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Minkah Md Fwacp DO, Owusu IK, Kokuro C, Norman BR, Arthur JA, Ogyefo IN, Kweki AG. Prevalence of Increased QTc Dispersion Among Hypertensive Patients and Its Correlation to Clinical Risk Factors: A Hospital-Based Case-Control Study. Cureus 2024; 16:e56423. [PMID: 38505141 PMCID: PMC10948943 DOI: 10.7759/cureus.56423] [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] [Accepted: 03/18/2024] [Indexed: 03/21/2024] Open
Abstract
Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ2 =38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.
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Affiliation(s)
| | - Isaac K Owusu
- Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
| | - Collins Kokuro
- Cardiology, Komfo Anokye Teaching Hospital, Kumasi, GHA
- Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
| | - Betty R Norman
- Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
- Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, GHA
| | - Joshua A Arthur
- Epidemiology and Public Health, Ghana Health Service, Accra, GHA
| | - Isaac N Ogyefo
- Medicine and Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
- Medicine and Surgery, Komfo Anokye Teaching Hospital, Kumasi, GHA
| | - Anthony G Kweki
- Internal Medicine and Cardiology, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust (ESNEFT), Colchester, GBR
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Ezeala-Adikaibe BA, Mbadiwe CN, Okafor UH, Nwobodo UM, Okwara CC, Okoli CP, Anyim OB, Anigbo EG, Chime PE, Ezeme MS, Onyebueke CG, Abonyi CM, Udeh CA, Okechukwu CU, Onodugo PN, Okpara CT, Nnaji OT, Obumneme-Anyim I, Orjioke C, Ekochin CF, Onyekonwu LC, Onodugo OD, Nwosu IN. Prevalence of hypertension in a rural community in southeastern Nigeria; an opportunity for early intervention. J Hum Hypertens 2023; 37:694-700. [PMID: 37120682 DOI: 10.1038/s41371-023-00833-x] [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: 08/02/2022] [Revised: 04/01/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023]
Abstract
Hypertension is a leading cause of non-communicable morbidity in Sub Saharan Africa. Recent studies suggest and increase in the prevalence of hypertension in rural Sub-Saharan Africa. Using a three-phase approach, a structured questionnaire was used to determine the prevalence of hypertension in a rural settlement is Enugu State, Southeast Nigeria. Blood pressure measurement was done according to the guidelines of the European Society of Hypertension. Out of 1576 participants aged 18 years and above, 1082 (68.7%) completed the full survey, their blood pressure was measured, and data analyzed. The prevalence of hypertension in this study was 27.6%, (95%CI 25-30.4), similar in males 29.2, (95%CI 24.7-30.4) and females 26.8%, (95%CI 23.5-30.2). p = 0.39. The prevalence of hypertension increased with age reaching a peak of 32.8% (95%CI 26.2-40) in the 40-49 age group, however this was not statistically significant P = 0.22. This age-related increase in the prevalence of hypertension tended towards significance in males (p = 0.05) but not in females (p = 0.44). Awareness of hypertension was 7.2%. Systolic blood pressure positively correlated with older age, higher blood glucose levels and waist-hip ratio. Diastolic blood pressure correlated with the type of work the patients is involved in and blood glucose levels. In conclusion, the prevalence of hypertension in a rural southeastern Nigeria community was 27.6%, however awareness was very low (7.9%). Most participants had mild hypertension thus offering a window of opportunity for public health educators in preventing the complications of hypertension. There is therefore the need for awareness campaigns to be intensified in rural communities.
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Affiliation(s)
- Birinus A Ezeala-Adikaibe
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria.
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Chigekwu Nkeiruka Mbadiwe
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Ume Monday Nwobodo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Chibuzo Celestine Okwara
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chibuike Paul Okoli
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Ekene Gideon Anigbo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Peter Ekpunobi Chime
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Mark Sunday Ezeme
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | | | - Callistus Afam Udeh
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Pauline Nkiruka Onodugo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Obiora Thomas Nnaji
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Casmir Orjioke
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Laura Chinwe Onyekonwu
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Ikechukwu Nnamdi Nwosu
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Uwakwe SI, Uwakwe C, Edeh NI, Chukwu CJ, Enyi C, Irouwakwe C, Chukwuemeka-Nworu JI, David AO, Ezepue EI, Aneke MC, Nwankwo BC, Isilebo CN, Ezurike CA, Nweke PO. Efficacy of rational emotive behavior therapy for the improvement of knowledge and risk perception of hypertension among university lecturers in South East Nigeria: REBT for university lecturers' hypertension improvement. Medicine (Baltimore) 2023; 102:e32171. [PMID: 36820571 PMCID: PMC9907944 DOI: 10.1097/md.0000000000032171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND This study determined the effectiveness of a rational emotive behavioral therapy (REBT) intervention on knowledge of risks of hypertension among university lecturers in South-east geopolitical zone of Nigeria. METHODS The study used a group randomized controlled trial design to group the participants into treatment group and a waiting-list control group and the hypertension knowledge questionnaire and the Perceived Risks of Hypertension Questionnaire to collect a pretest, posttest, and follow-up data of this study. The sample of the study was 84 university lecturers in public universities in Southeast Nigeria (University of Nigeria, Nsukka, Enugu State, Nnamdi Azikiwe University, Awka, Anambra State) who satisfies the requirements to participate in the study. The study lasted for 10 weeks. The data collected for the study were analyzed using repeated measures ANOVA and t test statistics. RESULTS The findings of this study were that REBT health educational intervention effectively increased the education foundation and business education lecturers' knowledge and perceived risk of hypertension compared to participants in waitlist group. Lastly, the outcomes of the follow-up measures indicate that the increased knowledge and perceived risks of hypertension acquired during the training program was sustained by the treatment group one month after the end of program. CONCLUSION The REBT health educational intervention program could be utilized to increase knowledge and perceived risks of hypertension among university lecturers in public universities in Southeast Nigeria.
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Affiliation(s)
- Stephen Iro Uwakwe
- Department of Educational Foundations, University of Nigeria, Nsukka, Nigeria
| | | | | | | | - Chinwe Enyi
- Department of Educational Foundations, University of Nigeria, Nsukka, Nigeria
| | | | | | | | | | - Mary Chioma Aneke
- Department of Educational Foundations, University of Nigeria, Nsukka, Nigeria
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Anyabolu EN, Okoye IC, Ufoaroh CU, Chukwuonye II, Echendu ST, Umeadi EN, Anyabolu AE. Hypertension in HAART-naϊve HIV Subjects in Southeast Nigeria: A single-Center Study. Niger Med J 2022; 63:425-431. [PMID: 38867751 PMCID: PMC11165327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background Hypertension is a major healthcare problem in Nigeria with a probable prevalence of 36.6%. Human immunodeficiency virus (HIV) infection is a global healthcare problem. The factors which influence hypertension in HIV subjects have not been completely identified. The study aimed to determine the prevalence of hypertension and the factors which might influence hypertension in HAART-naïve HIV subjects. Methodology This was a cross-sectional study involving 393 treatment-naïve HIV subjects and 136 age and sex-matched HIV seronegative controls. Anthropometric and demographic data were obtained, blood pressure measurements and other relevant investigations were performed. Hypertension was defined here as systolic blood pressure (SBP) ≥ 140mmHg and diastolic blood pressure (DBP) ≥ 90mmHg. Hypertension was compared between the HIV subjects and the non-HIV control. The association of the variables with hypertension in HIV subjects were determined. Results The mean age of the HIV subjects was 39±11 years. Females were 282(72.0%) and males 110(28.0%). The prevalence of hypertension was 23.7% in HIV subjects and 31.6% in the non-HIV control. The prevalence of hypertension was 17.2% in HIV subjects with high density lipoprotein cholesterol (HDL) <1.0mg/dl and this was significantly lower than the prevalence of hypertension of 27.1% in those whose serum HDL was ≥ 1.0mg/dl. There was no significant association between hypertension and 24-hour urine osmolality (24HUOsm) (p=0.094), body mass index (BMI) (p=0.572), 24-hour urine protein (24HUP) (p=0.606), serum total cholesterol (p=0.628), serum low density lipoprotein cholesterol (LDL) (p=0.116), triglyceride (TG) (p=0.925), Systolic blood pressure had a significant correlation with serum HDL, (r=0.114, p=0.024). Similarly, CD4 cell count correlated significantly with DBP (r=0.123, p=0.012. Serum HDL (p=0.0.024) and CD4 cell count (p=0.012) predicted hypertension in HIV subjects. Conclusion The prevalence of hypertension of 23.7% in HIV subjects was high in this study. Low CD4 cell count and low serum HDL were predictors of hypertension in HIV subjects.
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Affiliation(s)
| | | | | | | | | | - Esther Ngozi Umeadi
- Department of Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
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Unmet needs of hypertension care in Nigeria: results of the community action against non-communicable diseases (COMAAND) project preintervention survey. Blood Press Monit 2022; 27:27-32. [PMID: 34992204 DOI: 10.1097/mbp.0000000000000561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Assessing the state of hypertension care remains the first step towards planning a robust health system needed to tackle the rising burden of hypertension. Prior to the commencement of the Community Action Against Non-Communicable Disease project, we assessed hypertension care using the hypertension care cascade (HCC). This will serve as a baseline to evaluate project performance upon completion. METHODS Hypertensive subjects were grouped into a mutually exclusive care cascade of 5 categories including unscreened and undiagnosed; screened but undiagnosed; diagnosed but untreated; treated but uncontrolled and treated with controlled hypertension. RESULTS Of the 372 participants, mean age 48.9 years, 161 (43.3%) were hypertensive, of whom only 12.0% had controlled blood pressure (BP). Among the 88.0% with uncontrolled BP,19.0% were unscreened and undiagnosed, 48.5% were screened but undiagnosed, 13.0% were diagnosed but untreated and 7.5% were treated but BP uncontrolled. The HCC demonstrates that 19% of the hypertensive patients were lost at the screening stage, 60% of those who were screened never diagnosed, 40% of those who were diagnosed did not receive treatment and 60% of those who were on treatment did not reach target BP. CONCLUSION Unmet need of hypertension care is substantially high, thus underpinning the need for intervention with a multifaceted approach.
