Prevalence Of Hypertension In Nigeria Research Articles

Community Pharmacists and Promotion of Lifestyle Modification in Adults with Hypertension

Introduction The growing prevalence of hypertension is a problem of public health importance globally. Lifestyle modification is an important first-step in the management of hypertension requiring promotion by all healthcare professionals. However there is not enough focus on the contribution of pharmacists towards promotion of lifestyle modification (PLM) in the management of hypertension in Nigeria. Methods A phenomenological study involving in-depth interviews of 12 community pharmacists was conducted to explore how community pharmacists promote lifestyle modification in adults with hypertension Lagos, Nigeria and to develop a practice protocol for community pharmacists for guiding the practice of PLM. Participants were purposively selected as key knowledgeables who could give rich and nuanced insights about the phenomenon of PLM and an interview protocol was used to guide the interviews. Results From a thematic data analysis conducted, 7 themes emerged to categorize the practice of PLM by community pharmacists among hypertensive adults and the essence of a practice protocol. The themes pertaining to practice were cognitive factors, contextual factors, strategies, and self efficacy. From the perspectives of the participants, a practice protocol was developed that can serve as a guide to community pharmacists in Lagos while performing the role of PLM among adults with hypertension. Conclusion Community pharmacists are well positioned in communities to contribute to reducing the incidence and prevalence of hypertension in Nigeria. The availability of a practice protocol will enhance the performance of community pharmacists while promoting lifestyle modification and can help to standardize the practice of PLM. Key words: Hypertension, practice protocol, promotion of lifestyle modification, community pharmacists, phenomenology

Prevalence and correlates of undiagnosed hypertension among staff of a Nigerian university community.

Introductionthe prevalence of hypertension in Nigeria is high, with a considerable proportion of it being undiagnosed. Nevertheless, early identification of influencing variables for hypertension in different population groups is important for several reasons. This study aimed to determine the prevalence and correlates of undiagnosed hypertension among staff of a university community in Nigeria.Methodsa purposive sample of 281 staff of Bauchi State University, Gadau, Nigeria, fulfilled the inclusion criteria and were enrolled in this cross-sectional study. Demographics, blood pressure, height, weight, socioeconomic status and physical activity were measured. Diagnosis of hypertension was defined based on a systolic and diastolic blood pressure of ≥140 mmHg and ≥90 mmHg, respectively. Data obtained was analysed descriptively, and by means of Chi-square, univariate and multivariate statistics using SPSS v24 software.Resultsthe mean age and body mass index (BMI) of the participants was 34.5 years and 23.1 ± 5.17 Kg/m2, respectively. The prevalence rate of undiagnosed hypertension was 27.8%. Normotensives significantly differed from participants with undiagnosed hypertension in most of the clinical and demographic variables (p<0.05). Univariate and multivariate analyses revealed that a positive family history of hypertension had the highest odds of having undiagnosed hypertension (aOR: 0.833, 95%CI: 16.55-432.87, p= 0.000). Next, a higher BMI score (aOR: 0.425, 95%CI: 0.085-0.447, p= 0.000), male gender (aOR: 0.451, 95%CI: 0.141-0.829, p= 0.018), job cadre (aOR: 0.515, 95%CI: 0.073-0.550, p= 0.002) and low physical activity level (aOR: 0.572, 95%CI: 5.296-49.777, p=0.000) were other factors with about 50% odds for having undiagnosed hypertension among the participants. Lastly, smoking status and socioeconomic status of the participants were not significantly associated with undiagnosed hypertension (p>0.05).Conclusiona high percentage of the studied population have undiagnosed hypertension that is mainly associated with non-modifiable (especially positive family history) and a few modifiable risk factors. These variables can be used for early identification and in designing appropriate preventive strategies.

