1
|
Nwoke OC, Nubila NI, Ekowo OE, Nwoke NC, Okafor EN, Anakwue RC. Prevalence of Prehypertension, Hypertension, and its Determinants Among Young Adults in Enugu State, Nigeria. Niger Med J 2024; 65:241-254. [PMID: 39022562 PMCID: PMC11249480 DOI: 10.60787/nmj-v65i3-404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Emerging epidemiological data suggest that Hypertension (HTN) has become a significant public health challenge in sub-Saharan Africa. HTN in young adults is a problem lacking relevant attention because it is still erroneously considered a disease of the old. This study aimed to determine the prevalence of hypertension and its associated risk factors in undergraduate medical students at the University of Nigeria, Enugu Campus, Enugu State, Nigeria. Methodology This was a cross-sectional study conducted between March and April 2021. This study recruited 279 consenting medical students (136 males and 143 females) aged 18-35 years. They were administered with a structured questionnaire. Data on sociodemographic information and risk factors for hypertension were collected. Blood pressure, waist circumference, weight, height, and body mass index were measured using standard methods. All data collected were carried out following the Institutional ethical guidelines and that of the Helsinki as revised in 2000. Data were analyzed using IBM Statistical Package for Social Sciences version 25, and statistical tools employed include descriptive statistics and Chi tests. Results were recorded as mean standard deviation, and statistical significance was taken at p<0.05. Results This present study has shown a prevalence rate of 19.93% for hypertension. Isolated diastolic hypertension constituted a greater burden with a prevalence of 13.65% than systolic Hypertension (0.74%) and systolic-diastolic Hypertension 5.4%. The prevalence of prehypertension was 48.7%, with a higher incidence observed in females (25.8%), individuals aged 21-25 years (26.4), and those with normal BMI (35.1%). A significant association was observed between the stage of hypertension and gender (p = 0.005), and age category (p = 0.037). Of the examined cohort, 7.75% were underweight, 16.5% overweight, and 2.2% obese. Notably, systolic, and diastolic blood pressure, weight, as well as waist circumference showed significant (p = 0.01, p = 0.007, p =0.01 and p<0.0001 respectively) increases concomitant with advancing age. Conclusion There is an increased prevalence of prehypertension and hypertension among young adults. This calls for a comprehensive national screening, public enlightenment, and targeted prevention programs that foster healthy lifestyle behaviours, physical activity, and healthy eating among students.
Collapse
Affiliation(s)
- Obinna C Nwoke
- Department of Pharmacology and Therapeutics, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Nkoyo I Nubila
- Department of Pharmacology and Therapeutics, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Onyekachi E Ekowo
- Acute Medicine Department, Darent Valley Hospital, Dartford, United Kingdom
| | | | - Edwin N Okafor
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Raphael C Anakwue
- Department of Pharmacology and Therapeutics, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria
| |
Collapse
|
2
|
Papka NY, Babaniyi IB, Aikhionbare HA, Oladele JT, Chinawa JM. Blood Pressure Pattern and Prevalence of Hypertension amongst Apparently Healthy Primary School Pupils in Abuja, Nigeria. Niger Postgrad Med J 2024; 31:111-117. [PMID: 38826014 DOI: 10.4103/npmj.npmj_254_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/25/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVES The objective of this study was to determine the blood pressure (BP) pattern and prevalence of hypertension amongst apparently healthy primary school pupils in Abuja. METHODOLOGY This was a descriptive, cross-sectional study carried out on apparently healthy primary school children aged 6-12 years. BP was measured using a standard mercury sphygmomanometer according to standard guidelines. Data were analysed using SPSS version 17.0. Pearson's correlation coefficient (r) and analysis of variance were used to determine the relationship between BP and various variables where applicable. P = 0.05 was considered statistically significant. RESULTS Out of 1011 pupils recruited for the study, 457 (42.2%) were male. The mean systolic and diastolic BP (SBP and DBP) increased significantly with age from 94.5 mmHg to 101.0 mmHg and from 61.5 mmHg to 65.3 mmHg from 6 to 12 years for SBP and DBP, respectively (P < 0.05). The prevalence of high BP was 9.1%. Age was the only predictor of SBP (β = -0.629, 95% confidence interval [CI] -1.115, -0.142), while age, height and body mass index (BMI) were the predictors of DBP (β = -0.686, 95% CI of -1.152, -0.221; β = 0.490, 95% CI of 0.172, 0.809; β = 1.753, 95% CI of 0.374, 3.160) for age, height and BMI, respectively, at P < 0.05. CONCLUSION The predictors of SBP and DBP as shown in this study support the recommendations by various reports for taking body size into consideration in developing reference values for various populations. Age and body size are important determinants of BP in children. Its measurement should be encouraged in schools.
Collapse
Affiliation(s)
| | | | - Henry A Aikhionbare
- Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | | | | |
Collapse
|
3
|
Mukunya D, Musaba MW, Nambozo B, Oguttu F, Makoko BT, Napyo A, Nantale R, Wani S, Tumuhamye J, Auma P, Atim K, Wamulugwa J, Nahurira D, Okello D, Ssegawa L, Wandabwa J, Kiguli S, Chebet M. Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study. Clin Hypertens 2024; 30:4. [PMID: 38297357 PMCID: PMC10832100 DOI: 10.1186/s40885-023-00261-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/24/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Globally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour. METHODS We followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure. RESULTS The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6-36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01-5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16-6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00-8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure. CONCLUSION Our findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.
Collapse
Affiliation(s)
- David Mukunya
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
- Department of Research, Nikao Medical Center, P.O. Box 10005, Kampala, Uganda
| | - Milton W Musaba
- Department of Obstetrics and Gynecology, Busitema University, P.O. Box 1460, Mbale, Uganda
- Busitema University Centre of Excellency for Maternal Reproductive and Child Health, Mbale, Uganda
| | - Brendah Nambozo
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda.
| | - Faith Oguttu
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Brian Tonny Makoko
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Agnes Napyo
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Ritah Nantale
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
- Busitema University Centre of Excellency for Maternal Reproductive and Child Health, Mbale, Uganda
| | - Solomon Wani
- Department of Community and Public Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| | | | - Prossy Auma
- Department of Obstetrics and Gynecology, Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - Ketty Atim
- Department of Obstetrics and Gynecology, Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - Joan Wamulugwa
- Department of Pediatrics, Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - Doreck Nahurira
- Department of Obstetrics and Gynecology, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Dedan Okello
- Department of Pediatrics and Child Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Lawrence Ssegawa
- Department of Research, Sanyu Africa Research Institute, P.O. Box 2190, Mbale, Uganda
| | - Julius Wandabwa
- Department of Obstetrics and Gynecology, Busitema University, P.O. Box 1460, Mbale, Uganda
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Martin Chebet
- Department of Pediatrics and Child Health, Busitema University, P.O. Box 1460, Mbale, Uganda
| |
Collapse
|
4
|
Nsanya MK, Abramson R, Kisigo GA, Hickner A, Nyanza EC, Peck RN, Kapiga SH. Hypertension among adolescents in sub-Saharan Africa: a systematic review. Front Cardiovasc Med 2023; 10:1251817. [PMID: 38155990 PMCID: PMC10754047 DOI: 10.3389/fcvm.2023.1251817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/18/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA. Methods We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/. Results We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population. Conclusion The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN. Systematic Review Registration https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).