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6
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Umuerri EM, Aiwuyo HO. Prevalence and correlates of prehypertension and hypertension among adults in Delta State, Nigeria: a cross-sectional community-based study. Ghana Med J 2021; 54:48-57. [PMID: 32863413 PMCID: PMC7445701 DOI: 10.4314/gmj.v54i1.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk. Objective To determine the prevalence, awareness and correlates of prehypertension and hypertension among adults in Delta State, Nigeria. Methods This was a cross-sectional study. We recruited adults aged ≥18 years from two communities in Delta State, Nigeria, using the multi-stage sampling technique. The study instrument was a modified WHO-STEPS questionnaire. Prehypertension and hypertension were defined using the JNC-7 criteria. Ethical approval was obtained before the recruitment of participants. Results Of the 852 adults studied, the mean (±SD) age was 42.64 (±16.07) years, females (55.9%) and urban dwellers (55.8%). The prevalence of prehypertension and hypertension were 42.5% and 29.3%, respectively; both were higher among urban dwellers. The peak age-group for prehypertension and hypertension were 25-34 and 35-44 years, respectively. Awareness of hypertension was low; 12.0% (102/852). Blood pressure category significantly correlated with age, body mass index, place of residence, level of education, employment status and fruit intake. Conclusion The prevalence of prehypertension and hypertension in this study were high. Based on the premise that prehypertension is a precursor of hypertension and occurred more among youths, the higher prevalence of prehypertension gives an inkling to rising prevalence of hypertension. Funding Nil.
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Affiliation(s)
- Ejiroghene M Umuerri
- Department of Medicine, Delta State University, PMB 01, Abraka, Nigeria.,Cardiology Unit, Department of Medicine, Delta State University Teaching Hospital, PMB 07, Oghara, Nigeria
| | - Henry O Aiwuyo
- Cardiology Unit, Department of Medicine, Delta State University Teaching Hospital, PMB 07, Oghara, Nigeria
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Adeloye D, Owolabi EO, Ojji DB, Auta A, Dewan MT, Olanrewaju TO, Ogah OS, Omoyele C, Ezeigwe N, Mpazanje RG, Gadanya MA, Agogo E, Alemu W, Adebiyi AO, Harhay MO. Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence. J Clin Hypertens (Greenwich) 2021; 23:963-977. [PMID: 33600078 PMCID: PMC8678849 DOI: 10.1111/jch.14220] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria. A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed random‐effects meta‐analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta‐regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty‐three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre‐hypertension (120‐139/80‐89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%‐39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%‐34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age‐adjusted prevalence 8.6%, 95% CI: 6.5‐10.7) to 27.5 million individuals with hypertension in 2020 (age‐adjusted prevalence 32.5%, 95% CI: 29.8‐35.3). The age‐adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020. Only 29.0% of cases (95% CI: 19.7‐38.3) were aware of their hypertension, 12.0% (95% CI: 2.7‐21.2) were on treatment, and 2.8% (95% CI: 0.1‐5.7) had at‐goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.
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Affiliation(s)
- Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Eyitayo O Owolabi
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Dike B Ojji
- Department of Medicine, Faculty of Clinical Sciences, University of Abuja, Gwagwalada, Abuja, Nigeria
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | - Timothy O Olanrewaju
- Department of Medicine, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | | | | | | | | | - Muktar A Gadanya
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | | | | | | | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Anakwue RC, Nnakenyi ID, Maduforo AN, Young EE, Okoli CI, Ndiokwelu CI, Ezenduka CC. Heavy metal content of rice meals sold in a Nigerian market population with a high prevalence of hypertension. Ann Afr Med 2021; 20:37-41. [PMID: 33727510 PMCID: PMC8102898 DOI: 10.4103/aam.aam_12_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/09/2020] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Context Some market populations in Nigeria have been shown to have high prevalence of hypertension. Current evidence includes environmental pollutants such as heavy metals as risk factors for hypertension. Aim To study the heavy metal content of rice meals sold in a market population with a high prevalence of hypertension. Settings and Design This was a descriptive, cross-sectional study conducted in Ogbete market in Enugu, Southeast Nigeria. Subjects and Methods Five different cooked rice meals were obtained from 25 locations of the market. The rice meals included jollof rice, white rice and tomato stew, fried rice, white rice and vegetable sauce, and white rice and palm oil stew (ofeakwu). Accompanying protein (meat, fish, and egg) and vegetable salad were excluded. Similar rice meals were homogenized and analyzed in triplicates using spectrophotometric methods for mercury, copper, cadmium, lead, and arsenic determination. Statistical Analysis Used The mean concentrations of the heavy metals were compared using analysis of variance, and P < 0.05 was considered statistically significant. Results Twenty-five rice dishes were evaluated, five of each kind. Arsenic content ranged from 503 to 550 mg/kg and was comparable across the five rice dishes (P = 0.148). Copper was significantly highest (16767 mg/kg) in the white rice and tomato stew dish (P < 0.001), while mercury was significantly highest (33 mg/kg) in white rice and ofeakwu (P < 0.001). Jollof rice had the highest cadmium content (23 mg/kg), which was statistically significant (P = 0.021). Lead was not found in any of the rice dishes. Conclusions Risk factors such as heavy metals may play a role in the high prevalence of hypertension observed in market populations, and rice meals may be a major source of these heavy metals.
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Affiliation(s)
- Ralph C. Anakwue
- Department of Medicine, College of Medicine, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria
- Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria
| | - Ifeyinwa Dorothy Nnakenyi
- Department of Chemical Pathology, College of Medicine, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria
| | - Aloysius N. Maduforo
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka Campus, Enugu, Nigeria
| | - Ekenechukwu E. Young
- Department of Medicine, College of Medicine, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria
| | - Chijioke I. Okoli
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Nsukka, Nigeria
| | - Chika I. Ndiokwelu
- Department of Biochemistry, Human Nutrition and Dietetics Unit, College of Medicine, University of Calabar, Calabar, Nigeria
| | - Charles C. Ezenduka
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Nsukka, Nigeria
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Berhe DA, Yenit MK, Baraki AG. The Burden of Hypertension and Associated Factors Among Adults Visiting the Adult Outpatient Department at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2016. Vasc Health Risk Manag 2020; 16:545-552. [PMID: 33364773 PMCID: PMC7751300 DOI: 10.2147/vhrm.s285900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/09/2020] [Indexed: 01/13/2023] Open
Abstract
Background Hypertension is a global health concern that can lead to cardiovascular disease and death. In Ethiopia, the risks for cardiovascular disease have been increasing dramatically. But due to the high burden of communicable diseases, less emphasis is given to non-communicable diseases like hypertension. This study aimed to fill the information gap by determining the prevalence and the key determinants of hypertension in the study area. Methods Institution-based cross-sectional study was conducted in Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia from September to October 2016. A total of 414 adults visiting medical OPDs were selected using systematic random sampling. Data were collected by blood pressure measurements and a pre-tested structured questionnaire. Descriptive statistics were computed. Multivariable logistic regression analysis was used to determine the adjusted odds ratio with a 95% confidence interval. The goodness of fit of the model was also checked by Hosmer and Lemeshow test. Results The overall prevalence of hypertension in the study area was 38.9% (95% CI: 34.1-43.7). Age above 55 years (AOR = 3.33, 95% CI: 1.88-5.90), family history of hypertension (AOR = 2.71, 95% CI: 1.37-5.36), diabetes (AOR = 4.15, 95% CI 1.77-9.72), obesity (AOR = 5.50, 95% CI: 2.07-14.62), knee arthritis (AOR = 1.71, 95% CI: 1.24, 2.36), and not walking at least for 10 minutes continuously on daily basis (AOR = 2.86, 95% CI: 1.15 -7.12) were found to be independent predictors of hypertension. Conclusion Prevalence of hypertension was high in the study area, and a large proportion of them were also newly diagnosed. Factors like age, family history of hypertension, diabetes, obesity, knee arthritis, and exercise were found to be independent predictors of hypertension. Therefore, we recommend people who have these risk factors to have screening for hypertension.
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Affiliation(s)
- Daniel Awraris Berhe
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Banigbe BF, Itanyi IU, Ofili EO, Ogidi AG, Patel D, Ezeanolue EE. High prevalence of undiagnosed hypertension among men in North Central Nigeria: Results from the Healthy Beginning Initiative. PLoS One 2020; 15:e0242870. [PMID: 33253296 PMCID: PMC7703905 DOI: 10.1371/journal.pone.0242870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prevalence of hypertension in Nigeria is high and growing. The burden and risk factor distribution also vary by geographical zone. Information about prevalence, risk factors and disease status awareness are needed to guide evidence based public health response at the national and sub- national levels. PURPOSE This paper describes the prevalence of hypertension and its correlates, as well as hypertension status awareness among men in North Central, Nigeria. METHODS A cross sectional survey was administered to male partners of pregnant women participating in the Healthy Beginning Initiative program from 2016-2018. Information on socio-demographic characteristics, risk factors, physical measurement and blood pressure readings were collected using a standardized protocol. Data was analyzed with simple and multiple logistic regression. RESULTS The 6,538 men had a median age of 31 years [IQR: 26-37]. The prevalence of hypertension was 23.3% (95% CI: 22.3%-24.4%), while 46.7% had prehypertension. The odds of hypertension was associated with increasing age (OR:1.02, CI:1.01-1.03), being overweight (aOR:1.5,CI:1.3-1.8), being obese (aOR:2.6,CI:2.0-3.3), living in an urban area (aOR:1.6,CI:1.2-2.1), and alcohol use in the 30 days prior (aOR:1.2,CI:1.1-1.4). Overall, 4.5% (297/6,528) of participants had ever been told they have hypertension. Among the 23.3% (1,527/6,528) with hypertension, 7.1% (109/1,527) were aware of their disease status. Men aged 41-50 years (aOR: 1.8, CI: 1.0-3.3), and > 50 years (aOR: 2.2, CI: 1.1-4.3), had higher odds disease status awareness. Living in an urban area was associated with lower odds (aOR: 0.2, CI: 0.03-0.7) of hypertension status awareness. CONCLUSION This study showed that hypertension is already a significant public health burden in this population and that disease awareness level is very low. Alcohol use and obesity were associated with hypertension, highlighting some modifiable cardiovascular disease risk factors that are prevalent in the study population. Taken together, these findings can inform the design of interventions for primary and secondary cardiovascular disease prevention in Nigeria and similar settings.