Anthropometric, socio-demographic and biochemical risk factors of hypertension in Lagos, Nigeria

ABSTRACT Background Hypertension is a major modifiable risk factor for cardiovascular diseases and all-cause death globally and in Africa. The prevalence of hypertension in Nigeria is 28.9%. In Nigeria, analytical studies to determine risk factors and potential biomarkers of hypertension are lacking. This study was conducted to determine lifestyle, anthropometric, socio-demographic, and biochemical risk factors associated with hypertension in Lagos, Nigeria. Method This case–control study was conducted among 410 participants, aged 18–65 years. A well-structured questionnaire was used to collect data from cases and controls. Anthropometric and blood pressure measurements were taken. Blood samples were also collected for biochemical analysis. Logistic regression analysis was used to determine risk factors associated with hypertension. Data obtained were analyzed using SPSS version 25.0. P-value less than 0.05 was considered statistically significant. Result In total, 205 hypertensive cases and 205 normotensive controls were recruited. The mean ± SD age of the participants was 39.25 ± 11.49 years. Overall, 180 (44%) of participants were female. Logistic regression analysis indicated that obesity (OR = 3.324, 95% CI = 1.693–6.527, P= 0.000), family history (OR = 2.861, 95% CI = 1.731–4.729, P= 0.000), hypercholesterolemia (OR = 2.940, 95% CI = 1.577–5.480, P= 0.001), insufficient fruits and vegetables intake (OR = 0.152, 95% CI = 0.085–0.273, P= 0.000), frequent intake of dietary salt (OR = 0.400, 95% CI = 0.198–0.810, P= 0.011), and smoking status (OR = 3.709, 95% CI = 1.061–12.964, P= 0.040) were significantly associated with hypertension. Conclusion Population-based approaches to reduce exposure to hypertension risk factors are required for effective prevention and control of hypertension and cardiovascular diseases in Lagos, Nigeria.

High prevalence of undiagnosed hypertension among men in North Central Nigeria: Results from the Healthy Beginning Initiative.

BackgroundThe prevalence of hypertension in Nigeria is high and growing. The burden and risk factor distribution also vary by geographical zone. Information about prevalence, risk factors and disease status awareness are needed to guide evidence based public health response at the national and sub- national levels.PurposeThis paper describes the prevalence of hypertension and its correlates, as well as hypertension status awareness among men in North Central, Nigeria.MethodsA cross sectional survey was administered to male partners of pregnant women participating in the Healthy Beginning Initiative program from 2016–2018. Information on socio-demographic characteristics, risk factors, physical measurement and blood pressure readings were collected using a standardized protocol. Data was analyzed with simple and multiple logistic regression.ResultsThe 6,538 men had a median age of 31 years [IQR: 26–37]. The prevalence of hypertension was 23.3% (95% CI: 22.3%-24.4%), while 46.7% had prehypertension. The odds of hypertension was associated with increasing age (OR:1.02, CI:1.01–1.03), being overweight (aOR:1.5,CI:1.3–1.8), being obese (aOR:2.6,CI:2.0–3.3), living in an urban area (aOR:1.6,CI:1.2–2.1), and alcohol use in the 30 days prior (aOR:1.2,CI:1.1–1.4). Overall, 4.5% (297/6,528) of participants had ever been told they have hypertension. Among the 23.3% (1,527/6,528) with hypertension, 7.1% (109/1,527) were aware of their disease status. Men aged 41–50 years (aOR: 1.8, CI: 1.0–3.3), and > 50 years (aOR: 2.2, CI: 1.1–4.3), had higher odds disease status awareness. Living in an urban area was associated with lower odds (aOR: 0.2, CI: 0.03–0.7) of hypertension status awareness.ConclusionThis study showed that hypertension is already a significant public health burden in this population and that disease awareness level is very low. Alcohol use and obesity were associated with hypertension, highlighting some modifiable cardiovascular disease risk factors that are prevalent in the study population. Taken together, these findings can inform the design of interventions for primary and secondary cardiovascular disease prevention in Nigeria and similar settings.