Collapse
Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Rachel Abramson
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Godfrey A Kisigo
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andy Hickner
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Elias C Nyanza
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medicine - Cornell University, New York, NY, United States
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Saidi H Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
5
|
Kamdem F, Bika Léle EC, Hamadou B, Obe Meyong MAP, Fenkeu Kweban J, Moussa O, Mouliom S, Viché L, Ngoté H, Kenmegne C, Ndom Ebongue MS, Djibrilla S, Dzudié A. Prevalence and risk factors of pre-hypertension and high blood pressure among adolescents in Cameroonian schools. J Clin Hypertens (Greenwich) 2023; 25:845-852. [PMID: 37561361 PMCID: PMC10497023 DOI: 10.1111/jch.14711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
Blood pressure (BP) is the main driver of mortality with 12.8% of all deaths worldwide. Adolescents are not spared, precisely in Cameroon where they constitute more than half of its population. The objective of our work was to describe the prevalence and risk factors of pre-hypertension and high blood pressure (HBP) among adolescents in Cameroonian schools. Descriptive study over 5 months; from January to May 2019. The study population consisted of students from private and public schools in the city of Douala. Sociodemographic, anthropometric, and personal background data were collected. Physical activity (PA) was assessed using the short International Physical Activity Questionnaire (IPAQ). Multivariate logistic regression was used to determine factors associated with pre-hypertension and HBP. Differences were considered significant for p < .05. We recruited 771 students with an average age of 16 ± 1 years with female predominance (51.4%). The prevalences of pre-hypertension and HBP were 6.6% and 3%, respectively. Overweight/obesity (OR = 4.6; p < .0001), hyperglycemia [(OR = 4.06; p = .001)] physical inactivity (OR = 1.85; p = .019), and public institutions (OR = 1.87; p = .02) were associated with pre-hypertension. Similarly, overweight/obesity (OR = 2.99; p = .022), hyperglycemia (OR = 14.05; p < .0001), and physical inactivity (OR = 8.58; p < .0001) were correlated with HBP. Pre-hypertension and HBP are high in Cameroonian school adolescents and their risk factors are overweight/obesity, hyperglycemia, and physical inactivity.
Collapse
Affiliation(s)
- Felicite Kamdem
- Department of Internal MedicineDouala General HospitalDoualaCameroon
- Faculty of Medicine and Pharmaceutical SciencesUniversity of DoualaDoualaCameroon
| | - Elysée Claude Bika Léle
- Physiology and Medicine of Physical Activities and Sports UnitUniversity of DoualaDoualaCameroon
| | - Ba Hamadou
- Faculty of Medicine and Biomedical SciencesUniversity of Yaoundé IDoualaCameroon
| | | | | | - Oumarou Moussa
- Department of Internal MedicineDouala General HospitalDoualaCameroon
| | - Sidick Mouliom
- Department of Internal MedicineDouala General HospitalDoualaCameroon
- Faculty of Medicine and Pharmaceutical SciencesUniversity of DoualaDoualaCameroon
| | - Lade Viché
- Department of Internal MedicineDouala General HospitalDoualaCameroon
- Faculty of Medicine and Biomedical SciencesUniversity of N'GaoundéréDoualaCameroon
| | - Henri Ngoté
- Department of Internal MedicineDouala General HospitalDoualaCameroon
| | - Caroline Kenmegne
- Department of Internal MedicineDouala General HospitalDoualaCameroon
| | | | | | - Anastase Dzudié
- Department of Internal MedicineDouala General HospitalDoualaCameroon
- Physiology and Medicine of Physical Activities and Sports UnitUniversity of DoualaDoualaCameroon
| |
Collapse
|
6
|
Chen A, Waite L, Mocumbi AO, Chan YK, Beilby J, Ojji DB, Stewart S. Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health 2023; 11:e1238-e1248. [PMID: 37474231 DOI: 10.1016/s2214-109x(23)00218-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa. METHODS In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948). FINDINGS We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, pheterogeneity<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; pheterogeneity<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; pheterogeneity<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; pheterogeneity<0·0001). INTERPRETATION To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region. FUNDING None.
Collapse
Affiliation(s)
| | - Laura Waite
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Ana O Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Justin Beilby
- Torrens University Australia, Adelaide, SA, Australia
| | - Dike B Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Simon Stewart
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa; Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
| |
Collapse
|
7
|
Atoh I, Ezeogu J, Ekure E, Omokhodion SI, Njokanma FO. Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria. Front Pediatr 2023; 11:1184320. [PMID: 37425261 PMCID: PMC10326546 DOI: 10.3389/fped.2023.1184320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Adolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the impact of the 2017 American Academy of Pediatrics (AAP) Clinical Guideline on the prevalence of high blood pressure among adolescents when compared to the 2004 Fourth Report. Methodology A descriptive cross-sectional study was conducted from August 2020 to December 2020. The selection of 1,490 students, 10-19 years old, was by a two-stage sampling technique. Socio-demographic information and relevant clinical data were obtained using a structured questionnaire. Blood pressure was measured according to standard protocol. Categorical and numerical variables were summarized using frequency, percentages, mean, and standard deviation. The McNemar-Bowker test of symmetry was used to compare the blood pressure values in the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The Kappa statistic was used to test for the degree of agreement between the 2004 Fourth Report and the 2017 AAP Clinical Guideline. Results The prevalence rates of high blood pressure, elevated blood pressure, and hypertension among adolescents were 26.7%, 13.8%, and 12.9%, respectively, using the 2017 AAP Clinical Guideline, and 14.5%, 6.1%, and 8.4%, respectively, using the 2004 Fourth Report. The degree of agreement between the 2004 and 2017 guidelines with respect to the classification of blood pressure was 84.8%. The Kappa statistic was 0.71 (CI: 0.67-0.75). The impact of this was a 12.2%, 7.7%, and 4.5% increase in the prevalence of high blood pressure, elevated blood pressure, and hypertension, respectively, using the 2017 AAP Clinical Guideline. Conclusion The 2017 AAP Clinical Guideline detects a greater proportion of high blood pressure among adolescents. The adoption of this new guideline in clinical practice and its use in the routine screening of high blood pressure among adolescents is recommended.
Collapse
Affiliation(s)
- Ifeoma Atoh
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Joseph Ezeogu
- Department of Paediatrics, Federal University Teaching Hospital Owerri, Owerri, Nigeria
| | - Ekanem Ekure
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | | |
Collapse
|
8
|
Raina R, Khooblall A, Shah R, Vijayvargiya N, Khooblall P, Sharma B, Datla N, Narang A, Yerigeri K, Melachuri M, Kusumi K. Cardiovascular implications in adolescent and young adult hypertension. Rev Cardiovasc Med 2022; 23:166. [PMID: 39077603 PMCID: PMC11273899 DOI: 10.31083/j.rcm2305166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 08/02/2023] Open
Abstract
Background Hypertension is one of the most prevalent diseases in the United States, affecting an estimated 3.5% of children and adolescents. It can be adversely affect most organ systems but is particularly detrimental to the heart and vascular systems. The repercussions can be gauged through well-established measures of cardiovascular function including left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), carotid intima media thickness (cIMT), and aortic stiffness. Cardiovascular function is also affected by underlying etiologies of hypertension including chronic kidney disease, polycystic kidney disease, coarctation of the aorta, adrenal disorders, renal artery stenosis, obstructive sleep apnea, as well as various drugs and medications (decongestants, stimulants, Non-steroidal Anti-inflammatory Drugs (NSAIDs), and steroids). Methods An exhaustive literature search was conducted for clinical data regarding pediatric hypertension. Sixty-seven articles were incorporated with data on 189,477 subjects total. The data was then extracted and categorized as relating to hypertension incidence, LVMI, LVH, cIMT, and/or aortic stiffness. Results The prevalence of pediatric ( < 18 years) hypertension extracted from 47 studies from 1994 to 2018 averaged 4%. The LVMI assessed over 7 studies (n = 661) averaged 39.3 g/ m 2.7 in the hypertensive cohort and 30.1 g/ m 2.7 in the control cohort. The cIMT assessed over 7 studies (n = 580) averaged 0.55 mm in the hypertensive cohort and 0.49 mm in the control cohort. Ambulatory arterial stiffness parameters assessed over 5 studies (n = 573) in the normotensive cohort averaged 99.73 mmHg, 69.81 mmHg, 76.85 mmHg, and 46.90 mmHg, for SBP, DBP, MAP, and PP respectively. Ambulatory arterial stiffness parameters assessed over 5 studies (n = 573) in the hypertensive cohort averaged 129.56 mmHg, 73.69 mmHg, 95.08 mmHg, and 56.80 mmHg, for SBP, DBP, MAP, and PP respectively. Conclusions The significance of pediatric hypertension is emphasized by evidence of early cardiovascular disease as demonstrated by non-invasive measures including cIMT and arterial stiffness parameters, and target organ damage and including LVH and LVMI factors. Thus, early diagnosis and treatment of high blood pressure is paramount for improving long term cardiovascular health and preventing long term morbidity and mortality.