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Affiliation(s)
- Bolanle Feyisayo Banigbe
- APIN Public Health Initiatives, Abuja, Nigeria
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Elizabeth Odilile Ofili
- Clinical Research Center, Morehouse School of Medicine, Atlanta, Georgia, United States of America
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Amaka Grace Ogidi
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Dina Patel
- Healthy Sunrise Foundation, Las Vegas, Nevada, United States of America
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Las Vegas, Nevada, United States of America
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Opportunistic screening of cardiovascular disease risk factors in community pharmacies in Nigeria: a cross-sectional study. Int J Clin Pharm 2020; 42:1469-1479. [PMID: 32960427 DOI: 10.1007/s11096-020-01112-2] [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: 06/22/2019] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
Background Early identification and treatment of cardiovascular disease (CVD) risk factors through screening are crucial in the primary prevention of CVD and reduction in healthcare-related costs. Use of Non-Physician Healthcare-workers including Community Pharmacists has been advocated as an effective and cost-efficient model of healthcare delivery. In Nigeria the use of community pharmacists for mass screening of CVD risk factors has not been explored. Objective We sought to investigate the possibility of mass CVD risk factor screening in community pharmacies by pharmacists. Setting Lagos, Nigeria. Methods Between October and December 2018 eight hundred and eighty-nine apparently healthy participants were screened for obesity, hypertension, diabetes and hypercholesterolaemia in ten community pharmacies. Diabetes and hypercholesterolaemia were screened for using point-of-care testing modalities. A structured questionnaire was used to obtain the socio-demographic data of the participants. Main outcome measures Prevalence of overweight/obesity, hypertension, diabetes, hypercholesterolaemia, smoking and alcohol intake. Results Mean age of the subjects was 56.8 ± 21.1 years. Majority (57.4%) were females. Prevalence of smoking and alcohol intake were 4.3% and 26.7% respectively. 59.7% and 71.5% of males and females were either overweight (BMI ≥ 25 kg/m2) or obese (BMI ≥ 30 kg/m2) respectively. Prevalence of hypertension was 28.2% in all subjects, 30.9% in males and 26.3% in females, p < 0.001. Using BP > 130/80 mmHg prevalence of hypertension was 55.1%. Diabetes was detected in 3% of the subjects while 45.3% had hypercholesterolaemia. In total, 64.1% of the subjects were diagnosed with CVD risk factors for the first time. Conclusion Opportunistic screening for CVD risk factors is possible in community pharmacies and has the ability to detect previously undiagnosed risk factors. This community pharmacy based model could serve as a cost-effective approach to primary prevention of CVD.
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Prevalence, Awareness, Treatment and Control of Hypertension in Nigeria: Data from a Nationwide Survey 2017. Glob Heart 2020; 15:47. [PMID: 32923341 PMCID: PMC7427662 DOI: 10.5334/gh.848] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Previous studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or non-standardized thereby making evaluation of trend in hypertension care difficult. Methods We used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country. Results The overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; North-East, 27.5%; North-West, 26.8%; South-East, 52.8%; South-South, 44.6%; and South-West, 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men. Conclusion Our results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.
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Dada SA, Ajayi DD, Raimi TH, Thomas AA, Dele-Ojo B. Risk factors for kidney disease among civil servants: Report of annual screening and medical evaluation. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2020; 31:440-447. [PMID: 32394917 DOI: 10.4103/1319-2442.284019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The outlook of chronic kidney disease (CKD) is worse among the poor sub-Saharan Africa populace due to limited and unaffordable renal replacement therapy. Regular screening of at-risk population can contribute to delaying or even preventing the progression of the disease. This study was designed to evaluate prevalent risk factors for CKD among the urban dwelling civil servants in Ado Ekiti. This is a cross-sectional observational study involving healthy adults above 18 years old. Data on sociodemographic and relevant lifestyle pattern such as smoking, alcohol intake, personal and family history of hypertension, diabetes, and kidney disease were obtained. Clinical variables such as anthropometric measurements, blood pressure (BP), and blood samples for laboratory investigations were taken. There were 122 participants with a mean age of 47.26 ± 5.62 years. About half of them earn <$140/month. Fifty-two (42.6%) individuals admitted taking local herbs and/or Chinese medicines and about a third (36.1%) use unprescribed medi-cations including nonsteroidal anti-inflammatory drugs. Family history of high BP and diabetes mellitus was present in 15.6% and 11.5% of individuals, respectively. We found 45 (32.6%) individuals with body mass index ≥30 kg/m2, while 13.3% and 3.3% have at least 1+ of dipstick and microalbuminuria, respectively. About one-third (25.4%) were either found to be hypertensive or were on antihypertensives, while 12 (9.8%) were either diabetic or had hyperglycemia during the screening. There is a high prevalence of risk factors for CKD among these apparently well individuals. Regular screening, and treatment of the identified risk factors is recommended.
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Affiliation(s)
- Samuel Ayokunle Dada
- Department of Medicine, Nephrology Unit, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
| | - David Daisi Ajayi
- Department of Medical Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Endocrine Unit, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
| | - Awolowo A Thomas
- Department of Radiodiagnostic, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
| | - Bolade Dele-Ojo
- Department of Medicine, Cardiology Unit, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
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Kretchy IA, Boima V, Agyabeng K, Koduah A, Appiah B. Psycho-behavioural factors associated with medication adherence among male out-patients with hypertension in a Ghanaian hospital. PLoS One 2020; 15:e0227874. [PMID: 31995606 PMCID: PMC6988959 DOI: 10.1371/journal.pone.0227874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/01/2020] [Indexed: 11/18/2022] Open
Abstract
Medication adherence is a key health outcome that reflects the health and general well-being of patients with hypertension. Challenges with adherence are common and associated with clinical, behavioural and psychosocial factors. This study sought to provide data on the extent of medication adherence among male patients with hypertension and their biopsychosocial predictors. Patient and clinical characteristics, psychological distress, insomnia and sexual dysfunction were hypothesized to predict outcomes of medication adherence. Utilizing quantitative data from a hospital-based cross-sectional study from 358 male out-patients with hypertension attending a tertiary hospital in Ghana, medication adherence was associated with age, marital status, educational level, income, duration of diagnosis, number of medications taken and sexual dysfunction. These findings support the need for biopsychosocial interventions aiming at promoting adherence while taking these factors into consideration for the benefit of improving the health and general well-being of male patients with hypertension.
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Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
- * E-mail: ,
| | - Kofi Agyabeng
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bernard Appiah
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, TAMU, College Station, Texas, United States of America
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Ameh OI, Ekrikpo UE, Kengne AP. Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action. Kidney Int Rep 2019; 5:255-262. [PMID: 32154447 PMCID: PMC7056849 DOI: 10.1016/j.ekir.2019.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
The epidemiologic transition occurring in low- and middle-income countries (LMICs) has led to a surge in chronic kidney disease (CKD) prevalence because of a combination of highly prevalent chronic noncommunicable diseases (NCDs) and communicable diseases (CDs). The progressive rise in CKD prevalence in LMICs threatens the existing weak health systems in these countries as care for advanced CKD remains largely unavailable and unaffordable. An interplay of low literacy levels, poor health-seeking behavior, inadequate health care funding, weak health systems, and lack of skilled nephrology workforce has made it difficult for adequate CKD preventive measures to be implemented. Primary, secondary, and tertiary prevention measures need to be instituted in LMICs by a collaboration of governmental and nongovernmental organizations to stem this tide and help prevent deaths from other NCDs that share similar risk factors with CKD. For these to be effective, locally relevant knowledge is needed to contextualize existing prevention and control solutions, or to develop novel and more appropriate solutions for LMICs.
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Affiliation(s)
- Oluwatoyin I. Ameh
- Division of Nephrology, Zenith Medical & Kidney Centre, Gudu, Abuja, Nigeria
| | - Udeme E. Ekrikpo
- Renal Unit, Department of Internal Medicine, University of Uyo, Uyo, Nigeria
- Kidney & Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Andre-Pascal Kengne
- Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Correspondence: Andre-Pascal Kengne, Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
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Akokuwebe ME, Odimegwu C. Socioeconomic Determinants of Knowledge of Kidney Disease Among Residents in Nigerian Communities in Lagos State, Nigeria. Oman Med J 2019; 34:444-455. [PMID: 31555422 PMCID: PMC6745423 DOI: 10.5001/omj.2019.81] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives We sought to estimate the knowledge, sociodemographic determinants, and risk-inducing lifestyles of kidney disease (KD) among Nigerians living in Lagos State. Methods We conducted a cross-sectional descriptive study to assess the level of knowledge of KD and its associated sociodemographic factors of individuals living in urban and semi-urban communities of Lagos State, Nigeria. It is hoped that the results of this study will help to inform preventive modalities. We used a pretested, structured questionnaire to draw information from 1171 Nigerians aged ≥ 15 years. Results The mean age of respondents was 33.5±11.1 years. In our cohort, 72.4% of respondents were knowledgeable of KD, with media as their major source of information (41.6%). Knowledge of KD was significantly associated with age (p = 0.044), education (p < 0.001), marital status (p < 0.001), and place of residence (p = 0.048). The established KD risk-inducing lifestyle factors were habitual use of herbal supplements, significant alcohol consumption, and diabetes (p < 0.050). Significant predictors of knowledge of KD included primary education (Odds ratio (OR) = 0.367, 95% confidence interval (CI): 0.11–1.22; p =0.102), secondary education (OR = 0.296, 95% CI: 0.17–0.51; p < 0.001), Igbo ethnic group (OR = 1.471, 95% CI: 0.99–2.17; p = 0.047), and place of residence (OR = 1.332, 95% CI: 1.00–1.77; p = 0.048). Age 30–39 years (OR = 0.749, 95% CI: 0.48–1.18; p = 0.214), 40–49 years (OR = 1.083, 95% CI: 0.69–1.69; p = 0.727), and not working (OR = 1.178, 95% CI: 0.88–1.57; p < 0.269) were non-significant predictors of knowledge of KD. Conclusions Our cohort had inadequate knowledge of linking risk-inducing lifestyles to KD development. Effective measures and efforts should be made to create awareness and educate the general population on KD and prevention measures related to risk-inducing lifestyles to reduce the burden of KD among Nigerians.
