIVE: To assess urban and rural differences in blood pressure (BP) and hypertension, and to determine factors associated with BP in this sub-Saharan Africa population. STUDY DESIGN: Cross-sectional survey. SETTING: Ashanti region of Ghana, West Africa. PARTICIPANTS: There were 1431 participants (644 males and 787 females). Of these, 578 were from the rural setting (237 males and 341 females) and 853 from the urban setting (407 males and 446 females). RESULTS: Age-adjusted mean systolic and diastolic BP levels were lower in rural men than in urban men (129/75 versus 133/78, P<0.001). The mean systolic and diastolic BP levels were also lower in rural women than in urban women (126/76 versus 131/80, P<0.001). After adjustments for age, the odds ratios (95% CI) for being hypertensive were 1.9 (1.3-2.9; P<0.01) for urban men and 1.9 (1.3-2.8; P<0.0001) for urban women. Urban women were more likely than rural women to be aware of their hypertensive condition (odds ratio 2.3, 95% CI, 1.2-4.2; P<0.001). Treatment and control of hypertension did not differ between the groups in either men or women. In multiple linear regression analysis, age, urban dwelling, BMI and heart rate were independently associated with systolic and diastolic BP in both men and women. Smoking and alcohol consumption were independently associated with systolic and diastolic BP but only in men. CONCLUSION: The findings of this study demonstrate that high BP (hypertension) is an important public health burden in both urban and rural settings in this sub-Saharan African population. Cost-effective public health measures are urgently needed to prevent high BP from becoming another public health burden.

Adult↗
PubMed2006

Validity of the single-item question on self-rated health status in first generation Turkish and Moroccans versus native Dutch in the Netherlands.

BACKGROUND: The single-item question on self-rated health has been used in many studies as a global measure of general health. It is unclear whether ethnic minority groups in the Netherlands attach the same meaning to the single-item question as the native Dutch people do. OBJECTIVE: To assess the validity of using the single-item question on self-rated health in comparing health status in native Dutch with first generation Turkish and Moroccan ethnic groups in the Netherlands. METHODS: The associations between self-reported chronic illnesses and self-rated health were used to examine convergent validity, and self-rated health and health care use for predictive validity using logistic regression analysis. RESULTS: In general, chronic illnesses were associated with fair health and poor health ratings in all the ethnic groups but there were important differences in associations between the groups. There were significant interactions between ethnicity and chronic illnesses on fair health, and poor health, independent of socio-demographical factors. There was also significant interaction between ethnicity and self-rated health on health care uses. These findings indicate that the meaning(s) attached to the single-item question differ between these ethnic groups. CONCLUSION: The study findings suggest that the use of the single-item question on self-rated health to compare native Dutch with the first generation Turkish and Moroccan ethnic groups is not valid. These findings imply that researchers need to be cautious about the interpretation of self-rated health ratings when comparing different ethnic groups. A qualitative research is needed to find out more about how these single-item ratings are being interpreted by Turkish and Moroccan elderly in the Netherlands.

Aged↗
PubMed2006

Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: The Amsterdam Health Monitor Survey.

OBJECTIVE: To assess ethnic differences in the prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands. DESIGN: A cross-sectional survey. PARTICIPANTS: A random sample of 1304 adults aged 18 years and over. Of these, 39.2% were Dutch, 33.2% were Turkish and 27.6% were Moroccan. RESULTS: The prevalence of hypertension was lower in Turkish (men 25.8% and women 22.2%) and Moroccan (men 26.1% and women 19.6%) than in Dutch individuals (men 48.8% and women 35.0%). Except for Turkish women, these differences persisted after adjustment for age and body mass index: the odds ratios (95% confidence interval) for being hypertensive were 0.47 (0.30-0.74; P < 0.001) for Turkish men, 0.48 (0.30-0.76; P < 0.001) for Moroccan men and 0.51 (0.28-0.94; P = 0.03) for Moroccan women. Only Moroccan hypertensive women were less likely than Dutch women to be aware of their condition 0.31 (0.11-0.81; P < 0.01) and to be treated 0.32 (0.12-0.88; P < 0.01) for hypertension. There were no differences in hypertension control between the ethnic groups in both men and women. CONCLUSION: The lower prevalence of hypertension among Moroccan men may contribute to the low cardiovascular disease (CVD) mortality reported among this group in the Netherlands. The differential risks in CVD mortality between Moroccan men and women may partly result from the lower hypertension awareness and treatment rates in Moroccan women. Strategies aimed at improving the detection and treatment of hypertension among Moroccan women may improve the sex disparity in cardiovascular mortality between Moroccan men and women in the Netherlands.