Collapse
Affiliation(s)
- Rupesh Raina
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
- Department of Nephrology, Akron Children’s Hospital, Akron, OH 44308, USA
| | - Amrit Khooblall
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
| | - Raghav Shah
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
| | - Nina Vijayvargiya
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
| | - Prajit Khooblall
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Bhavya Sharma
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Nikhil Datla
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Aarushi Narang
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
| | - Keval Yerigeri
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Manasa Melachuri
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Kirsten Kusumi
- Department of Pediatric Nephrology, Akron Children's Hospital, Akron, OH 44308, USA
| |
Collapse
|
9
|
|
10
|
Ayogu RNB, Nwodo CJ. Epidemiological characteristics of hypertension, impaired fasting capillary glucose and their comorbidity: a retrospective cross-sectional population-based study of rural adolescents in Southeast Nigeria. BMJ Open 2021; 11:e041481. [PMID: 33952534 PMCID: PMC8103371 DOI: 10.1136/bmjopen-2020-041481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To assess the prevalence of hypertension, impaired fasting capillary glucose (IFCG) and coexistence of both as well as determinants of these conditions among rural adolescents. DESIGN A retrospective cross-sectional population-based study. SETTING Three rural communities in southeast Nigeria. PARTICIPANTS A total of 401 adolescents (10 - 19 years) selected through a five-stage sampling technique completed the study. Sick adolescents, pregnant and nursing adolescent mothers were excluded. PRIMARY OUTCOME MEASURES Prevalence and determinants of hypertension, IFCG and comorbidity of both were assessed through weight, height, blood pressure, fasting capillary glucose measurements and statistical analysis. RESULTS Prehypertension (10.7%), hypertension alone (12.7%), IFCG alone (11.0%), diabetes (0.2%) and hypertension with IFCG (6.2%) were prevalent among the adolescents. The adolescents aged 15 - 19 years were less likely to be affected by hypertension alone (adjusted OR (AOR)=0.36, 95% CI 0.18 to 0.74, p<0.01). The likelihood of having hypertension alone was three times higher among those who smoked any substance (AOR=3.43, 95% CI 1.34 to 8.78, p<0.05) and 2.85 times higher among those who consumed alcohol (AOR=2.85, 95% CI 1.33 to 6.10, p<0.01). Meal skipping (AOR=2.69, 95% CI 1.16 to 6.25, p<0.05), consumption of fried/baked snacks (AOR=15.46, 95% CI 1.62 to 147.37, p<0.05) and vegetables (AOR=2.27, 95% CI 1.11 to 4.66, p<0.05) were also significant risk factors of hypertension alone. Skipping meals (AOR=2.15, 95% CI 0. 93 to 4.99, p>0.05) and longer than 7 hours of night sleep (AOR=1.88, 95% CI 0.94 TO 3.73, p>0.05) increased the risk of IFCG alone by twofold. Female adolescents (AOR=0.29, 95% CI 0.10 to 0.78, p<0.05) and those who consumed fried/baked snacks (AOR=0.09, 95% CI 0.02 to 0.37, p<0.01) were less likely to have hypertension with IFPG than males and those who consumed non-fried/baked snacks, respectively. CONCLUSION This study reported relatively low prevalence of hypertension alone, IFCG alone, hypertension with IFCG and epidemiological characteristics that can become focus of interventions to curtail the emergence of cardiovascular events at an early age. Awareness creation through health and nutrition education is emphasised.
Collapse
Affiliation(s)
- Rufina N B Ayogu
- Department of Nutrition and Dietetics, University of Nigeria Faculty of Agriculture, Nsukka, Nigeria
| | - Chinenye Juliet Nwodo
- Department of Nutrition and Dietetics, University of Nigeria Faculty of Agriculture, Nsukka, Nigeria
| |
Collapse
|
11
|
Nsanya MK, Ayieko P, Hashim R, Mgema E, Fitzgerald D, Kapiga S, Peck RN. Sustained high blood pressure and 24-h ambulatory blood pressure monitoring in Tanzanian adolescents. Sci Rep 2021; 11:8397. [PMID: 33864003 PMCID: PMC8052360 DOI: 10.1038/s41598-021-87996-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/30/2021] [Indexed: 12/20/2022] Open
Abstract
Estimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1-4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.
Collapse
Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania.
| | - Philip Ayieko
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Ezekiel Mgema
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | | | - Saidi Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medical College, New York, USA
| |
Collapse
|
12
|
Sungwa EE, Kibona SE, Dika HI, Laisser RM, Gemuhay HM, Kabalimu TK, Kidenya BR. Prevalence and factors that are associated with elevated blood pressure among primary school children in Mwanza Region, Tanzania. Pan Afr Med J 2020; 37:283. [PMID: 33654510 PMCID: PMC7896535 DOI: 10.11604/pamj.2020.37.283.21119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 10/29/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction hypertension (HTN) among children is reported to be increasing due to sedentary lifestyles. In developed countries the prevalence of paediatric HTN is recorded to be up to 21% while the magnitude of the same is up to 11% in Tanzania. This study aimed to determine the blood pressure profile and factors associated with elevated blood pressure (BP) among children of Mwanza region. Methods a cross sectional study involving 742 children aged 6 to 16 years in selected primary schools in Mwanza region was conducted from June to August 2019. Data were collected using self-administered structured questionnaires where parents helped children to fill in. Blood pressure, body weight and height were measured using digital portable sphygmomanometer, self-calibrating digital weighing scale and Shorr measuring board respectively. Data were analyzed using EpiInfo. Results this study found mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 109.2 ± 8.1 mmHg and 62.3 ± 7.2 mmHg respectively. Prevalence of elevated BP was 18.1%. Pre-hypertension 9.6%, and hypertension 8.5%. The age specific elevated BP prevalence was significantly higher (OR = 1.9, 95% CI: 1.2 - 2.9, p = 0.008) among children aged ≥10 years (21.4%) than younger ones (15.1%). Prevalence was also higher (OR = 1.5, 95% CI: 1.1 - 2.3, p = 0.048) among girls (20.1%) than boys (16.0%). Elevated BP was found to be associated with obesity (OR = 3.5, 95% CI: 1.6 - 7.7, p = <0.001), overweight (OR = 1.9, 95% CI: 1.1 - 3.3, p = 0.037), eating fried food (OR = 2.2, 95% CI: 1.1 - 4.4, p = 0.023), drinking sugar soft drinks (OR = 2.0, 95% CI: 1.2 - 3.5, p = 0.002) and not eating fruits (OR = 13.4, 1.6, 95% CI: 2.1 - 65.8, p-value 0.006). Conclusion findings indicate high prevalence of elevated BP among children of Mwanza region. There was an association between elevated BP and increased age, gender, sedentary lifestyle and obesity. Importance of measuring paediatric blood pressure and health information regarding effects of sedentary life is recommended to Tanzanians. Parents should encourage their children to have active physical activities. Moreover, health workers should implement programmes to modify sedentary lifestyle and prevent children from elevated blood pressure.