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Affiliation(s)
- Monica Ewomazino Akokuwebe
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of Witwatersrand, Johannesburg, South Africa
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Chimberengwa PT, Naidoo M. Knowledge, attitudes and practices related to hypertension among residents of a disadvantaged rural community in southern Zimbabwe. PLoS One 2019; 14:e0215500. [PMID: 31237883 PMCID: PMC6657811 DOI: 10.1371/journal.pone.0215500] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022] Open
Abstract
Background Hypertension contributes significantly to cardiovascular and renal diseases.
It can be controlled by lifestyle modifications, however in poor communities
there is lack of awareness, and treatment and control of hypertension is
often poor. The aim of this study was to determine hypertension knowledge,
attitudes and practices in a disadvantaged rural community in Matebeleland
South province of Zimbabwe. Methods We conducted a descriptive cross-sectional survey on hypertensive patients in
the community. A pre-tested and validated interviewer-administered
questionnaire was used to collect demographic, awareness, treatment and
control data among consenting hypertensive patients. Results 304 respondents were enrolled into the study (mean age, 59 years), and a
majority were women (65.4%). The treatment default rate was 30.9%, and 25%
of respondents on medication did not know their blood pressure control
status. Knowledge on hypertension was poor, with 64.8% of respondents
stating that stress was its main cause, 85.9% stated that palpitations were
a symptom of hypertension and 59.8% of respondents added salt on the table.
The more education respondents had received, the more likely they were
knowledgeable about hypertension (odds ratio for secondary education, 3.68
[95% CI: 1.61–8.41], and for tertiary education, 7.52 [95% CI: 2.76–20.46],
compared to those without formal education). Those who believed in herbal
medicines (50.7%) and those who used traditional medicines (14.5%) were 53%
(95% CI: 0.29–0.76) and 68% (95% CI: 0.29–0.76) less likely to be
knowledgeable about hypertension compared to those who did not believe in or
use traditional medicines, respectively. Conclusion Members of the community had poor knowledge on hypertension. This was
associated with a lack of education and with strong beliefs in herbal and
traditional medicines in the community, which influenced attitudes and
practices on hypertension. Dietary risk factors were linked to poor
knowledge. Hypertensive medicine shortages at the clinic resulted in
worsened hypertension care and poor hypertension outcomes in the
community.
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Affiliation(s)
- Pugie Tawanda Chimberengwa
- Discipline of Public Health Medicine, School of Nursing and
Public Health, University of KwaZulu-Natal, Durban, South
Africa
- * E-mail:
| | - Mergan Naidoo
- Discipline of Public Health Medicine, School of Nursing and
Public Health, University of KwaZulu-Natal, Durban, South
Africa
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Onodugo O, Ezeala-Adikaibe A, Orjioke C, Onodugo PN, Ijoma UN, Chime P, Mbadiwe N, Onyekonwu C, Anyim OB, Obumneme-Anyim IN, Young E, Nwatu CB, Okoye JU, Nwobodo MU. Factors Associated with Asymptomatic Proteinuria in Adult Nigerians. A Community-Based Study. Health (London) 2019. [DOI: 10.4236/health.2019.116051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ambakederemo TE, Chikezie EU. Assessment of some traditional cardiovascular risk factors in medical doctors in Southern Nigeria. Vasc Health Risk Manag 2018; 14:299-309. [PMID: 30498356 PMCID: PMC6207391 DOI: 10.2147/vhrm.s176361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Almost one third of deaths globally are caused by cardiovascular diseases (CVDs). Certain occupations may promote the development and worsening of risk factor for CVDs. We assessed some traditional cardiovascular risk factors and lifestyle choices that may predispose to CVDs in medical doctors in a tertiary health facility in Southern Nigeria. STUDY DESIGN Cross-sectional study. PARTICIPANTS AND METHODS One hundred sixty-nine apparently healthy medical doctors were recruited. A structured self-administered questionnaire was used to gather data on CVD risk factors. Anthropometric and blood pressure (BP) measurements were taken. RESULTS Majority were males (68.0%), aged 20-39 years (43.8%), single (62.7%), and house officers (58.0%) with<1 year (48.5%) work experience. Over half were either overweight or obese. While 77.2% of those not centrally obese were males, only about 22.8% of females did not meet the criteria for central obesity (P-value < 0.05). While respondents had BP in prehypertensive (48.2%), stage 1 (18.5%), or stage 2 hypertension (3.6%) ranges, only 7.7% had a previous diagnosis of hypertension. Only 25.4% took fruits on a daily basis and engaged in aerobic exercises up to 30 minutes daily or at least 3-5 times a week. Other poor lifestyle choices included non-lean meat intake (76.8%), low water intake (88.2%), and junk food and soda drinks intake (daily 28%, weekly 51.2%). CONCLUSION Findings of a high prevalence of overweight/obesity, physical inactivity, and junk food intake and low fruits intake among doctors is worrisome. There is a need to educate doctors on adopting healthier lifestyles to reduce risk of CVDs.
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Affiliation(s)
| | - Eze Uzoechi Chikezie
- Department of Mental Health, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa, Nigeria
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Joseph-Shehu EM, Ncama BP. Evaluation of health status and its predictor among university staff in Nigeria. BMC Cardiovasc Disord 2018; 18:183. [PMID: 30236072 PMCID: PMC6148776 DOI: 10.1186/s12872-018-0918-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hypertension, diabetes mellitus and obesity share some characteristics in relation to diagnosis, management, and prevention. Overweight, obesity and waist-hip ratio (WHR) are associated with increased risk for development of diabetes and hypertension. Surveillance and regular screening exercises are essential in control and prevention of overweight, obesity, diabetes and hypertension. There is limited literature that reported on these health status parameters among university staff in low- and middle-income countries such as Nigeria. It is currently unclear whether Nigerian have a high or low proportion of metabolic risk factors. Therefore, the study aims to examine health status parameters and their predictors among university staff in Nigeria. METHODS The study used a cross-sectional descriptive design. Data were collected from 280 university staff in Nigeria. A self-administered questionnaire with sections for sociodemographic data and physical assessment was used to gather information from the participants. Data were analysed using the Statistical Package for Social Science (IBM-SPSS version 25). Univariable and multivariable logistic regression was conducted to explore the association between predictors and health status parameters of the participants. RESULT The response rate was 87.5%. University staff had mean systolic blood pressure of 132.04 mmHg ± 19.20 mmHg, diastolic blood pressure of 78.11 mmHg ± 10.81 mmHg, body mass index of 27.74 ± 5.22, waist-hip ratio of 0.88 ± 0.68 and random blood sugar of 98.65 ± 21.30 mg/dL. Predictors of high blood pressure were age (adjusted odds ratio [aOR] = 1.10, CI 95%: [1.05-1.14]) and gender (aOR = 0.5, CI 95%: [0.8-0.9]) and predictors of body mass index were gender (aOR = 2.3, CI 95%: [1.3-4.2]) and religion (aOR = 0.3, CI 95%: [0.2-0.7]). Gender and age had statistically significant association with waist-hip ratio and random blood sugar respectively. CONCLUSION The prevalence rates of high blood pressure and random blood sugar; overweight, obesity and risk WHR are on the increase compared to previous studies. Lifestyle modification, organized and explicit health campaigns coupled with regular screening and surveillance will contribute to the prevention and control of noncommunicable diseases.
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Affiliation(s)
- Elizabeth M. Joseph-Shehu
- School of Nursing and Public Health, Postgraduate Office, Ground Floor, George Campbell Building, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing Science, Faculty of Health Sciences, National Open University of Nigeria, Abuja, Nigeria
| | - Busisiwe P. Ncama
- School of Nursing and Public Health, Postgraduate Office, Ground Floor, George Campbell Building, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
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Azeez I, Yusuf B. CASE FINDING OF HYPERTENSION AT A SECONDARY HEALTH CARE FACILITY IN SOUTH-WEST NIGERIA. Ann Ib Postgrad Med 2018; 16:44-51. [PMID: 30254558 PMCID: PMC6143890] [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: 11/12/2022] Open
Abstract
BACKGROUND The prevalence of hypertension is higher in Semi-urban areas than in rural areas. There is a rising prevalence of hypertension in developing countries. Significant independent association has been found between age, family history and prevalence of hypertension according to the literature. This study sought to determine the prevalence of hypertension at the State Hospital Oyo and provide evidence for routine checks of blood pressure (BP) for adult patients. METHODS A Cross-sectional study was conducted at the General Outpatient Clinic of the State Hospital Oyo. 350 adults between the ages of 18 and 70 years were recruited for the study. A total sampling technique was used to recruit consecutive patients until a sample size of 350 was achieved. RESULTS The prevalence of hypertension was 102/350 = 29%. Thirty (29.70%) of respondents who were 55 years and above had systolic hypertension while 24 (23.80%) had normal BP (χ2 = 87.62, p-value = 0.0001). Majority (57.6%) of respondents who had tertiary education had normal blood pressure while 24 (20.3%) had systolic hypertension (χ2 = 39.88, p-value = 0.0001). Twenty one (36.8%s) of respondents who were obese had systolic hypertension while 16 (28.1%) had normal blood pressure (χ2 = 20.61 , p-value = 0.02). Thirteen (12.80%) of respondents who were 55 years and above had diastolic hypertension while a majority (58.40%) had normal BP (χ2 = 33.40, p-value = 0.0001). CONCLUSION Age, obesity and education were found to be risk factors for developing hypertension. However after adjusting for other variables, the predictor of risk of developing hypertension was age of respondents.
