CASE FINDING OF HYPERTENSION AT A SECONDARY HEALTH CARE FACILITY IN SOUTH-WEST NIGERIA

I.A. Azeez1 and B.O. Yusuf2

  1. State Hospital Oyo, Oyo State, Nigeria.
  2. Department of Environmental Science, University of Ibadan, Ibadan

ABSTRACT

Background: The prevalence of hypertension is higher in Semi-urban areas than in rural areas. There is a rising prevalence of hypertension in developing countries. Significant independent association has been found between age, family history and prevalence of hypertension according to the literature. This study sought to determine the prevalence of hypertension at the State Hospital Oyo and provide evidence for routine checks of blood pressure (BP) for adult patients.

Methods: A Cross-sectional study was conducted at the General Outpatient Clinic of the State Hospital Oyo. 350 adults between the ages of 18 and 70 years were recruited for the study. A total sampling technique was used to recruit consecutive patients until a sample size of 350 was achieved.

Results: The prevalence of hypertension was 102/350 = 29%. Thirty (29.70%) of respondents who were 55 years and above had systolic hypertension while 24 (23.80%) had normal BP (2 = 87.62, p-value = 0.0001). Majority (57.6%) of respondents who had tertiary education had normal blood pressure while 24 (20.3%) had systolic hypertension ( 2 = 39.88, p-value = 0.0001). Twenty one (36.8%s) of respondents who were obese had systolic hypertension while 16 (28.1%) had normal blood pressure (2 = 20.61 , p-value = 0.02). Thirteen (12.80%) of respondents who were 55 years and above had diastolic hypertension while a majority (58.40%) had normal BP (2 = 33.40, p-value = 0.0001).

Conclusions: Age, obesity and education were found to be risk factors for developing hypertension. However after adjusting for other variables, the predictor of risk of developing hypertension was age of respondents.

Keywords: Obesity, Age, Prevalence, Hypertension


INTRODUCTION

Hypertension is defined as a persistent systolic blood pressure (SBP) reading of 140 mmHg or greater and or a diastolic blood pressure (DBP) reading of 90 mmHg or greater.1,2 Hypertension is divided into two main categories: essential (primary) hypertension and secondary hypertension. Essential hypertension occurs in about 90% to 95% of the cases and is of unknown cause, while secondary hypertension occurs in the remaining 5% to 10% of the cases and are of known causes.3,4

Ugwuja et al found 23.2% prevalence rate and reported that age, consumption of red meat, body mass index (BMI), and the number of children in the family were associated with hypertension.5 Hypertension is a major risk factor for other cardiovascular diseases (CVDs).6,7 However, Suleiman reported a prevalence of 15.00% in a semi-urban community of South-South Nigeria.8 Asekun-Olarinmoye et al also reported 13.16% prevalence in a rural community in South-West Nigeria.9 According to a study conducted in Iraq the overall prevalence of hypertension was 26.5% (19.1% were known hypertensive and 7.4% were unrecognized hypertensive). Of the recognized hypertensive, only 25.4% were with controlled blood pressure. Significant independent association was found between age, family history of hypertension, education, type of the family, socioeconomic status and prevalence of hypertension. A substantial number of people with hypertension were unaware of their condition and more than one quarter of hypertensive patients (28.1%) were unrecognized10,11. Factors found to be related with hypertension were population group, older age, higher body mass index, higher fasting plasma glucose level, lower level of education and tobacco use. The socio-demographic factors significantly related with hypertension status were age, sex, education, religion, BMI, and marital status.12,13

The prevalence of hypertension was associated with family history of hypertension according to a work done by Iloh and Amadi. The prevalence of hypertension in primary care setting is showing an upward trend. However, the occurrence of hypertension is a reflection of not only family predisposition but interaction and clustering of sociobiological and behavioural factors according to Iloh and Amadi 14. There is a rising prevalence of hypertension and diabetes mellitus in rural communities in Southern Nigeria. Intensive health education and community surveillance programmes in rural communities is important to achieve prevention and control of non-communicable diseases in Nigeria.15

High prevalence of undiagnosed hypertension exists in Okparabe community in Southern Nigeria with associated elevated BMI values. 16Hypertension and stroke are important threats to the people in Sub-Sahara Africa. The prevalence of hypertension is higher in Semi-urban than in rural areas.17,18,19,20 Systolic and Diastolic hypertension increase with increasing age and higher in males than females.21 Weight reduction via dietary interventions and calorie restriction can reduce  Blood Pressure in the overweight and obese patients. Sodium chloride restriction, potassium and calcium supplements can improve the process of lowering Blood Pressure.22

According to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, normal blood pressure is less than 120/80mmHg. Pre-hypertension is blood pressure of 120-139/80-89mmHg. Prehypertension is not a disease category however it is a description to categorize individuals at high risk of developing hypertension, so that both patients and physicians are informed of this risk and encouraged to intervene and prevent the disease from developing. Pre-hypertensive people are not candidates for drug therapy rather they should be explicitly counseled to practice lifestyle modifications in order to reduce risk of developing hypertension in the future.

This study sort to determine the overall prevalence of hypertension, its determinants and to provide evidence for routine checks of blood pressure for patients attending General Outpatient Clinic at the State Hospital Oyo.

MATERIALS AND METHODS

A cross-sectional study was conducted from 1st of February 2016 to 31st of March 2016 at the General Outpatient Clinic of the State Hospital Oyo, Oyo State. Three hundred and fifty adults between the ages of 18 and 70 years were recruited for the study. A total sampling technique was used to recruit consecutive patients until a sample size of 350 was achieved. Inclusion criteria include consenting patients who were 18-70 years old.

Sample size was estimated using the formula:

formula

For the purpose of this study, a minimum of 338 patients had been recruited. 

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