Collapse
Affiliation(s)
- Edson Elias Sungwa
- Department of Reproductive and Child Health, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Shangwe Ezekiel Kibona
- Department of Reproductive and Child Health, Ilemela Municipal Council, Mwanza, Tanzania
| | - Haruna Ismail Dika
- Department of Physiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Rose Mjawa Laisser
- Department of Maternal and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Helena Marco Gemuhay
- Department of Paediatric Nursing, St. John's University of Tanzania, Dodoma, Tanzania
| | | | - Benson Richard Kidenya
- Department of Biochemistry, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| |
Collapse
|
13
|
Ukoh UC, Ujunwa FA, Muoneke UV, Manyike PC, Okike CO, Ibe BC. Oscillometric blood pressure profile of adolescent secondary school students in Abakaliki metropolis. Ann Afr Med 2020; 19:31-39. [PMID: 32174613 PMCID: PMC7189881 DOI: 10.4103/aam.aam_21_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/25/2019] [Accepted: 11/05/2019] [Indexed: 12/02/2022] Open
Abstract
Context Adolescence is characterized by a tremendous pace in growth, biological, and psychosocial changes. This may translate to rapid increases in anthropometric parameters and indulgence in youth risk behaviors, and these are the risk factors for arterial hypertension (HTN). Aim This study aimed to determine the oscillometric blood pressure (BP) profile of apparently healthy secondary school adolescents in Abakaliki metropolis and its relationship with sex and anthropometric variables. Subjects and Methods This multistage process selected 2401 students among those aged 10-19 years spanning from August 2015 to January 2016. BP was measured using the oscillometric method. Information on modifiable risk factors for HTN was obtained. Anthropometric parameters were measured. Data were analyzed with Student's t-test, analysis of variance, and correlation analysis. Results The mean age (years) of the study population was 15.12 ± 2.29. The mean systolic BP (SBP) and diastolic BP (DBP) were 106.72 ± 11.37 mmHg and 63.60 ± 7.34 mmHg, respectively. Females had significantly higher mean DBP but with no significant gender difference in mean SBP. The means of anthropometric parameters were 49.19 ± 10.28 kg, 1.54 ± 0.10 m, and 20.46 ± 2.86 kg/m2 for weight, height, and body mass index, respectively, and all showed significant gender differences, with females having higher values except for height. A relatively low rate of indulgence in alcohol use compared to another study in the same region as well as a significant association of alcohol use among those found to have HTN was noted. The prevalence of HTN was 4.6%, which was significantly higher in females. Conclusions Routine BP monitoring is recommended for adolescents, especially those with prevailing risk factors including a family history of HTN, obesity, and substance and alcohol misuse. Early detection will help in mitigating the effect of these cardiovascular risk factors.
Collapse
Affiliation(s)
- Uchechukwu C. Ukoh
- Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Ebonyi, Nigeria
| | - Fortune A. Ujunwa
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Uzoamaka Vivian Muoneke
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Pius C. Manyike
- 3Department of Paediatrics, College of Medicine, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
| | - Clifford O. Okike
- Department of Paediatrics, Federal Medical Centre, Asaba, Delta, Nigeria
| | - Bede C. Ibe
- Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Ebonyi, Nigeria
- 3Department of Paediatrics, College of Medicine, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
| |
Collapse
|
14
|
Amadi OF, Okeke IB, Ndu IK, Ekwochi U, Nduagubam OC, Ezenwosu OU, Asinobi IN, Osuorah CDI. Hypertension in Children: Could the Prevalence be on the Increase? Niger Med J 2019; 60:262-267. [PMID: 31844356 PMCID: PMC6900897 DOI: 10.4103/nmj.nmj_51_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/19/2019] [Accepted: 09/18/2019] [Indexed: 01/05/2023] Open
Abstract
Background In children particularly in the developing world, there is a tendency to downplay the role of primary hypertension in their health. In adults, a number of factors have clearly been associated with the incidence of hypertension. Knowledge of the prevalence of hypertension and its associated factors among children in our environment is important and could inform the need for lifestyle changes and routine blood pressure (BP) checks in children so as to reduce BP-related health risks. Aim The aim of this study is to document the prevalence of hypertension and its risk factors among children in Enugu, Nigeria. Materials and Methods Children aged 6-17 years attending the outpatient clinic of a tertiary hospital, were enrolled for the study. Their socioeconomic status (SES), weight, height, BP, and dipstick urinalysis were measured using standardized methods. Adherence to Mediterranean diet was assessed using the Mediterranean Diet Quality Index (KIDMED). The prevalence of hypertension and the influence of these factors on their BP were analyzed. Results Forty-six (9%) of the 491 participants had hypertension. Of these 46 hypertensive children, 72% were females while a significantly higher proportion 57% (P = 0.006), were in the age group 13-17 years. While age, gender, and the presence of protein in urine were significantly associated with hypertension in these children; body mass index, diet, family history of hypertension, and SES were not. Conclusion The prevalence of hypertension in children in this environment is high and appears to be increasing. There is need for routine BP and urinalysis check for all children in our clinics and wards.
Collapse
Affiliation(s)
- Ogechukwu F Amadi
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Ifenyinwa B Okeke
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Ikenna K Ndu
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Uchenna Ekwochi
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Obinna C Nduagubam
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Osita U Ezenwosu
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | - Isaac N Asinobi
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | | |
Collapse
|
15
|
Nsanya MK, Kavishe BB, Katende D, Mosha N, Hansen C, Nsubuga RN, Munderi P, Grosskurth H, Kapiga S. Prevalence of high blood pressure and associated factors among adolescents and young people in Tanzania and Uganda. J Clin Hypertens (Greenwich) 2019; 21:470-478. [PMID: 30811099 PMCID: PMC8030556 DOI: 10.1111/jch.13502] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/09/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Abstract
We conducted a cross-sectional study among school/college students in Tanzania and Uganda to determine the prevalence of high blood pressure (BP) and associated factors. Participants were classified to have high BP if they had pre-hypertension or hypertension. Interviews were done using the WHO STEPS instrument. Using data from both countries (n = 1596), the overall prevalence of high BP was 40% (95% CI: 37-42). The prevalence of pre-hypertension was 29% (95% CI: 26-31) and that of hypertension was 11% (95% CI: 10-13). High BP was independently associated with obesity (aOR = 6.7, 95% CI: 2.2-20.0), male sex (aOR = 3.2, 95% CI: 2.4-4.4), and among males aged above 20 years (aOR = 5.5, 95% CI: 2.9-10.5). Consumption of fruits/vegetables was associated with decreased odds for high BP (aOR = 0.7, 95% CI: 0.50-0.98). The increasing burden of pre-hypertension across age groups could explain the early onset of hypertension and cardiovascular diseases (CVDs) among young African adults. There is a need for longitudinal studies to explore the drivers of pre-hypertension in East African adolescents.