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Affiliation(s)
| | - B.O. Yusuf
- Department of Environmental Science, University of Ibadan, Ibadan
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Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study. Int J Hypertens 2018; 2018:8307591. [PMID: 29854433 PMCID: PMC5944291 DOI: 10.1155/2018/8307591] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/07/2018] [Accepted: 03/20/2018] [Indexed: 11/17/2022] Open
Abstract
Background and Methods Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. Methods In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB). Data was analyzed following a semantic thematic analysis approach. Results Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Conclusion Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.
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Sarfo FS, Mobula LM, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O, Ofori-Adjei D. Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study. PLoS One 2018; 13:e0193494. [PMID: 29554106 PMCID: PMC5858765 DOI: 10.1371/journal.pone.0193494] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/12/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The burden of uncontrolled hypertension in Low-and-Middle Income Countries (LMICs) is high, with an increased risk of cardiovascular diseases and chronic renal failure in these settings. OBJECTIVE To assess the factors associated with uncontrolled blood pressure control in a cross-section of Ghanaian hypertensive subjects involved in an on-going multicenter epidemiological study aimed at improving access to hypertension treatment. METHODS A cross-sectional study involving 2,870 participants with hypertension with or without diabetes who were enrolled at 5 hospitals in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-hypertensive medications and treatment adherence were collected. The 14-item version of the Hill-Bone compliance to high blood pressure therapy scale was used to assess adherence to treatment in 3 domains namely adherence to medications, salt intake and clinic appointments. Questionnaires on knowledge, attitudes and practices on hypertension, sources of antihypertensive medications and challenges with accessing these medications were also administered. Blood pressure, weight and height were measured for each subject at enrollment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model. RESULTS The mean ± SD age of study participants was 58.9 ± 16.6 years, with a female preponderance (76.8%). Among study participants, 1,213 (42.3%) study participants had blood pressure measurements under control. Factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95% CI) included receiving therapy at a tertiary level of care: 2.47 (1.57-3.87), longer duration of hypertension diagnosis: 1.01 (1.00-1.03), poor adherence to therapy: 1.21 (1.09-1.35) for each 5 points higher score on the Hill-Bone scale, reported difficulties in obtaining antihypertensive medications: 1.24 (1.02-1.49) and number of antihypertensive medications prescribed: 1.32 (1.21-1.44). CONCLUSION We have found high rates of uncontrolled blood pressure among Ghanaian patients with hypertension accessing healthcare in public institutions. The system-level and individual-level factors associated with poor blood pressure control should be addressed to improve hypertension management among Ghanaians.
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Affiliation(s)
- Fred Stephen Sarfo
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - Linda M. Mobula
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Gilbert Burnham
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Daniel Ansong
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Osei Sarfo-Kantanka
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ofori-Adjei
- Department of Medicine & Therapeutics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
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Bello-Ovosi BO, Asuke S, Abdulrahman SO, Ibrahim MS, Ovosi JO, Ogunsina MA, Anumah FO. Prevalence and correlates of hypertension and diabetes mellitus in an urban community in North-Western Nigeria. Pan Afr Med J 2018; 29:97. [PMID: 29875978 PMCID: PMC5987122 DOI: 10.11604/pamj.2018.29.97.14191] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/17/2018] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Worldwide, hypertension and diabetes mellitus (DM) are major causes of morbidity and mortality. This study assesses the prevalence and correlates of hypertension and DM in an urban community in northwestern Nigeria. METHODS This was a cross-sectional descriptive study. Adults aged 18 years and above, who attended a medical outreach program were interviewed and screened for hypertension and DM. Anthropometry, blood glucose and blood pressure were measured with standard instruments and methodology. Primary outcomes were hypertension and DM. Data were analyzed using STATA version 14 and presented as mean ± standard deviation and frequencies. Chi-square and Pearson's correlation co-efficient were used to identify the correlates of hypertension and DM, at 5% level of significance. RESULTS The mean age of participants was 51.0 ± 14.0 years and 87.8% were females. Prevalence of hypertension and DM were 55.9% and 23.3% respectively. Age greater than 40 years and female gender were associated with risk of hypertension and DM respectively, p < 0.05. There was a weak correlation between systolic hypertension and age (r = 0.18, p = 0.02), diastolic hypertension and body mass index (r = 0.16, p = 0.03) and blood sugar and waist circumference (r = 0.19, p = 0.02). CONCLUSION The high prevalence of hypertension and DM among the study population highlights the need for the development and implementation of a community-based public health interventions aimed at reducing their risk factors.
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Affiliation(s)
| | - Sunday Asuke
- Department of Community Medicine, Bingham University, Jos, Nigeria
| | | | | | | | - Modupe Arinola Ogunsina
- Department of Internal Medicine, Kaduna State University/BarauDikko Teaching Hospital, Kaduna, Nigeria
| | - Felicia Ohunene Anumah
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
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Raji YR, Abiona T, Gureje O. Awareness of hypertension and its impact on blood pressure control among elderly nigerians: report from the Ibadan study of aging. Pan Afr Med J 2017; 27:190. [PMID: 28904715 PMCID: PMC5579467 DOI: 10.11604/pamj.2017.27.190.11682] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/04/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Hypertension is highly prevalent among the elderly. Its awareness has a direct influence on control through drug adherence. Earlier studies have shown that awareness of hypertension is low among sub-Saharan African populations but only a few studies have looked at the prevalence and awareness of hypertension among the elderly. METHODS The Ibadan Study of Ageing is a longitudinal cohort study of the mental and physical health status as well as the functioning of elderly persons residing in the Yoruba-speaking areas of Nigeria. Study was conducted in multiple waves from 2003/2004 to 2009. This report is based on the sample studied in 2007 (N = 1469). Respondents, aged ≥ 65 years, were assessed for the presence of hypertension, its awareness, receipt of and adherence to medication for the condition, and effectiveness of treatment on the control of blood pressure. Blood pressure was measured with the use of digital monitors (Omron MS - 2 Basic Model). Awareness of the diagnosis of hypertension was ascertained by self-reports. We explored social, economic, demographic and clinical correlates of the presence of hypertension, its awareness and control using multiple logistic regression analyses. RESULTS The sample was composed of 809 (55.1%) females and 666 (44.9%) males. The mean age of the participants was 76.9 ± 8.4 years. Hypertension (defined as previous diagnosis by a health provider or a measured blood pressure higher than or equal to 140/90 mm Hg) was recorded in 973 (62.2%) participants, with females having a prevalence of 61.4% and males that of 70.1%. Other than female gender, residing in urban/semi urban areas and being overweight or obesity were associated with the occurrence of hypertension. Among those assessed to have hypertension, 78% were not previously aware of its presence. Factors independently associated with lack of awareness of hypertension included low socioeconomic class (OR 8.21, 95% CI 3.72-18.11, P < 0.001), and BMI >25kg/m2 (OR 3.11, 95% CI 1.36-7.09, P < 0.009). Among those who were aware of the presence of hypertension and were on treatment, 77.3% still had uncontrolled hypertension. Only obesity or overweight (OR 5.56, 95% CI 1.35 - 22.83, P < 0.016) was independently associated with poor blood pressure control. CONCLUSION The prevalence of hypertension among elderly Nigerians is high and those affected are often not aware of having the condition. Only a minority of those who receive treatment for the condition have adequate blood pressure control. The findings highlight the need for improved healthcare for the growing population of elderly persons, with particular attention to early detection and effective control of the condition.
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Affiliation(s)
- Yemi Raheem Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Taiwo Abiona
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Jardim TV, Reiger S, Abrahams-Gessel S, Gomez-Olive FX, Wagner RG, Wade A, Bärnighausen TW, Salomon J, Tollman S, Gaziano TA. Hypertension management in a population of older adults in rural South Africa. J Hypertens 2017; 35:1283-1289. [PMID: 28441697 PMCID: PMC5505070 DOI: 10.1097/hjh.0000000000001312] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Assess awareness, treatment, and control of hypertension, as an indication of its management, in rural South Africa, especially regarding modifiers of these variables. METHODS A population-representative sample of adults aged at least 40 years residing in the rural Agincourt subdistrict (Mpumalanga Province) covered by a long-term health and sociodemographic surveillance system was recruited. In-person interviews, physical exams, and dried blood spots were collected. Hypertension awareness, treatment, and control rates were assessed. A regression model was built to identify predictors of those outcomes. RESULTS The mean age of the 2884 hypertensive participants was 64.1 ± 12.7 years. Hypertension awareness rate was 64.4%, treatment among those aware was 89.3 and 45.8% of those treated were controlled. Considering aware and unaware hypertensives, treatment rate was 49.7% and control 22.8%. In the multivariable regression model, awareness was predicted by female sex, age at least 60 years, higher social economic status, prior cardiovascular disease (CVD), nonimmigrant status, literacy, and physical limitation. Improved control among those treated was predicted by age at least 60 years. Blood pressure control among all hypertensive study participants was predicted by female sex, being HIV-negative, age at least 60 years, nonimmigrant status, and prior CVD. CONCLUSION High rates of awareness and treatment of hypertension as well as good levels of control were found in this population, probably explained by the long-term surveillance program conducted in the area. Considering the predictors of hypertension management, particular attention should be given to men, residents younger than 60 years, immigrants, and study participants without CVD as these characteristics were predictors of poor outcome.