Removing the mask on hypertension (REMAH) study: Design; quality of blood pressure phenotypes and characteristics of the first 490 participants

Purpose: Previous studies that evaluated the prevalence of hypertension in Nigeria were either clinic based, non-standardized or did not include out-of-clinic blood pressure (BP) measurement.Materials and Methods: We selected a rural and an urban community in one state in each of the 6 geopolitical zones of Nigeria. Five consecutive BP of adults older than 18 years were measured in the clinic following which, each participant was provided with a home BP device to obtain duplicate morning and evening BP for 3 days.Result: Out of 556 invited from Anambra State, South-East Nigeria, 490 (88%) consented. Overall, more women participated in both rural (115 vs 61, p < .0001) and urban (213 vs 101; p < .0001) sites. About 35.9% of participants had their home BP monitored. Of the 4890 clinic BP readings, 29.8%, 16.3%, 16.6%, 16.4% and 20.8% ended in 0,2,4,6 and 8 digits respectively. Only 0.8% ended in odd numbers. Of the identical BP readings,5 (0.20%), 6 (0.25%), 56 (2.30%) and 316 (12.9%) SBP and 8 (0.33%), 17 (0.70%), 93 (3.80%), 319 (13.1%) DBP had no difference in five, four, three and two values of the five consecutive readings.Conclusion: REMAH is feasible and the quality of BP will ensure that the final results are robust.

Prevalence and risk factors of hypertension in Nigeria

Background: Literature abounds on prevalence of hypertension in Nigeria and urban area of Oyo state but none in Oke-Ogun geo-political zone which constitute 10 local governments out of the 33 in Oyo state, despite the fact that they have high genetic and environmental predisposition to developing high blood pressure. Objectives: The purpose of the study was to determine the prevalence of high blood pressure and associated risk factors among indigenes of Oke-Ogun, Oyo state. Method: A total of 10,000 respondents were recruited using proportionate sampling techniques. Hypertension was defined according to the eight Joint National Committee on the prevention, detection, evaluation, and treatment of hypertension - JNC-8 criteria. The fasting plasma glucose- FPG of the respondents were classified as normal (≤6mmol/l), pre-diabetes (6.1-6.9mmol/l), and diabetes (≥7mmol/l). BMI was calculated as weight (kg)/height (m2) and classified as malnutrition/underweight (<16-18.49), normal (18.5-24.9), overweight (25-29.9) and obese (30-≥40). Data were analyzed using descriptive statistics, Chi-square and binary logistic regression tests at p<0.05. Results: The mean systolic and diastolic blood pressure was 138±27.8, 86.13±14.4 respectively. The overall prevalence of hypertension was 38.5%. Over sixty-four percent (64.1%) were diabetics. 63.4% had no formal education. Majority (82.95%) earned less than N18, 000.00 per month and 43.3% had a family history of hypertension. Conclusions: There is high prevalence of hypertension among the people of Oke-Ogun, in Oyo state. Their low socio-economic status, low educational background, malnutrition and genetic predisposition were identified risk factors.

Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review.