Collapse
Affiliation(s)
- Mussa K. Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
| | - Bazil B. Kavishe
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
| | - David Katende
- Uganda Virus Research Unit/Medical Research UnitEntebbeUganda
| | - Neema Mosha
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
| | - Christian Hansen
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
- London School of Hygiene and Tropical MedicineLondonUK
| | | | - Paula Munderi
- Uganda Virus Research Unit/Medical Research UnitEntebbeUganda
| | - Heiner Grosskurth
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
- London School of Hygiene and Tropical MedicineLondonUK
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical ResearchMwanzaTanzania
- London School of Hygiene and Tropical MedicineLondonUK
| |
Collapse
|
16
|
Wariri O, Jalo I, Bode-Thomas F. Discriminative ability of adiposity measures for elevated blood pressure among adolescents in a resource-constrained setting in northeast Nigeria: a cross-sectional analysis. BMC OBESITY 2018; 5:35. [PMID: 30524740 PMCID: PMC6276203 DOI: 10.1186/s40608-018-0211-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
Background Several studies examining the association and discriminative ability of adiposity measures for prehypertension and hypertension among adolescents have reported varying outcomes. We aimed to determine the discriminative ability of the Body Mass index (BMI), Waist Circumference (WC), and Waist-to-Height Ratio (WHtR) adiposity measures for elevated blood pressure (prehypertension and hypertension combined) among adolescents in Gombe, northeast Nigeria. Methods This cross-sectional study used a multi-stage sampling technique and involved 367 secondary school adolescent (10–18 years) boys and girls in Gombe Local Government Area, Gombe State, northeast Nigeria from January to September 2015. We examined and compared the associations and discriminative ability of the BMI, WC and the WHtR for elevated blood pressure using multiple logistic regression and receiver operating characteristics (ROC) curves. Area under the curves (AUC), odds ratio (OR) and 95% confidence intervals (CI) are reported. Results All three measures of adiposity were strongly and positively associated with elevated blood pressure. The BMI obesity showed the strongest association with elevated blood pressure with odds that was double the odds of WC and triple that of WHtR [adjusted OR for BMI 15.3, 95% CI (4.8–27.9)]. The discriminative ability of adiposity measures for elevated blood pressure using AUC was comparable (0.786 for BMI, vs 0.780 for WC, vs 0.761 for WHtR). Conclusion We provide evidence, here on the BMI, WC and WHtR to support the use of simple indirect measures of adiposity in evaluating adiposity-related risk including prehypertension and hypertension among Nigerian adolescents. Electronic supplementary material The online version of this article (10.1186/s40608-018-0211-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Oghenebrume Wariri
- Vaccines and Immunity Theme, MRC Unit, The Gambia at The London School of Hygience and Tropical Medicine, Fajara, The Gambia
| | - Iliya Jalo
- Department of Paediatrics, Federal Teaching Hospital (FTH), Gombe, Nigeria.,3Department of Paediatrics, College of Medical Sciences, Gombe State University, Gombe, Nigeria
| | - Fidelia Bode-Thomas
- 4Paediatric Cardiology Unit, Department of Paediatrics, Jos University Teaching Hospital (JUTH), Jos, Nigeria
| |
Collapse
|
17
|
Ezeudu CE, Chukwuka JO, Ebenebe JC, Igwe WC, Egbuonu I. Hypertension and prehypertension among adolescents attending secondary schools in urban area of South-East, Nigeria. Pan Afr Med J 2018; 31:145. [PMID: 31037205 PMCID: PMC6462383 DOI: 10.11604/pamj.2018.31.145.15994] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction in the past, the need for regular blood pressure screening in children was doubtful, and the main reason against it is that hypertension is an adult illness and there is no evidence that screening healthy children for hypertension was worthwhile. We did this study to determine the prevalence of hypertension and prehypertension as well as some risk factors for hypertension among secondary school adolescents in an urban area of the South-East, Nigeria. Methods this was a cross-sectional study of 984 adolescents aged 10-19 years in secondary schools in Awka South Local Government Area of Anambra state, South-East, Nigeria. The multi-stage sampling method was used to select the subjects. Data were collected from all eligible subjects with the aid of a questionnaire administered to them. Weight, height, and blood pressure were measured and recorded. Results nine hundred and eighty-four adolescents were recruited for this study, and they comprised 470 (47.8%) males and 514 (52.2%) giving a male: female ratio of 1:1.1. Their ages ranged from 10-19 years. The mean systolic blood pressure and mean diastolic BP were 110.5±10.2mmHg 71.5±8.5mmHg respectively. Prevalence of hypertension and pre-hypertension were 6.3% and 5.0% respectively. There were a higher proportion of females (7.3%) than males (5.4%) with hypertension, and more females (5.8%) than males (4.2%) with prehypertension but these were not statistically significant. Overweight and obesity were significantly associated with hypertension. Conclusion hypertension exists among secondary school adolescents in Awka South Local government area of Anambra state, with a prevalence of 6.3%. Early detection and treatment will forestall the early development of complications.
Collapse
Affiliation(s)
| | - John Onuora Chukwuka
- Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nnewi Campus, Nigeria
| | - Joy Chinelo Ebenebe
- Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nnewi Campus, Nigeria
| | | | - Ifeoma Egbuonu
- Department of Paediatrics, Chukwuemeka Odimegwu Ojukwu University Teaching Hospital, Awka, Anambra State, Nigeria
| |
Collapse
|
18
|
Uwaezuoke SN, Okoli CV, Ubesie AC, Ikefuna AN. Primary hypertension among a population of Nigerian secondary school adolescents: Prevalence and correlation with anthropometric indices: A cross-sectional study. Niger J Clin Pract 2018; 19:649-54. [PMID: 27538555 DOI: 10.4103/1119-3077.188706] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To assess the prevalence of primary hypertension and its correlation with anthropometric indices among a population of Nigerian adolescents. MATERIALS AND METHODS A cross-sectional study of secondary school adolescents aged 10-19 years in Enugu, Nigeria, using multi-staged sampling method. Anthropometry and blood pressures were measured using standardized instruments. Data analysis was with the Statistical Package for Social Sciences (SPSS) Version 20.0 (Chicago, IL, USA). RESULTS A total of 2419 adolescents (mean age, 14.80 ± 2.07 years) were included in the study. Prevalence of hypertension was 10.7%. Systolic and diastolic hypertension were observed in 232 (9.6%) and 85 (3.5%) of the participants, respectively. Forty-two of the 137 obese (30.7%) compared to 158 among the 1777 (7.7%) with normal body mass index (BMI) (P < 0.001) had systolic hypertension. Waist circumference (r = 0.37) and BMI (r = 0.37) significantly and positively correlated with systolic hypertension. CONCLUSION Obese and overweight adolescents had higher prevalence of primary hypertension than their counterparts with normal BMI.
Collapse
Affiliation(s)
- S N Uwaezuoke
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - C V Okoli
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - A C Ubesie
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - A N Ikefuna
- Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, Enugu State; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| |
Collapse
|
19
|
Okpokowuruk FS, Akpan MU, Ikpeme EE. Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria. Pan Afr Med J 2017; 28:303. [PMID: 29854068 PMCID: PMC5966115 DOI: 10.11604/pamj.2017.28.303.14396] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 12/04/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction In the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study. Methods Two hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey. Results The prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure. Conclusion The prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference.