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Affiliation(s)
- Thiago Veiga Jardim
- Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston
| | - Sheridan Reiger
- Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston
| | | | - F. Xavier Gomez-Olive
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Africa Wits-INDEPTH Genomic Studies of Cardiovascular Disease, University of the Witwatersrand; Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine
| | - Ryan G. Wagner
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Africa Wits-INDEPTH Genomic Studies of Cardiovascular Disease, University of the Witwatersrand; Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine
- Umea Centre for Global Health Research, Umea University, Umea, Sweden
| | - Alisha Wade
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Africa Wits-INDEPTH Genomic Studies of Cardiovascular Disease, University of the Witwatersrand; Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Till W. Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Africa Health Research Institute (AHRI), Mtubatuba, South Africa
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Joshua Salomon
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephen Tollman
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Africa Wits-INDEPTH Genomic Studies of Cardiovascular Disease, University of the Witwatersrand; Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine
- Africa Health Research Institute (AHRI), Mtubatuba, South Africa
| | - Thomas A. Gaziano
- Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston
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Awareness, Treatment, and Control of Hypertension in Primary Health Care and Secondary Referral Medical Outpatient Clinic Settings at Enugu, Southeast Nigeria. Int J Hypertens 2017; 2016:5628453. [PMID: 28050277 PMCID: PMC5168444 DOI: 10.1155/2016/5628453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 11/01/2016] [Indexed: 01/19/2023] Open
Abstract
Essential hypertension is the most common noncommunicable disease (NCD), affecting more than half the adult population in many countries and being the major NCD contributor to the double burden of disease in developing countries. We undertook a survey of the hypertension awareness, treatment, and control in primary and secondary referral health care clinics in Enugu, Nigeria, and compared these data with those obtained in local community surveys. The prevalence of hypertension in the primary care clinic (9.2%) was lower than in a previously reported community survey (42.2%), while, in the referral clinic, 70.3% of patients attending were hypertensive. Hypertension awareness rates were 91.9%, 29.4%, and 93.2% in these respective health care settings. Treatment and control rates (89.9% and 72.9%) were better in the secondary care clinic than in the primary care centre (87.7% and 46.0%). (Chi-square analysis confirmed statistically significant differences between these rates (p < 0.05).) These data may form a useful index of health care system effectiveness in Nigeria. Possible reasons for the differences observed and effective strategies to address the waxing pandemic of hypertension are discussed.
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Adeloye D, Basquill C, Aderemi AV, Thompson JY, Obi FA. An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. J Hypertens 2016; 33:230-42. [PMID: 25380154 DOI: 10.1097/hjh.0000000000000413] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypertension is a leading cause of morbidity and mortality in Africa, and Nigeria, the most populous country in the continent, hugely contributes to this burden. OBJECTIVE To provide an improved estimate of the prevalence and number of cases of hypertension in Nigeria based on the cut-off 'at least 140/90 mmHg', towards ensuring better awareness, control and policy response in the country. METHODS We conducted a systematic search of Medline, EMBASE and Global Health from January 1980 to December 2013 for population-based studies providing estimates on the prevalence of hypertension in Nigeria. From the extracted crude prevalence rates, we conducted a random-effects meta-analysis, and further estimated the overall awareness rate of hypertension in Nigeria, expressed as percentage of all hypertension cases. We applied a meta-regression epidemiological modelling, using United Nations population demographics for the years 2010 and 2030, to determine the prevalence and number of cases of hypertension in Nigeria for the 2 years. RESULTS Our search returned 2260 publications, 27 of which met our selection criteria. From the random-effects meta-analysis, we estimated an overall hypertension prevalence of 28.9% (25.1, 32.8), with a prevalence of 29.5% (24.8, 34.3) among men and 25.0% (20.2, 29.7) among women. We estimated a prevalence of 30.6% (24.5, 36.6) and 26.4% (19.4, 33.4) among urban and rural dwellers, respectively. The pooled awareness rate of hypertension was 17.4% (11.4, 23.3). The overall mean SBP was 128.6 (125.5, 130.8) mmHg, and the DBP was 80.6 (78.5, 82.7) mmHg. From our modelling, we estimated about 20.8 million cases of hypertension in Nigeria among people aged at least 20 years in 2010, with a prevalence of 28.0% (24.6, 31.9) in both sexes - 30.7% (24.9, 33.7) among men and 25.2% (22.7, 31.9) among women. By 2030, we projected an increase to 39.1 million cases of hypertension among people aged at least 20 years with a prevalence of 30.8% (24.5, 33.7) in both sexes - 32.6% (27.3, 38.2) among men and 29.0% (21.9-32.2) among women. CONCLUSIONS Our findings suggest the prevalence of hypertension is high in Nigeria, and the overall awareness of raised blood pressure among hypertension cases is low in the country. We hope this study will inform appropriate public health response towards reducing this burden.
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Affiliation(s)
- Davies Adeloye
- aCentre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, University of Edinburgh Medical School, Edinburgh bSchool of Biosciences, University of Kent, Canterbury, Kent cNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK dHealth Reform Foundation of Nigeria, HERFON Secretariat, Asokoro, Abuja, Federal Capital Territory, Nigeria
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Determinants of Mean Blood Pressure and Hypertension among Workers in West Africa. Int J Hypertens 2016; 2016:3192149. [PMID: 26949543 PMCID: PMC4754493 DOI: 10.1155/2016/3192149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/03/2016] [Accepted: 01/06/2016] [Indexed: 12/11/2022] Open
Abstract
Background. This review was undertaken to estimate the mean blood pressure and evaluate its determinants as well as the determinants of hypertension among workers in West Africa. Methods. In a follow-up to an earlier study, a systematic search for articles published between 1980 and August 2015 was undertaken using major databases. Results. A total of 55 articles involving 34,919 different cadres of workers from six countries were retrieved. The mean systolic blood pressure (BP) ranged from 116.6 ± 1.3 mmHg to 151.7 ± 13.6 mmHg while the mean diastolic BP ranged from 69.6 ± 11.0 mmHg to 97.1 ± 9.1 mmHg. Population-wide prehypertension was common. The major determinants of mean BP and hypertension were similar and included male sex, older age group, higher socioeconomic status, obesity, alcohol consumption, plasma glucose, and sodium excretion. Ethnicity and educational level were inconsistently associated with hypertension. Workers at higher risk of cardiovascular event did not perceive themselves as such. Conclusion. The prevailing mean prehypertensive BP, low perception of risk, and clustering of risk factors call for interventions such as healthy diets, improved physical activity, and a favourable work environment. Successful models for improving the cardiovascular health of sedentary informal sector workers in Africa are urgently needed.
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Knowledge, Treatment, Control, and Risk Factors for Hypertension among Adults in Southern Iran. Int J Hypertens 2015; 2015:897070. [PMID: 26783454 PMCID: PMC4689970 DOI: 10.1155/2015/897070] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/22/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Hypertension is the first and the most common risk factor to diseases such as cardiovascular, stroke, and renal diseases. The aim of this study was to determine the factors relevant to hypertension knowledge, treatment, and control in southern Iran. In this cross-sectional study, conducted in Kohgiluye Boyer-Ahmad province, south of Iran, a total of 1836 hypertension patients were randomly selected to participate voluntarily in the study. Hypertension treatment and its control were defined during study. In addition, knowledge about hypertension was measured by hypertension knowledge level scale (HK-LS). Treatment rates were 75.5 and 37.7 percent for female and male, respectively. Habitat, education, income, family history with hypertension, smoking, and time of diagnosis to the disease were found to be related to the treatment of the disease. Control rates were 30.7 and 31.4 for males and females, respectively. Habitat, education, and time of diagnosis to the disease were related to control. Over 50 percent of patients had average knowledge on hypertension. Considering the low rate of control and knowledge on hypertension among patients, health care providers should reinforce their services to improve appropriate knowledge level among elders and, also, plan comprehensive programs to promote health in order to encourage patients change and reform their life style.
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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.
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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
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Boima V, Ademola AD, Odusola AO, Agyekum F, Nwafor CE, Cole H, Salako BL, Ogedegbe G, Tayo BO. Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria. Int J Hypertens 2015; 2015:205716. [PMID: 26509081 PMCID: PMC4610060 DOI: 10.1155/2015/205716] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/25/2015] [Indexed: 11/18/2022] Open
Abstract
Background. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n = 120), Ghana; and University of Port Harcourt Teaching Hospital, (n = 73) Apapa General Hospital Lagos (n = 79) and University College Hospital Ibadan (n = 85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r = -0.208, P < 0.001), concern about medications (r = -0.0347, P = 0.002), and knowledge of hypertension (r = 0.14, P = 0.006). MNA was associated with formal education (P = 0.001) and use of herbal preparation (P = 0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P = 0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P = 0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.
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Affiliation(s)
- Vincent Boima
- School of Medicine and Dentistry, University of Ghana, P.O. Box 4236, Accra, Ghana
- Department of Medicine, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana
| | - Adebowale Dele Ademola
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan PMB 5017, Oyo State, Nigeria
- Department of Paediatrics, University College Hospital, Ibadan PMB 5116, Oyo State, Nigeria
| | - Aina Olufemi Odusola
- Department of Medicine, General Hospital, Randle Avenue, Apapa PMB 1014, Lagos, Nigeria
| | - Francis Agyekum
- Department of Medicine, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana
| | - Chibuike Eze Nwafor
- Cardiology Division, Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt PMB 6173, Rivers State, Nigeria
| | - Helen Cole
- Department of Population Health, NYU School of Medicine, 227 E. 30th Street, 6th Floor, New York, NY 10016, USA
| | - Babatunde L. Salako
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan PMB 5017, Oyo State, Nigeria
- Department of Medicine, University College Hospital, Ibadan PMB 5116, Oyo State, Nigeria
| | - Gbenga Ogedegbe
- Department of Population Health, NYU School of Medicine, 227 E. 30th Street, 6th Floor, New York, NY 10016, USA
- Global Institute of Public Health, New York University, New York, NY 10003, USA
| | - Bamidele O. Tayo
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA
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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.