BackgroundThe global burden of hypertension and other non-communicable diseases (NCDs) is rapidly increasing, and the African continent seems to be the most affected region in the world. The prevalence of hypertension in Nigeria forms a substantial portion of the total burden in Africa because of the large population of the country currently estimated to be over 170 million.ObjectiveThe purpose of this systematic review is to summarise up to date data on the prevalence and distribution of hypertension in Nigeria from prevalence studies.MethodsA search of the following databases: PubMed, EMBase and WHO cardiovascular InfoBase from 1968 till date was conducted to identify studies which provide estimates of prevalence of hypertension in Nigeria.ResultsThe search yielded a total of 1748 hits from which 45 relevant studies met the inclusion criteria for the review. The overall crude prevalence of hypertension ranged from 0.1% (95%CI:-0.1 to 0.3) to 17.5% (95% CI: 13.6 to 21.4) in children and 2.1% (95%CI: 1.4 to 2.8) to 47.2% (95%CI: 43.6 to 50.8) in adults depending on the benchmark used for diagnosis of hypertension, the setting in which the study was conducted, sex and ethnic group. The crude prevalence of hypertension ranged from 6.2% (95%CI: 4.0 to 8.4) to 48.9% (95%CI: 42.3 to 55.5) for men and 10% (95%CI: 8.1 to 12) to 47.3% (95%CI: 43 to 51.6%) for women. In most studies, prevalence of hypertension was higher in males than females. In addition, prevalence across urban and rural ranged from 9.5% (95%CI: 13.6 to 21.4) to 51.6% (95%CI: 49.8 to 53.4) and 4.8% (95%CI: 2.9 to 6.7) to 43% (95%CI: 42.1 to 43.9) respectively.ConclusionsThe prevalence of hypertension is high among the Nigerian population. Appropriate interventions need to be developed and implemented to reduce the preventable burden of hypertension especially at Primary Health Care Centres which is the first point of call for over 55% of the Nigerian population.

An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis.

Hypertension is a leading cause of morbidity and mortality in Africa, and Nigeria, the most populous country in the continent, hugely contributes to this burden. To provide an improved estimate of the prevalence and number of cases of hypertension in Nigeria based on the cut-off 'at least 140/90 mmHg', towards ensuring better awareness, control and policy response in the country. We conducted a systematic search of Medline, EMBASE and Global Health from January 1980 to December 2013 for population-based studies providing estimates on the prevalence of hypertension in Nigeria. From the extracted crude prevalence rates, we conducted a random-effects meta-analysis, and further estimated the overall awareness rate of hypertension in Nigeria, expressed as percentage of all hypertension cases. We applied a meta-regression epidemiological modelling, using United Nations population demographics for the years 2010 and 2030, to determine the prevalence and number of cases of hypertension in Nigeria for the 2 years. Our search returned 2260 publications, 27 of which met our selection criteria. From the random-effects meta-analysis, we estimated an overall hypertension prevalence of 28.9% (25.1, 32.8), with a prevalence of 29.5% (24.8, 34.3) among men and 25.0% (20.2, 29.7) among women. We estimated a prevalence of 30.6% (24.5, 36.6) and 26.4% (19.4, 33.4) among urban and rural dwellers, respectively. The pooled awareness rate of hypertension was 17.4% (11.4, 23.3). The overall mean SBP was 128.6 (125.5, 130.8) mmHg, and the DBP was 80.6 (78.5, 82.7) mmHg. From our modelling, we estimated about 20.8 million cases of hypertension in Nigeria among people aged at least 20 years in 2010, with a prevalence of 28.0% (24.6, 31.9) in both sexes - 30.7% (24.9, 33.7) among men and 25.2% (22.7, 31.9) among women. By 2030, we projected an increase to 39.1 million cases of hypertension among people aged at least 20 years with a prevalence of 30.8% (24.5, 33.7) in both sexes - 32.6% (27.3, 38.2) among men and 29.0% (21.9-32.2) among women. Our findings suggest the prevalence of hypertension is high in Nigeria, and the overall awareness of raised blood pressure among hypertension cases is low in the country. We hope this study will inform appropriate public health response towards reducing this burden.

