System Drivers of Hypertension Control in Africa: A Beta Regression and Dynamic Factor Modeling Approach
Francis Ayiah-Mensah
*
Department of Mathematics, Statistics and Actuarial Science, Takoradi Technical University, Sekondi-Takoradi, Ghana.
Senyefia Bosson-Amedenu
Department of Mathematics, Statistics and Actuarial Science, Takoradi Technical University, Sekondi-Takoradi, Ghana.
Gabriel Okyere
Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
George Oduro-Okyireh
Department of Interdisciplinary Studies, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong-Asanti, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Noncommunicable Disease (NCD) Risk Factor Collaboration supplied population-representative data detailing hypertension management in Africa for individuals aged 30 to 79 years from 1990-2019. Ten cascade indicators were analysed via both age-standardized and crude metrics. Beta regression with a logit link and a continuous function of year was used to assess the effects of sex on each outcome. A one-factor state‒space model integrated mixed temporal dynamics and enabled forecasts extending to 2030, adding policy scenario that enhances diagnosis and treatment by 10 percentage points. Compared with men, women were more likely to receive therapy and control on both metrics (odds ratios of approximately 2.2 and 2.1). Diagnosis indicated negligible benefits for females. Women presented a greater prevalence of untreated stage-2 disease, although they demonstrated superior control. A prevalent latent factor indicated significant persistence (ϕ approximately 0.98). By 2030, the scenario indicated a significant increase in control, particularly for women. Findings also indicate the need for increased capacity to prevent the onset of severe uncontrolled disease. The results reveal a dual approach of treatment and management while simultaneously emphasizing diagnosis and intervention. It is recommended to implement a cohesive data pipeline featuring monthly joint-factor dashboards and prompt remedial measures linked to control and untreated stage-2 indications.
Keywords: Hypertension diagnosis, hypertension treatment, hypertension forecasting, hypertension cascade, hypertension sex disparities