Collapse
Affiliation(s)
- Frances Sam Okpokowuruk
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Mkpouto Udeme Akpan
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Enobong Emmanuel Ikpeme
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| |
Collapse
|
20
|
Aleali AM, Latifi SM, Rashidi H, Payami SP, Sabet A. Prevalence of hypertension and prehypertension in adolescence in Ahvaz, Iran. Diabetes Metab Syndr 2017; 11 Suppl 2:S547-S550. [PMID: 28420576 DOI: 10.1016/j.dsx.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/05/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. OBJECTIVES The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. PATIENTS AND METHODS This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. RESULTS Total participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls (46%). The prevalence of high blood pressure was 1.7% (2.5% in boys and 0.8%). The prevalence of pre-hypertension was 9%(7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. CONCLUSIONS The prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies showed high correlation between being overweight and an increase in systolic and diastolic blood pressure.
Collapse
Affiliation(s)
- Armaghan Moravej Aleali
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Seyed Mahmoud Latifi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran.
| | - Homeira Rashidi
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Seyed Peyman Payami
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Azar Sabet
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| |
Collapse
|
21
|
Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2017; 2:e375-e386. [PMID: 29253478 DOI: 10.1016/s2468-2667(17)30123-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 06/04/2017] [Accepted: 06/09/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite substantial attention paid to the threat of elevated blood pressure in children and adolescents in high-income countries and the epidemic of hypertension in African adult populations, data on the burden of elevated blood pressure in African children and adolescents have not yet been synthesised. We did a systematic review and meta-analysis to provide estimates of the prevalence of elevated blood pressure and assess associated factors among children and adolescents in Africa. METHODS We searched Embase, PubMed, African Journals Online, and African Index Medicus to identify articles published from Jan 1, 1996, to Feb 2, 2017, and searched the reference list of retrieved articles. Each study was independently reviewed for methodological quality. We used a random-effects model to estimate the prevalence of elevated blood pressure across studies and heterogeneity (I2) was assessed via the χ2 test on Cochran's Q statistic. This review is registered with PROSPERO, number CRD42015019029. FINDINGS We included 51 studies in qualitative synthesis and 25 in the meta-analysis reporting data of a pooled sample of 54 196 participants aged 2-19 years. Study quality was high with only four medium-quality studies and no low-quality studies. Prevalence of elevated blood pressure varied widely across studies (range 0·2-24·8%). The pooled prevalence of elevated blood pressure (systolic or diastolic blood pressure ≥95th percentile) was 5·5% (95% CI 4·2-6·9), whereas that of slightly elevated blood pressure (systolic or diastolic blood pressure ≥90th percentile and <95th percentile) was 12·7% (2·1-30·4). The prevalence of elevated blood pressure was largely associated with body-mass index (BMI), with a prevalence of elevated blood pressure six times higher in obese (30·8%, 95% CI 20·1-42·6) versus normal-weight children (5·5%, 3·1-8·4; p<0·0001). INTERPRETATION This study suggests a high prevalence of elevated blood pressure among children and adolescents in Africa, with overweight and obesity being an important risk factor. Efforts to address this burden of elevated blood pressure in children and adolescents should mainly focus on primary prevention at the community level, by promoting healthy lifestyles and avoiding other cardiovascular risk factors, especially overweight and obesity. This study also stresses the need for more elaborate studies using uniform and reliable diagnostic methods to reliably map the burden of elevated blood pressure in children and adolescents in Africa. FUNDING None.
Collapse
|
22
|
Ejike CECC. Prevalence of Hypertension in Nigerian Children and Adolescents: A Systematic Review and Trend Analysis of Data from the Past Four Decades. J Trop Pediatr 2017; 63:229-241. [PMID: 28082664 DOI: 10.1093/tropej/fmw087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Despite four decades of research, there is no systematic review and trend analysis on paediatric (pre)hypertension in Nigeria. This article reviewed data from cross-sectional studies on the subject. From the initial 9334 articles identified, 30 studies that met the inclusion criteria were systematically reviewed. Data from studies that defined hypertension as blood pressure (BP) greater than the 95th percentile for age, height and sex gave a prevalence of 8.2% [95% confidence interval (CI): 3.6-28.2%] for prehypertension and 5.1% (95% CI: 2.9-8.6%) for hypertension. For studies that defined hypertension as BP greater than 2 SD points from the mean of the population, the prevalence of hypertension was found to be 4.0% (95% CI: 2.8-5.7%). A significant negative trend (Z = -0.89; α < 0.01) with small magnitude (Q = -0.019; 95% CI: -0.070 to 0.028) was found for hypertension in the reviewed population. The prevalence of (pre)hypertension in Nigerian children and adolescents is moderate but has slightly declined over time.
Collapse
Affiliation(s)
- Chukwunonso E C C Ejike
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, Federal University Ndufu-Alike, Ikwo, PMB 1010 Abakaliki, Ebonyi State, Nigeria
| |
Collapse
|
23
|
Cheah WL, Hazmi H, Chia HQ, Tindin E, Ahmad Zafri NA, Mohd Shah SH. Hypertension and its association with anthropometric indexes among pre-university students. Int J Adolesc Med Health 2017. [PMID: 26215534 DOI: 10.1515/ijamh-2015-0020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hypertension has become increasingly common among adolescents. This study aimed to investigate the prevalence of hypertension and its association with anthropometric indexes among pre-university students. This was a cross-sectional study carried out among pre-university students of a public university. Anthropometric measurements were conducted using mobile stadiometers, digital body fat scales and measuring tapes. Body fat percentage was measured with a body composition analyzer, and blood pressure was determined using digital blood pressure monitors. Statistical analyses were done using Statistical Package for Social Sciences (SPSS) Statistics 20. A total of 218 respondents participated in the study. The prevalence of hypertension at risk was 7.3%, which was higher among males (16.7%). About 22% of the respondents were overweight and obese. The majority of males had a normal waist circumference (WC) (75.9%), but almost half of females had a WC value in the unhealthy category (47.0%). Females had higher conicity indexes and body fat compared to males. Respondents who were found to have hypertension at risk had a higher prevalence of being overweight and having unhealthy WC and waist-to-height ratio and had high conicity indexes and a high percentage of fat. Risk factors independently associated with hypertension at risk included male gender (odds ratio=4.213, 95% CI, 1.238-14.342) and body mass index (odds ratio=7.865, 95% CI, 1.165-53.099). Regular screening of hypertension at risk among adolescents and initiation of early treatment for those affected should be conducted to avoid further complication in later life.
Collapse
|
24
|
Jobe M, Agbla SC, Prentice AM, Hennig BJ. High blood pressure and associated risk factors as indicator of preclinical hypertension in rural West Africa: A focus on children and adolescents in The Gambia. Medicine (Baltimore) 2017; 96:e6170. [PMID: 28353557 PMCID: PMC5380241 DOI: 10.1097/md.0000000000006170] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Hypertension is fast becoming a major public health problem across sub-Saharan Africa. We sought to determine the prevalence of high blood pressure (BP) and associated risk factors as indicator of preclinical hypertension in a rural Gambian population.We analyzed data on 6160 healthy Gambians cross-sectionally. Attention was given to 5 to <18-year olds (N = 3637), as data from sub-Saharan Africa on this young age group are scarce. High BP was defined as systolic blood pressure (SBP) above the 95th percentile for age-sex specific height z scores in <18-year olds employing population-specific reference values. Standard high BP categories were applied to ≥18-year olds.In <18-year olds, the multivariable analysis gave an adjusted high BP prevalence ratio of 0.95 (95% confidence interval [CI] 0.92-0.98; P = 0.002) for age and 1.13 (95% CI 1.06-1.19; P < 0.0001) for weight-for-height z score (zWT-HT); sex and hemoglobin were not shown to affect high BP. In adults age 1.05 (95% CI 1.04-1.05; P < 0.0001), body mass index z score 1.28 (95% CI 1.16-1.40; P < 0.0001), hemoglobin 0.90 (95% CI 0.85-0.96; P < 0.0001) and high fasting glucose 2.60 (95% CI 2.02-3.36; P < 0.0001, though the number was very low) were confirmed as risk factors for high BP prevalence; sex was not associated.The reported high BP prevalence and associated risk factors in adults are comparable to other studies conducted in the region. The observed high BP prevalence of 8.2% (95% CI 7.4-9.2) in our generally lean young Gambians (<18 years) is alarming, given that high BP tracks from childhood to adulthood. Hence there is an urgent need for further investigation into risk factors of pediatric high BP/hypertension even in rural African settings.