Adolescent↗
PubMed2005

Blood pressure patterns in rural, semi-urban and urban children in the Ashanti region of Ghana, West Africa.

BACKGROUND: High blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan/Africa. It is unclear whether this is reflected in children. The main purpose of this study was to assess blood pressure patterns among rural, semi-urban, and urban children and to determine the association of blood pressure with locality and body mass index (BMI) in this sub-Saharan Africa setting. METHODS: We conducted a cross-sectional survey among school children aged 8-16 years in the Ashanti region of Ghana (West-Africa). There were 1277 children in the study (616 boys and 661 females). Of these 214 were from rural, 296 from semi-urban and 767 from urban settings. RESULTS: Blood pressure increased with increasing age in rural, semi-urban and urban areas, and in both boys and girls. The rural boys had a lower systolic and diastolic blood pressure than semi-urban boys (104.7/62.3 vs. 109.2/66.5; p < 0.001) and lower systolic blood pressure than urban boys (104.7 vs. 107.6; p < 0.01). Girls had a higher blood pressure than boys (109.1/66.7 vs. 107.5/63.8; p < 0.01). With the exception of a lower diastolic blood pressure amongst rural girls, no differences were found between rural girls (107.4/64.4) and semi-urban girls (108.0/66.1) and urban girls (109.8/67.5). In multiple linear regression analysis, locality and BMI were independently associated with blood pressure in both boys and girls. CONCLUSION: These findings underscore the urgent need for public health measures to prevent increasing blood pressure and its sequelae from becoming another public health burden. More work on blood pressure in children in sub-Saharan African and other developing countries is needed to prevent high blood pressure from becoming a major burden in many of these countries.

Adolescent↗
PubMed2005

Does nocturnal blood pressure fall in people of African and South Asian descent differ from that in European white populations? A systematic review and meta-analysis.

OBJECTIVE: To assess whether nocturnal blood pressure fall in people of African (Black) and South Asian descent differs from that of the European origin white populations (White). METHODS: A systematic literature review was carried out using Medline 1966-2003 and Embase 1980-2003, and citations from references. The meta-analysis was performed using Cochrane review manager software (RevMan version 4.2; The Cochrane Collaboration, Oxford, UK). RESULTS: Seventeen studies were identified; 11 studies from the USA, one from the USA and Canada, and six studies from the United Kingdom. The mean percentage systolic blood pressure (SBP) nocturnal fall was below 10% (non-dipping) in 10 of 17 studies (59%) and the diastolic blood pressure (DBP) nocturnal fall was below 10% in four of 16 studies (25%) in Blacks compared with four of 17 studies (24%) in SBP and none in DBP nocturnal falls in Whites. Compared with Whites, Blacks had a significantly lower mean percentage nocturnal fall; the overall weighted mean difference in SBP was -3.07 (95% confidence interval, -3.81, -2.33; P < 0.00001) and in DBP was -2.98 (95% confidence interval, -3.97, -2.00; P < 0.00001). Two studies on South Asians showed a higher SBP but a similar mean DBP nocturnal fall compared with Whites. CONCLUSION: Smaller nocturnal blood pressure falls and a higher prevalence of non-dipping may contribute to the higher levels of hypertension complications seen in Black people. No such phenomenon was seen in South Asians but more research is needed to explore their higher stroke mortality.

Asian People↗
PubMed2005

Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study.

OBJECTIVE: To assess ethnic differences in prevalence, levels of awareness, treatment and control of hypertension among Dutch ethnic groups and to determine whether these differences are consistent with the UK findings. DESIGN: Cross-sectional survey. SETTING: South-east Amsterdam, The Netherlands. PARTICIPANTS: A random sample of 1383 non-institutional adults aged 35-60 years. Of these, 36.7% were White, 42% were Black and 21.3% were South Asian people. MAIN OUTCOME MEASURES: Prevalence of hypertension, rates of awareness, treatment, and control of hypertension. RESULTS: The Black and South Asian subjects had a higher prevalence of hypertension compared with White people. After adjustments for age, the odds ratios (95% confidence interval) for being hypertensive were 2.2 (1.4-3.4; P < 0.0001) and 3.8 (2.6-5.7; P < 0.0001) for Black men and women, respectively, and 1.7 (1.0-2.6; P = 0.039) and 2.8 (1.8-4.5; P < 0.0001) for South Asian men and women, compared with White people. There were no differences in awareness and pharmacological treatment of hypertension between the groups. However, Black hypertensive men 0.3 (0.1-0.7; P < 0.01) and women 0.5 (0.3-0.9; P < 0.05) were less likely to have their blood pressure adequately controlled compared with White people. CONCLUSION: The higher prevalence of hypertension found among Black and South Asian people in The Netherlands is consistent with the UK studies. However, the lower control rates and the similar levels of awareness and treatment of hypertension in Black Surinamese contrast with the higher rates reported in African Caribbeans in the UK. The rates for the South Asians in The Netherlands were relatively favourable compared to similar South Asian groups in the UK. These findings underscore the urgent need to develop strategies aimed at improving the prevention and control of hypertension, especially among Black people, in The Netherlands.