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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
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Opeodu OI, Adeyemi BF. PREVALENCE OF COEXISTING DIABETES MELLITUS AND HYPERTENSION AMONG DENTAL PATIENTS IN A TERTIARY CARE HOSPITAL. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2015; 5:16-35. [PMID: 27830131 PMCID: PMC5036267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Diabetes mellitus and hypertension are quite important in dental settings as may present as an emergency during dental treatment or may necessitate a modification in the patient's management. OBJECTIVES To determine the prevalence of coexistence of diabetes mellitus and hypertension among a group of dental outpatients and to assess the relationship between these medical conditions and a cross-section of factors. METHODOLOGY A cross sectional survey of 203 outpatients presenting in a Dental Clinic within a Tertiary hospital was undertaken. The capillary blood glucose of respondents was measured using a glucometer. Patients with a random blood glucose (RBS) ≥ 200 mg/dl were considered diabetic. Their blood pressure (BP) was assessed using a digital sphygmomanometer and a systolic BP of <120-139 and diastolic BP of <80-89 mmHg was taken as normal. Relationship between the two parameters was tested using Chi-square and p-value <0.05 was taken as statistically significant. RESULTS The age range of respondents was 16-75 years with a mean of 40.4 ±13.1 years and most (56.2%) of them were females. Their mean blood glucose was 108.7± 43.1 mg/dl, mean systolic blood pressure was 121.2 ± 14.9 mm Hg and mean diastolic blood pressure was 76.8 ± 13.3 mm Hg. Twenty-seven (13.3%) had high systolic BP, while 37 (18.2%) had high diastolic BP. Nine (4.4%) had their blood glucose in the range of diabetes. There was a co-existence of high blood glucose and diastolic blood pressure in 6 (3.0%) of the respondents and statistically significant association (p = .000) between the blood glucose and diastolic blood pressure. CONCLUSION Dentists should note that co-existence of diabetes mellitus and diabetes in a dental patient is an index of increased morbidity and mortality and should always screen for these medical conditions.
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Affiliation(s)
- O I Opeodu
- Department of Periodontology & Community Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - B F Adeyemi
- Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Nwatu CB, Ofoegbu EN, Unachukwu CN, Young EE, Okafor CI, Okoli CE. Prevalence of prediabetes and associated risk factors in a rural Nigerian community. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0401-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Population-based prevalence of high blood pressure among adults in an urban slum in Enugu, South East Nigeria. J Hum Hypertens 2015; 30:285-91. [PMID: 26016595 DOI: 10.1038/jhh.2015.49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/17/2015] [Accepted: 04/14/2015] [Indexed: 11/08/2022]
Abstract
In sub-Saharan Africa (SSA), rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders. Apart from high prevalence rates, recent trends with regard to hypertension in Africa include: low levels of awareness, treatment and control. Although a large number of studies provide data about hypertension in SSA, few studies focused on special populations such as urban slum dwellers. The WHO STEP-wise approach to surveillance of noncommunicable diseases was used to access the prevalence of hypertension among adults in one of the urban slums in Enugu. Out of the 811 individuals aged 20 years and above surveyed, 774 (95.4%) cases were analyzed. About 4.7% and 2.7% reported a past history of diabetes and stroke, respectively, whereas 15% had a positive family history of hypertension. The mean (95% confidence interval (CI)) body mass index (BMI) was 23.7 (23.2-24.2) kg m(-2) among males and 26.6 (25.7-26.7) kg m(-2) among females (P<0.0001). The prevalence of hypertension was 52.5% (95% CI: 48.9-56.0) and 55.4% (95% CI: 49.5-61.3) in males and 50.8% (95% CI: 46.4-55.1) in females (P=0.23). It increased with age peaking at 45-54 years in females and ⩾55 years in males. About 40.1% were aware of their hypertension and 28.8% of those aware had normal blood pressure. In regression analysis, systolic (R(2)=0.192) and diastolic (R(2)=0.129) blood pressures increased with age and BMI. The prevalence of high blood pressure among adults in Enugu slums is very high and a cause for concern, and calls for urgent attention.
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Reddy V, Sridhar A, Machado RF, Chen J. High sodium causes hypertension: evidence from clinical trials and animal experiments. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2015; 13:1-8. [PMID: 25609366 DOI: 10.1016/s2095-4964(15)60155-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hypertension is a cardiovascular disease affecting approximately one out of every seven people worldwide. High-sodium consumption has been generally accepted as a risk factor for developing hypertension. Today, global sodium consumption greatly exceeds guidelines recommended by all medical institutions. This review synthesizes the data of landmark mammalian and human studies which investigated the role of sodium in the pathogenesis of hypertension, along with modern studies questioning this relationship. Recent studies concerning the potential pathways by which high-sodium concentration induces hypertension were reviewed. Human trials and population studies revealed a strong correlation between high blood pressure and average dietary sodium; and animal studies found a dramatic reduction in vascular function in a variety of mammals treated with high-sodium diets. In spite of a few contrarian studies, we found overwhelming evidence that elevated sodium consumption could cause hypertension.
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Affiliation(s)
- Vamsi Reddy
- Section of Pulmonary, Critical Care Medicine, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA
| | - Arvind Sridhar
- Section of Pulmonary, Critical Care Medicine, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA
| | - Roberto F Machado
- Section of Pulmonary, Critical Care Medicine, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA
| | - Jiwang Chen
- Section of Pulmonary, Critical Care Medicine, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA; E-mail:
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Ugwuja E, Ezenkwa U, Nwibo A, Ogbanshi M, Idoko O, Nnabu R. Prevalence and determinants of hypertension in an agrarian rural community in southeast Nigeria. Ann Med Health Sci Res 2015; 5:45-9. [PMID: 25745576 PMCID: PMC4350062 DOI: 10.4103/2141-9248.149787] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Hypertension is a cardiovascular disease of increasing global burden with prevalence in Nigeria ranging from 8% to 46.4%. AIM To determine the prevalence and determinants of hypertension in Igbeagu, a rural community in South-Eastern Nigeria. SUBJECTS AND METHODS Consenting residents aged 18 years and above participated in this survey. A structured questionnaire was administered on the participants in their native dialect. Blood pressure (BP) and anthropometric parameters of the participants were measured using standard techniques. Hypertension was defined as systolic BP ≥ 140 mmHg and diastolic BP of ≥ 90 mmHg. RESULTS Two hundred and sixty-seven participants had their BP and data completed satisfactorily. Sixty-two persons were hypertensive, giving a prevalence rate of 23.2% (62/267). Age, consumption of red meat, body mass index (BMI), and the number of children in the family were associated with hypertension. Regression analysis showed that only BMI and age were independent risk factors for hypertension. CONCLUSION Although the prevalence of hypertension in this study and their associated risk factors were in agreement with studies done previously in Nigeria, the association between number of children in the family and hypertension is yet to be understood. Efforts are needed to curb the high prevalence of hypertension in this community.
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Affiliation(s)
- Ei Ugwuja
- Department of Chemical Pathology, Ebonyi State University, Abakaliki, Nigeria ; Department of Biochemistry, Ebonyi State University, Abakaliki, Nigeria
| | - Us Ezenkwa
- Department of Chemical Pathology, Ebonyi State University, Abakaliki, Nigeria
| | - An Nwibo
- Department of Chemical Pathology, Ebonyi State University, Abakaliki, Nigeria
| | - M Ogbanshi
- Department of Biochemistry, Ebonyi State University, Abakaliki, Nigeria
| | - O Idoko
- Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
| | - R Nnabu
- Department of Community Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
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Isara AR, Okundia PO. The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria. Pan Afr Med J 2015; 20:103. [PMID: 26090051 PMCID: PMC4458303 DOI: 10.11604/pamj.2015.20.103.5619] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/13/2015] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION The African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. METHODS A community based descriptive cross-sectional study. Adults aged 18 years and above residing in the rural communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Data were collected using a structured interviewer-administered questionnaire. RESULTS Of the 845 participants, 349 (41.3%) were aged 50-69 years, 263 (31.1%) were males, and 305 (36.1%) were farmers. Overweight and obesity were found in 184 (21.8%) and 90 (10.6%) of them respectively. The overall prevalence of hypertension was 37.6% (males 43.7%, females 35.1%, p = 0.018) while that of diabetes mellitus was 4.6% (males 1.9%, females 5.8%, p = 0.012). Predictors of hypertension were age ≥ 40 years (OR = 5.04, CI: 2.99 - 8.48), overweight/obesity (OR = 1.56, CI: 1.15 - 2.13) while females are less likely to develop hypertension (OR = 0.72, CI: 0.53 - 0.98). The significant predictor of diabetes mellitus was overweight/obesity (OR = 3.53, CI: 1.78 - 6.98). CONCLUSION The rising prevalence of hypertension and diabetes mellitus is assuming an epidemic level in rural communities in southern Nigeria. There is an urgent need for intensive health education and community surveillance programmes targeted at rural communities in order to achieve prevention and control of these non-communicable diseases in Nigeria.