Collapse
Affiliation(s)
- Modou Jobe
- Nutrition Theme, MRC Unit The Gambia, Atlantic Boulevard, Fajara, Banjul, The Gambia
| | - Schadrac C. Agbla
- Tropical Epidemiology Group, Faculty of Epidemiology and Population Health
| | - Andrew M. Prentice
- Nutrition Theme, MRC Unit The Gambia, Atlantic Boulevard, Fajara, Banjul, The Gambia
- MRC International Nutrition Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
| | - Branwen J. Hennig
- Nutrition Theme, MRC Unit The Gambia, Atlantic Boulevard, Fajara, Banjul, The Gambia
- MRC International Nutrition Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
| |
Collapse
|
25
|
Adebiyi AO, Uchendu OC, Bamgboye E, Ibitoye O, Omotola B. Perceived effectiveness of graphic health warnings as a deterrent for smoking initiation among adolescents in selected schools in southwest Nigeria. Tob Induc Dis 2016; 14:7. [PMID: 26997939 PMCID: PMC4797136 DOI: 10.1186/s12971-016-0074-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 03/16/2016] [Indexed: 11/11/2022] Open
Abstract
Background There has been a sustained increment in young people initiating smoking in low middle income countries like Nigeria. Health warnings on cigarette packages are a prominent source of health information and an effective means of communicating specific disease risks to adolescents and young adults alike. This study evaluated the perceived effectiveness of selected graphic warnings on smoking initiation amongst in-school adolescents. Methods This was a cross-sectional study conducted amongst secondary school students aged 13–17years in Igbo-Ora, Nigeria. A two-stage sampling technique with the school classes as the final sampling unit was used to select the students. An interviewer assisted questionnaire was used to obtain information on students demographic characteristics and their perception of graphic warnings using four images from the pictorial health warning galleries of the World Health Organization showing: ‘cigarette smoking causes cancer of the airways, harms children, causes stroke and causes impotence respectively'. Results A total of 544 senior secondary students were included in this study with a male female ratio of 0.8:1. Of those interviewed, 40 (7.4 %) indicated that they had ever considered smoking, nine (1.7 %) responded that they had ever smoked and two students indicated that they were current smokers. With all the images, fear was the dominant emotion expressed by the respondents. This was expressed by 307 (56.4), 215 (39.5), 203 (37.3) and 228 (41.9 %) respondents to images 1, 2, 3, and 4 respectively. Furthermore, 76.7, 44.7, 58.5 and 62.1 % of respondents felt Images 1, 2, 3 and 4 respectively will to a large extent prevent people from initiating smoking. There was no association between perceived effectiveness and gender. However, those younger than 15 years rated images on cancer of the airway and impotence as probably effective to a larger extent than did those who were 15 years and older (p = 0.032). Conclusion Introduction of graphic health warnings, especially with an imagery depicting cancer and impotence may influence non-smokers to remain abstinent. Therefore, this study provides a template for a future policy-relevant study on graphic health warning in Nigeria.
Collapse
Affiliation(s)
- A O Adebiyi
- Department of Preventive Medicine and Primary Care, University of Ibadan, Ibadan, Nigeria
| | - O C Uchendu
- Department of Preventive Medicine and Primary Care, University of Ibadan, Ibadan, Nigeria
| | - E Bamgboye
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - O Ibitoye
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - B Omotola
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
26
|
Nyombi KV, Kizito S, Mukunya D, Nabukalu A, Bukama M, Lunyera J, Asiimwe M, Kimuli I, Kalyesubula R. High prevalence of hypertension and cardiovascular disease risk factors among medical students at Makerere University College of Health Sciences, Kampala, Uganda. BMC Res Notes 2016; 9:110. [PMID: 26887672 PMCID: PMC4756514 DOI: 10.1186/s13104-016-1924-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 02/08/2016] [Indexed: 11/18/2022] Open
Abstract
Background Cardiovascular disease has become a leading global health challenge representing the largest cause of mortality in adults worldwide. Non communicable diseases are neglected in Uganda over infectious diseases. With increased urbanization, there is likely increase in burden of these NCDs yet there is paucity of reliable data regarding the NCD burden. We assessed the prevalence of hypertension and other cardiovascular disease risk factors among medical students at Makerere University, College of Health Sciences in Kampala, Uganda. Methods We conducted a cross-sectional study at Makerere University comprising 180 medical students. We used a standardized questionnaire and anthropometric measurements to assess their cardiovascular disease risk factors using JNC-7. Logistic regression was used to assess factors associated with elevated blood pressure. Results Of the 180 students surveyed, 107 (59 %) were males, mean age was 22 years (SD = 3 years), and 159 (88 %) were in their preclinical years of training. Cardiovascular risk factors with the highest prevalence were alcohol consumption (31.7 %); elevated systolic blood pressure (14 %); and excessive salt intake (13 %). Participants with elevated systolic blood pressure were more likely to be older (OR = 1.18), overweight (OR = 1.08), and with a personal history of cardiovascular disease (OR = 4.68). Conclusions The prevalence of hypertension and known cardiovascular disease risk factors is high among the medical students. Strategies to prevent cardiovascular disease among the young population should be put in place.
Collapse
Affiliation(s)
- Kenneth V Nyombi
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Samuel Kizito
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - David Mukunya
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Angella Nabukalu
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Martin Bukama
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Joseph Lunyera
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Martha Asiimwe
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Ivan Kimuli
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Robert Kalyesubula
- Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| |
Collapse
|
27
|
Odunaiya NA, Louw QA, Grimmer KA. Are lifestyle cardiovascular disease risk factors associated with pre-hypertension in 15-18 years rural Nigerian youth? A cross sectional study. BMC Cardiovasc Disord 2015; 15:144. [PMID: 26537355 PMCID: PMC4632346 DOI: 10.1186/s12872-015-0134-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/25/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a public health concern worldwide. Hypertensive heart disease is predominant in Nigeria. To effectively reduce CVD in Nigeria, the prevalence of, and factors associated with, pre-hypertension in Nigerian youth first need to be established. METHODS A locally-validated CVD risk factor survey was completed by 15-18 year olds in a rural setting in south-west Nigeria. Body Mass Index (BMI), waist-hip ratio and systolic and diastolic blood pressure was measured. Putative risk factors were tested in gender-specific hypothesized causal pathways for overweight/obesity, and for pre-hypertension. RESULTS Of 1079 participants, prevalence of systolic pre-hypertension was 33.2 %, diastolic pre-hypertension prevalence approximated 5 %, and hypertension occurred in less than 10 % sample. There were no gender differences in prevalence of pre- hypertension, and significant predictors of systolic pre-hypertension (high BMI and older age) were identified. Considering high BMI, older age was a risk for both genders, whilst fried food preference was female-only risk, and low breakfast cereal intake was a male-only risk. CONCLUSION Rural Nigerian adolescents are at-risk of future CVD because of lifestyle factors, and high prevalence of systolic pre-hypertension. Relevant interventions can now be proposed to reduce BMI and thus ameliorate future rural adult Nigerian CVD.