Prevalence and risk factors for hypertension and association with ethnicity in Nigeria : results from a national survey : cardiovascular topics

SummaryBackgroundNon-communicable diseases are now a global priority. We report on the prevalence of hypertension and its risk factors, including ethnicity, in a nationally representative sample of Nigerian adults recruited to a survey of visual impairment.MethodsA multi-stage, stratified, cluster random sample with probability proportional to size procedures was used to obtain a nationally representative sample of 13 591 subjects aged ≥ 40 years. Of these, 13 504 (99.4%) had a blood pressure measurement.ResultsThe prevalence of hypertension was 44.9% [95% confidence interval (CI): 43.5–46.3%]. Increasing age, gender, urban residence and body mass index were independent risk factors (p < 0.001). The Kanuri ethnic group had the highest prevalence of hypertension (77.5%, 95% CI: 71.0–84.0%).ConclusionsThe high prevalence of hypertension in Nigeria is a cause for concern and suggests that it is inevitable that the impact of hypertension-related ill health is imminent, with the accompanying financial and societal costs to families and the state of Nigeria.

Left ventricular mass formulae and prevalence rates of echocardiographic left ventricular hypertrophy in Nigerians with essential hypertension

Background:Left ventricular hypertrophy (LVH) as a marker of cardiac damage in hypertension has important prognostic implications. With high prevalence of hypertension in Nigeria and the untoward effect of LVH, it is essential that the prevalence of LVH be determined.Aims:To determine prevalence of LVH and its severity in clinical practice among hypertensive patients referred for echocardiographic assessment in Nigeria.Materials and Methods:Devereux and Troy formulae were used to calculate echocardiographic LV mass (LVM) in 401 subjects and thereafter normalized to body surface area (BSA), heigth2 (ht2) and height2.7 (ht2.7) to define LVH to standard gender-specific thresholds.Results:Mean age was 53.22 ± 16.56 years (male = 53.18 ± 15.80; female = 53.27 ± 17.43; P = 0.958) with a male:female ratio of 1.13:1. Prevalence rates of LVH ranged between 38.9–51.3% using the Devereux Formula and 62.4–71.1% using the Troy formula. LVM/(ht2.7) using the Troy formula gave the highest prevalence rate of LVH. Majority of the patients with LVH had severe form of hypertrophy with the prevalence rates ranging from 22.3% (LVM/BSA; Devereux formula) to 47.1% (LVM/ht2.7; Troy formula).Conclusion:Prevalence of LVH by any echocardiographic criteria is high. There is a need to come to a consensus on the best formula and indexing variables, that will unify the reporting of LVH.

A meta analysis of prevalence rate of hypertension in Nigerian populations

This study aimed at synthesizing population-based studies on prevalence of hypertension in Nigeria from 1990 to 2009. General databases and subject-specific databases were searched for primary studies. Manuscripts of appropriate studies were retrieved. Based on some criteria, only eligible studies were included in the study. A total of 9 studies all from South-West region of Nigeria that fulfilled the inclusion criteria were retrieved. Prevalence of hypertension ranged from a minimum of 12.4% to a maximum of 34.8%. Combined prevalence rate of hypertension was 22% and with 95% confidence interval of 17 to 27%. There was also gender difference with respect to prevalence of hypertension as males had higher prevalence of hypertension compared to females. This study showed that prevalence of hypertension is high in Nigeria. There is a need to develop strategies to prevent, treat, and control hypertension effectively in Nigeria. Key words: Hypertension, prevalence, epidemiology, meta analysis.

High prevalence and low awareness of hypertension in a market population in enugu, Nigeria.

Background. A community-based study put the prevalence of hypertension in Nigeria at 32.8%. Market workers in Nigeria lead sedentary life style and often depend on salt-laden fast food while at work. Method. An unselected population of market workers were screened for hypertension and its risk factors by a pretested, structured questionnaire, clinical examination, and laboratory investigation. Hypertension was defined as BP ≥ 140 and/or ≥ 90 mmHg or being on drug therapy. Results. Forty-two percent of the screened population were hypertensive. Of this number, 70.6% did not know they were hypertensive before the screening. More males than females (P = .022) were hypertensive. Prevalence of hypertension increased with age from 5.4% in the age group <20 years to 80% in the age group ≥70 years. Conclusion. The prevalence of hypertension in market workers in this study was 42%, and the majority of them were unaware of their disease.