INTRODUCTION:
Hypertension is a major contributor to cardiovascular disease (CVD) and a growing public health concern in low- and middle-income countries (LMICs), including Ghana. While public health economic models are widely used to evaluate prevention strategies, most are developed in high-income countries and may lack relevance in LMIC settings due to contextual differences. This study presents an adapted public health economic model for hypertension prevention in Ghana and explores the associated methodological challenges.

METHODS:
We adapted the School for Public Health Research (SPHR) Diabetes Prevention Model, an individual-level microsimulation model developed in England. The adapted model integrates demographic and behavioural risk factors, including body mass index, alcohol use, and salt intake, using data from the WHO Study on global AGEing and adult health (SAGE) and the 2014 Ghana Demographic and Health Survey (GDHS). Cardiovascular risk was estimated using WHO CVD risk charts, and cost data were sourced from local literature and adjusted to 2025 values. The model was structured for probabilistic sensitivity analysis to capture uncertainty in local data inputs.

RESULTS:
Base-case results estimate an average per-person cost of $1162.32 associated with hypertension over a lifetime, corresponding with 3.40 years lost due to premature death or disability. Behavioural interventions targeting salt and alcohol consumption have the potential to avert disability-adjusted life years (DALYs) and reduce healthcare costs. Key adaptation challenges included limited longitudinal data, missing values, and potential bias due to reliance on observational or self-reported data.

CONCLUSIONS:
Adapting a validated model to the Ghanaian context demonstrates that public health economic models can provide valuable evidence for decision-making in LMICs. However, improved data quality and tailored modelling approaches are essential to enhance the robustness and relevance of such evaluations for policy planning.