Adult↗
PubMed2005

Does the white-coat effect in people of African and South Asian descent differ from that in White people of European origin? A systematic review and meta-analysis.

OBJECTIVE: To assess whether the white-coat effect in people of African (Blacks) and South Asian descent differs from that of people of European origin (Whites), and if so, whether this explains demonstrated ethnic variations in blood pressure. METHODS: A systematic literature review was carried out using Medline 1966-2003, Embase 1980-2003, and citations from references. The meta-analysis was performed using the Cochrane review manager software (RevMan version 4.2; Oxford, UK). RESULTS: Eight studies were examined, four studies from the UK and four from the USA. The mean systolic and diastolic white-coat effect was similar in Blacks and Whites. The weighted mean difference in systolic white-coat effect was 0.31 [confidence interval 95% (CI)=-1.96, 2.57; P=0.79] and in diastolic white-coat effect was 0.18 (95% CI=-1.70, 1.35; P=0.82). Two studies reported on South Asians. Both systolic and diastolic white-coat effect was significantly lower in South Asians than in Whites; the weighted mean difference in systolic white-coat effect was -8.90 (95% CI=-13.04, -4.76; P<0.0001) and in diastolic white-coat effect was -4.66 (95% CI=-7.29, -2.03; P<0.0001). CONCLUSION: The blood pressure differences between Blacks and Whites are unlikely to be a result of variations in white-coat effect. In contrast, the slightly lower clinic blood pressure in some South Asian populations such as Bangladeshis might be partly caused by a low white-coat effect but more studies are needed in this subject.

Asian People↗
PubMed2005

Negro, Black, Black African, African Caribbean, African American or what? Labelling African origin populations in the health arena in the 21st century.

Broad terms such as Black, African, or Black African are entrenched in scientific writings although there is considerable diversity within African descent populations and such terms may be both offensive and inaccurate. This paper outlines the heterogeneity within African populations, and discusses the strengths and limitations of the term Black and related labels from epidemiological and public health perspectives in Europe and the USA. This paper calls for debate on appropriate terminologies for African descent populations and concludes with the proposals that (1) describing the population under consideration is of paramount importance (2) the word African origin or simply African is an appropriate and necessary prefix for an ethnic label, for example, African Caribbean or African Kenyan or African Surinamese (3) documents should define the ethnic labels (4) the label Black should be phased out except when used in political contexts.

Black People↗
PubMed2003

Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data.

The aim of the study was to review published evidence on whether blood pressure (BP) levels and the prevalence of hypertension are higher in adult populations of African descent living in the UK as compared to the white population. A systematic literature review was carried out using MEDLINE 1966-2002 and EMBASE 1980-2002 and citations from references. In all, 14 studies were identified. Nearly all studies were carried out in the London area. The data showed important differences between studies in terms of age and sex of samples, definition of African/black and methods of evaluating BP. A total of 10 studies reported higher mean systolic BPs, while 11 studies reported higher mean diastolic BPs in men from African descent compared to white men. In women, 10 of 12 studies reported higher systolic, and 10 of 12 studies reported higher diastolic BPs. For prevalence of hypertension, eight of 10 studies reported higher rates in men from African descent; eight of nine studies showed higher rates of hypertension in women from African descent. Overall, the most representative sample and up-to-date data came from the Health Survey for England '99. Ethnic group differences in BP were not present in the younger age groups. Women of African descent had higher BP and higher body mass index (BMI). In men of African descent high BP did not coincide with higher BMI. In conclusion, the reported higher rates of hypertension in people from African descent in the UK are confirmatory of the USA African-American and white comparisons. Variations in study methods, size and body composition, and in the mix of Afro-Caribbean and West African groups explain much of the inconsistent results in the UK studies.

Adult↗