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The Kumasi Study



The prevalence of hypertension is highest amongst people of African descent living in the industrialised countries and in sub-Saharan Africa, and it is the most important factor leading to stroke and chronic renal disease in those countries. Hypertension is becoming a public health priority even in sub-Saharan Africa where detection and appropriate management of hypertension are still not widely available. Salt intake is an important determinant of population blood pressure. In addition, salt intake is a modifiable environmental factor and it is possible by nutritional education to reduce population blood pressure. People of African descent are particularly sensitive to the blood pressure-lowering effects of dietary salt reduction. Populations in sub-Saharan Africa are particularly suited for such an intervention because the majority of the dietary salt is purchased as common salt and added to the food during cooking or at table.

The project aims at reducing dietary salt intake by means of health education and promotion in a population in West Africa. It also aims at reducing, as a consequence, the average level of blood pressure in such a population.

The project is a community-based cluster randomised trial of dietary salt reduction by education and health promotion involving twelve communities in the Ejisu-Juabeng (rural) and Kumasi (semi-Urban) Districts of the Ashanti Region of Ghana. It involves the recruitment of participants into one of two arms of the study (‘control’ and ‘intervention’ clusters). The intervention cluster of villages will be exposed to a vigorous campaign of nutritional education to reduce salt intake. There will be re-enforcement of the educational activities throughout the six months’ period of the intervention.


Study team



  1. Cappuccio FP, Kerry SM, Micah FB, Plange-Rhule J, Eastwood JB. A community programme to reduce salt intake and blood pressure in Ghana (ISRCTN 88789643). BMC Public Health 2006;6:13.
  2. Harries TH, Twumasi-Abosi V, Plange-Rhule J, Cappuccio FP. Hypertension management in Kumasi: barriers and prejudice? J Hum Hypertens 2005; 19: 975-7
  3. Kerry SM, Micah FB, Plange-Rhule J, Eastwood JB, Cappuccio FP. Blood pressure and body mass index in lean rural and semi-urban subjects in West Africa. J Hypertens 2005;23:1645-1651.
  4. Kerry SM, Cappuccio FP, Emmett L, Plange-Rhule J, Eastwood JB. Reducing selection bias in a cluster randomised trial in West African villages. Clinical Trials 2005;2:125-9
  5. Kerry SM, Emmett L, Micah FB, Martin-Peprah R, Antwi S, Phillips RO, Plange-Rhule J, Eastwood JB, Cappuccio FP. Rural and semi-urban differences in salt intake, and its dietary sources, in Ashanti, West Africa. Ethn Dis 2005;15:33-39.
  6. Cappuccio FP, Micah FB, Emmett L, Kerry SM, Antwi S, Martin-Peprah R, Phillips RO, Plange-Rhule J, Eastwood JB. Prevalence, detection, management and control of hypertension in Ashanti, West Africa. Hypertension 2004;43:1017-22.
  7. Cappuccio FP. Epidemiologic transition, migration and cardiovascular disease. Int J Epidemiol 2004;33:387-8.
  8. Plange-Rhule J, Cappuccio FP, Emmett L, Kerry SM, Edmundson AR, Acheampong D, Eastwood JB. A community study of health promotion in rural West Africa: details of a household survey and population census. Q J Med 2002;95:1-6.
  9. Dong YB, Plange-Rhule J, Owusu I, Micah F, Eastwood JB, Carter ND, Saggar-Malik AK, Cappuccio FP, Jeffery S. T594M mutation of the beta-subunit of the epithelial sodium channel in Ghanaian populations from Kumasi and London and a possible association with hypertension. Genetic Testing 2002;6:63-5.
  10. Cappuccio FP, Plange-Rhule J, Phillips RO, Eastwood JB. Prevention of hypertension and stroke in Africa. Lancet 2000;356:677-8.
  11. Plange-Rhule J, Phillips R, Acheampong JW, Saggar-Malik AK, Cappuccio FP, Eastwood JB. Hypertension and renal failure in Kumasi, Ghana. J Hum Hypert 1999;13:37-40.

 ISHIB2003 Distinguished Research Award

This award is presented annually to an ISHIB member who has demonstrated exceptional work reducing health disparities in ethnic minority populations.

ISHIB2003 Awards Winner
Distinguished Researcher
Francesco P. Cappuccio, MD, MSc
St. George's Hospital Medical School
London, England


Principal Investigator:

F.P. Cappuccio (WMS)

J.B. Eastwood,
S.M. Kerry (SGUL);
J. Plange-Rhule (KATH, Kumasi, Ghana)
Clinical Fellows:
F.B. Micah
S. Antwi
R.O. Phillips
R. Martin-Prepah
(KATH, Kumasi, Ghana)


The Association of Physicians of Great Britain & Ireland
The Wellcome Trust