Collapse
Affiliation(s)
- N A Odunaiya
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
- Department of Physiotherapy, University of Ibadan, Ibadan, Nigeria.
| | - Q A Louw
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
| | - K A Grimmer
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
- International Center for Allied Health Evidence, University of South Australia, Adelaide, Australia.
| |
Collapse
|
28
|
Akinlua JT, Meakin R, Umar AM, Freemantle N. Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review. PLoS One 2015; 10:e0140021. [PMID: 26461923 PMCID: PMC4603956 DOI: 10.1371/journal.pone.0140021] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/19/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The 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. OBJECTIVE The purpose of this systematic review is to summarise up to date data on the prevalence and distribution of hypertension in Nigeria from prevalence studies. METHODS A 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. RESULTS The 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. CONCLUSIONS The 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.
Collapse
Affiliation(s)
- James Tosin Akinlua
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
| | - Richard Meakin
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
| | - Aminu Mahmoud Umar
- College of Science and Technology, University of Salford, Salford Crescent, Manchester, M5 4WT, United Kingdom
| | - Nick Freemantle
- Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), Rowland Hill street, London, NW3 2PF, United Kingdom
| |
Collapse
|
29
|
Nam EW, Sharma B, Kim HY, Paja DJV, Yoon YM, Lee SH, Kim EH, Oh CH, Kim YS, Song CH, Kim JK. Obesity and Hypertension among School-going Adolescents in Peru. J Lifestyle Med 2015; 5:60-7. [PMID: 26770892 PMCID: PMC4711960 DOI: 10.15280/jlm.2015.5.2.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/01/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. METHODS A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. RESULTS The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). CONCLUSION The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.
Collapse
Affiliation(s)
- Eun Woo Nam
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Bimala Sharma
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Ha Yun Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | | | - Young Min Yoon
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Health Administration, Graduate School, Yonsei University, Korea
| | - Sun Ha Lee
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | - Eun Hwan Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Yun Seop Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea
| | | | - Jong Koo Kim
- Yonsei Global Health Center, Yonsei University, Wonju, Korea; Department of Family Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| |
Collapse
|
30
|
Okwuonu CG, Ngoka SC, Chimezie OJ, Eze TH, Uwanurochi K, Mbanaso AU. Towards prevention of hypertension in Nigeria: a study of prehypertension and its associations among apparently healthy adults in Umuahia, South-East Nigeria. Int J Prev Med 2015; 6:61. [PMID: 26288705 PMCID: PMC4521306 DOI: 10.4103/2008-7802.160968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 04/05/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The prevalence of hypertension is on the increase in Nigeria. Prehypertension is considered a precursor of hypertension and a predictor of excessive cardiovascular risk. Identifying individuals with prehypertension and initiating effective measures will aid in reducing the incidence and prevalence of hypertension in our environment. The aim of this study was to quantify the magnitude of prehypertension and determine its associations among adults in a representative semi-urban Nigerian population. METHODS A cross-sectional study which was carried out in a semi-urban setting in Southeast Nigeria. Blood pressure (BP) was measured using the standard methods. A cardiovascular risk factor screening based on physical characteristics, individual medical, and family history of participants was done. RESULTS There were a total of 389 participants comprising 223 (57.3%) males and 116 (42.7%) females; male:female ratio been 1.9:1. The prevalence of prehypertension and hypertension were 45.5% and 37.8%, respectively. Males were significantly more likely to have prehypertension than females (61% vs. 39% respectively; OR = 1.32, P = 0.03). There was a weak positive significant correlation between age and both systolic (r = 0.16, P < 0.01) and diastolic (r = 0.12, P = 0.02) blood pressures. Up to 72.6% of individuals with prehypertension have abnormal body mass index (BMI). While up to 8.5% of the participants had a family history of cardiovascular disease, 20.3%, and 17.3% had a history of significant intake of alcohol and smoking, respectively. CONCLUSIONS The prevalence of prehypertension in the community was high. It was associated with increasing age, male gender, and increasing BMI. Interventions at this stage may aid in stemming the rising prevalence of hypertension in our environment.
Collapse
Affiliation(s)
- Chimezie Godswill Okwuonu
- Nephrology Unit, Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Stanley Chidozie Ngoka
- Nephrology Unit, Department of Internal Medicine, Federal Medical Centre, Owerri, Imo State, Nigeria
| | - Oluchi Justina Chimezie
- Department of Ophthalmology and Eye Centre, Abia State Specialist Hospital and Diagnostic Centre, Umuahia, Abia State, Nigeria
| | - Tochukwu Hycinth Eze
- Nephrology Unit, Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Kelechukwu Uwanurochi
- Cardiology Unit, Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | | |
Collapse
|
31
|
Nkeh-Chungag BN, Sekokotla AM, Sewani-Rusike C, Namugowa A, Iputo JE. Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study. Cent Eur J Public Health 2015; 23:59-64. [DOI: 10.21101/cejph.a3922] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
32
|
Mushengezi B, Chillo P. Association between body fat composition and blood pressure level among secondary school adolescents in Dar es Salaam, Tanzania. Pan Afr Med J 2014; 19:327. [PMID: 25918567 PMCID: PMC4405073 DOI: 10.11604/pamj.2014.19.327.5222] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/17/2014] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Excess body fat and high blood pressure (BP) are important risk factors for increased cardiovascular morbidity and mortality, and both may have their roots of occurrence in childhood and adolescence. The present study aimed at determining the association between body fat composition and BP level among adolescents in Tanzania. METHODS A cross-sectional study involving 5 randomly selected secondary schools within Dar es Salaam was conducted between June and November 2013. Structured questionnaires were used to collect information on demographic characteristics and other cardiovascular risk factors. BP, height, weight and waist circumference were measured following standard methods. Body fat was assessed by skinfold thickness and categorized as underfat, healthy, overfat or obese according to World Health Organization definitions. Hypertension was defined as BP ≥ 90(th) percentile for age, height and gender of the adolescent. RESULTS The study included 582 adolescents (mean age 16.5 ± 1.8 years, 52.1% boys). The proportion of adolescents with overfat or obesity was 22.2%. Systolic, diastolic and combined hypertension was present in 17.5%, 5.5%, and 4.0% respectively. In the total population mean body fat percent correlated positively with diastolic BP and mean arterial pressure (MAP) but not with systolic BP. In multivariate analysis body mass index (β=0.21, p=0.008) and waist circumference (β=0.12, p=0.049), but not body fat percentage (β=-0.09, p=0.399) independently predicted higher MAP. CONCLUSION Body mass index predicts BP level better than body fat composition and should be used as a measure of increased risk for hypertension among adolescents.
Collapse
Affiliation(s)
| | - Pilly Chillo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| |
Collapse
|
33
|
Caffarelli C, Santamaria F, Vottero A, Dascola CP, Mirra V, Sperli F, Bernasconi S. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses. Ital J Pediatr 2014; 40:62. [PMID: 25015124 PMCID: PMC4106226 DOI: 10.1186/1824-7288-40-62] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 06/30/2014] [Indexed: 12/30/2022] Open
Abstract
This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections.
Collapse
Affiliation(s)
- Carlo Caffarelli
- Department of Clinical and Experimental Medicine, Clinica Pediatrica, University of Parma, Parma, Italy.
| | | | | | | | | | | | | |
Collapse
|