SKINFOLD MEASUREMENTS AS DETERMINANTS OF BLOOD PRESSURE LEVELS AMONG ADULT HYPERTENSIVES ATTENDING A SECONDARY HEALTHCARE CENTRE IN NIGERIA

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I.A. Azeez¹, B.I. Yusuf², A.A. Fasanmade³

1. Department of Family Medicine, University College Hospital, Ibadan, Nigeria.
2. Department of Environmental Health Sciences, College of Medicine, University of Ibadan, Nigeria.
3. Department of Medicine, College of Medicine, University of Ibadan, Nigeria.

Abstract

Background: The prevalence of obesity is increasing globally, making it a growing pandemic affecting adults and children. Obesity is associated with multiple morbidities and mortalities increasing the burden on the health care system.

Objective: There is inadequacy of data in Nigeria on the prevalence of obesity among adult patients with hypertension and adequate data on these conditions would help in their comprehensive management.

Methods: This was a cross-sectional study of 354 patients with hypertension, and the systematic sampling technique was used to recruit patients. The data were analysed using SPSS software version 23. Logistic regressions and linear regressions were done to determine the predictors of obesity and blood pressure levels.

Results: The mean age of the respondents was 52.60(SD±8.26) years and the prevalence of obesity was 53.1%. After adjusting for other variables, the predictors of obesity were female sex. Females were about six times more likely to be obese than males (OR=6.23; 95%CI= 3.16 – 12.32). For every 1 unit increase in triceps skinfold, there was a statistically significant increase in diastolic blood pressure by about 2.77units (95% C.I equals 2.63 to 2.91, p-value= 0.0001). Also, for every 1 unit increase in biceps skinfold, there was a statistically significant increase in systolic blood pressure by about 5.78 units (95% C.I equals 5.46- 6.10, p-value= 0.0001).

Conclusions: The prevalence of obesity was high, and the predictors of obesity were female sex. Triceps skinfold measurements were predictors of diastolic blood pressure while biceps skinfold measurements were predictors of systolic blood pressure.

Keywords: Blood pressure, Determinants, Hypertensives, Skinfold measurements

Introduction

Obesity is defined as excessive fat accumulation in the body resulting in impairment of health. The prevalence of obesity is increasing globally, making it a growing pandemic affecting adults and children. Even in the paediatric age group, the prevalence is growing which may predispose them to diabetes mellitus and cardiovascular diseases later in life. Physical inactivity and poor diet are the major risk factors for overweight and obesity. Based on the report of a Scottish Survey, 68.2% of males and 60.4% of females were overweight or obese.¹ In Scotland, the prevalence of overweight and obesity has increased over the years. By 2016, 65% of adults aged 16 and above were overweight, while 29% were obese.² In another study conducted among healthcare workers in a Scottish Survey, 69% of the nurses were overweight or obese. The prevalence of overweight and obesity was higher in the nurses compared with other healthcare professionals.³ About 67% of adults and 25% of children were obese in Scotland. Obesity can decrease the average life span by about 10 years.⁴ Lecube et al. reported low self-perception of obesity among the participants in a Spanish study. Family history, aging, eating of snacks, and alcohol intake were associated with being overweight and obese.⁵

In a study conducted in Nairobi, Kenya, to find out the predictors of overweight and obesity among women, high-calorie diets and sedentary lifestyles were the predisposing factors. This was a community study with a good methodology and hence it had good external validity.⁶ Initially, there were epidemics of communicable diseases but in the last few years, there has been an increasing prevalence of noncommunicable diseases of which obesity and overweight are included.⁷ In another study on the prevalence and pattern of overweight and obesity in a rural community in Nigeria, Adebayo et al. reported that 8.4% were obese and 20.8% were overweight.⁸ It was observed that the mode of nutrition in the rural communities was healthier and there were increased physical activities. Oladoyinbo ^{et al}. conducted a study in South-Western Nigeria among some traders at a market. The prevalence of obesity (26.7%) and abdominal obesity (52.0%s) were found to be high with female preponderance.⁹ In a study conducted in Jos, Nigeria, among chief executives, the prevalence of obesity was 38%, and the knowledge of obesity on the risk factor and associated complications was fair among the respondents. There is a need to counsel the chief executives of organizations to do regular check-ups and counsel them on the health problems related to obesity and overweight.¹⁰

Teachers are predisposed to physical inactivity and poor diets, especially in urban schools. In a study conducted in South-Southern Nigeria among primary school teachers, it was reported that the prevalence of hypertension was 27.4%, the prevalence of obesity was 80.8% and abdominal obesity was 84.1%.¹¹ Teachers in this part of Nigeria need health education on obesity and its accompanied co-morbidities to prevent the problems associated with them. In another study conducted to assess the gender variation in factors associated with overweight, obesity, and hypertension, Ajani et al. reported the crude prevalence of overweight and obesity to be 70.7%. The prevalence of general obesity was higher in females while the prevalence of abdominal obesity was higher in males. The prevalence of hypertension was higher in females than males.¹² There is inadequate data in Nigeria on the prevalence of obesity, obesity in patients with hypertension, and adequate data on this condition would help in their comprehensive management.