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Affiliation(s)
- Alphonsus Rukevwe Isara
- Department of Community Health, University of Benin Teaching Hospital, P. M. B. 1111, Benin City. Nigeria
| | - Patrick Otamere Okundia
- Department of E.N.T Surgery, Stella Obasanjo Women and Children Hospital, Benin City, Nigeria
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Bosu WK. The prevalence, awareness, and control of hypertension among workers in West Africa: a systematic review. Glob Health Action 2015; 8:26227. [PMID: 25623611 PMCID: PMC4306751 DOI: 10.3402/gha.v8.26227] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/20/2014] [Accepted: 12/04/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND : Interventions in workplace settings are considered to be cost-effective in preventing cardiovascular diseases. A systematic review was conducted to assess the prevalence of hypertension and the level of awareness and control among workers in West Africa. DESIGN A systematic search for studies on formal and informal sector workers aged ≥15 years in West Africa published between 1980 and September 2014 was undertaken using the Ovid Medline, Embase, PubMed, and Google Scholar databases. Clinical and obstetric studies and studies that did not report prevalence were excluded. Data on study settings, characteristics of workers, blood pressure (BP) levels, prevalence of hypertension, and associated demographic factors were extracted. RESULTS A total of 45 studies from six countries were identified involving 30,727 formal and informal sector workers. In 40 studies with a common definition of hypertension, the prevalence ranged from 12.0% among automobile garage workers to 68.9% among traditional chiefs. In 15 of these studies, the prevalence exceeded 30%. Typically sedentary workers such as traders, bank workers, civil servants, and chiefs were at high risk. Among health care workers, the prevalence ranged from 17.5 to 37.5%. The prevalence increased with age and was higher among males and workers with higher socio-economic status. Complications of hypertension, co-morbidities, and clustering of risk factors were common. The crude prevalence of hypertension increased progressively from 12.9% in studies published in the 1980s to 34.4% in those published in 2010-2014. The proportion of hypertensives who were previously aware of their diagnosis, were on treatment or had their BP controlled was 19.6-84.0%, 0-79.2%, and 0-12.7%, respectively. Hypertensive subjects, including health workers, rarely checked their BP except when they were ill. CONCLUSIONS There is a high prevalence of hypertension among West Africa's workforce, of which a significant proportion is undiagnosed, severe or complicated. The clustering of risk factors, co-morbidities, and general low awareness warrant an integrated and multisectoral approach. Models for workplace health programmes aiming to improve cardiovascular health should be extended to informal sector workers.
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Affiliation(s)
- William K Bosu
- Department of Epidemics and Disease Control, West African Health Organisation, Bobo-Dioulasso, Burkina Faso; ;
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Odusola AO, Hendriks M, Schultsz C, Bolarinwa OA, Akande T, Osibogun A, Agyemang C, Ogedegbe G, Agbede K, Adenusi P, Lange J, van Weert H, Stronks K, Haafkens JA. Perceptions of inhibitors and facilitators for adhering to hypertension treatment among insured patients in rural Nigeria: a qualitative study. BMC Health Serv Res 2014; 14:624. [PMID: 25491509 PMCID: PMC4267751 DOI: 10.1186/s12913-014-0624-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 11/19/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Universal health care coverage has been identified as a promising strategy for improving hypertension treatment and control rates in sub Saharan Africa (SSA). Yet, even when quality care is accessible, poor adherence can compromise treatment outcomes. To provide information for adherence support interventions, this study explored what low income patients who received hypertension care in the context of a community based health insurance program in Nigeria perceive as inhibitors and facilitators for adhering to pharmacotherapy and healthy behaviors. METHODS We conducted a qualitative interview study with 40 insured hypertensive patients who had received hypertension care for > 1 year in a rural primary care hospital in Kwara state, Nigeria. Supported by MAXQDA software, interview transcripts were inductively coded. Codes were then grouped into concepts and thematic categories, leading to matrices for inhibitors and facilitators of treatment adherence. RESULTS Important patient-identified facilitators of medication adherence included: affordability of care (through health insurance); trust in orthodox "western" medicines; trust in Doctor; dreaded dangers of hypertension; and use of prayer to support efficacy of pills. Inhibitors of medication adherence included: inconvenient clinic operating hours; long waiting times; under-dispensing of prescriptions; side-effects of pills; faith motivated changes of medication regimen; herbal supplementation/substitution of pills; and ignorance that regular use is needed. Local practices and norms were identified as important inhibitors to the uptake of healthier behaviors (e.g. use of salt for food preservation; negative cultural images associated with decreased body size and physical activity). Important factors facilitating such behaviors were the awareness that salt substitutes and products for composing healthier meals were cheaply available at local markets and that exercise could be integrated in people's daily activities (e.g. farming, yam pounding, and household chores). CONCLUSIONS With a better understanding of patient perceived inhibitors and facilitators of adherence to hypertension treatment, this study provides information for patient education and health system level interventions that can be designed to improve compliance. TRIAL REGISTRATION ISRCTN47894401 .
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Affiliation(s)
- Aina O Odusola
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
| | - Marleen Hendriks
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
| | - Constance Schultsz
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
| | - Oladimeji A Bolarinwa
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, P.M.B. 1459, postal code 240001, Ilorin, Nigeria.
| | - Tanimola Akande
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, P.M.B. 1459, postal code 240001, Ilorin, Nigeria.
| | - Akin Osibogun
- Department of Community Health, Lagos University Teaching Hospital, P.M.B.12003, Surulere, Lagos, Nigeria.
| | - Charles Agyemang
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - Gbenga Ogedegbe
- Division of Health and Behavior, Center for Healthful Behavior Change, Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA.
| | - Kayode Agbede
- Ogo Oluwa Hospital, 64/65 Ahmadu Bello Way, Bacita, Kwara State, Nigeria.
| | - Peju Adenusi
- Hygeia Community Health Care, Hygeia HMO, 13B Idejo Street, Lagos, Nigeria.
| | - Joep Lange
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
| | - Henk van Weert
- Department of General Practice, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105, AZ, The Netherlands.
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - Joke A Haafkens
- Department of General Practice, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105, AZ, The Netherlands.
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Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. PLoS One 2014; 9:e104300. [PMID: 25090232 PMCID: PMC4121276 DOI: 10.1371/journal.pone.0104300] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 07/10/2014] [Indexed: 12/14/2022] Open
Abstract
Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.
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Affiliation(s)
- Davies Adeloye
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
- * E-mail:
| | - Catriona Basquill
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
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Odili AN, Ogedengbe JO, Nwegbu M, Anumah FO, Asala S, Staessen JA. Nigerian Population Research on Environment, Gene and Health (NIPREGH) - objectives and protocol. J Biomed Res 2014; 28:360-7. [PMID: 25332707 PMCID: PMC4197386 DOI: 10.7555/jbr.28.20130199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/11/2014] [Accepted: 05/07/2014] [Indexed: 11/21/2022] Open
Abstract
Sub-Saharan Africa is currently undergoing an epidemiological transition from a disease burden largely attributable to communicable diseases to that resulting from a combination of both communicable and chronic non-communicable diseases. Data on chronic disease incidence, lifestyle, environmental and genetic risk factors are sparse in this region. This report aimed at providing relevant information in respect to risk factors that increase blood pressure and lead to development of intermediate cardiovascular phenotypes. We presented the rationale, objectives and key methodological features of the Nigerian Population Research on Environment, Gene and Health (NIPREGH) study. The challenges encountered in carrying out population study in this part of the world and the approaches at surmounting them were also presented. The preliminary data as at 20 November 2013 showed that out of the 205 individuals invited starting from early April 2013, 160 (72 women) consented and were enrolled; giving a response rate of 78%. Participants' age ranged from 18 to 80 years, with a mean (SD) of 39.8 (12.4) years and they were of 34 different ethnic groups spread over 24 states out of the 36 states that constitute Nigeria. The mean (SD) of office and home blood pressures were 113.0 (15.2) mm Hg systolic, 73.5 (12.5) mm Hg diastolic and 117.3 (15.0) mm Hg systolic, and 76.0 (9.6) mm Hg diastolic, respectively. Forty-three (26.8%) participants were hypertensive and 8 (5.0%) were diabetic. In addition to having the unique potential of recruiting a cohort that is a true representative of the entire Nigerian population, NIPREGH is feasible and the objectives realisable.
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Affiliation(s)
- Augustine N Odili
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria. ; Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - John O Ogedengbe
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Maxwell Nwegbu
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Felicia O Anumah
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Samuel Asala
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Jan A Staessen
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium. ; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands. ; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands
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Awosan, KJ, Ibrahim, MTO, Essien, E, Yusuf, AA, Okolo, A. Dietary pattern, lifestyle, nutrition status and prevalence of hypertension among traders in Sokoto Central market, Sokoto, Nigeria. ACTA ACUST UNITED AC 2014. [DOI: 10.5897/ijnam2013.0158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Metabolic alterations in different stages of hypertension in an apparently healthy nigerian population. Int J Hypertens 2013; 2013:351357. [PMID: 24371523 PMCID: PMC3858970 DOI: 10.1155/2013/351357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/18/2013] [Accepted: 10/22/2013] [Indexed: 01/14/2023] Open
Abstract
Metabolic syndrome (MS) amplifies hypertension (HTN) associated with increased risk of cardiovascular disease (CVD). MS components and other CVD risk measures were investigated in different stages of hypertension. 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The International Diabetes Federation (2005) and the National High Blood Pressure Education Program Coordinating Committee criteria were used for MS and HTN classifications, respectively. Anthropometric indices were obtained by standard methods. Levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDLC) were determined by enzymatic methods, while low-density lipoprotein cholesterol (LDLC) was calculated. Data analysed statistically were significant at P < 0.05. 143 (26.8%), 197 (36.9%), and 194 (36.3%) of the traders had normotension, pre-HTN and HTN (stages 1 and 2), respectively. All indices tested except HDLC were significantly different among BP groups (P < 0.05). Waist to hip (WHR) and waist to height (WHT) ratios were significantly different between HTN groups (P < 0.05). HTN was associated with MS and female gender (P < 0.05). Metabolic alterations and significant HTN were observed. Treatment of the individual components of the syndrome and improvement of modifiable metabolic factors may be necessary to reduce MS and high BP.
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Blood pressure gradients and cardiovascular risk factors in urban and rural populations in Abia State South Eastern Nigeria using the WHO STEPwise approach. PLoS One 2013; 8:e73403. [PMID: 24039932 PMCID: PMC3764162 DOI: 10.1371/journal.pone.0073403] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/20/2013] [Indexed: 01/19/2023] Open
Abstract
Background Developing countries of sub-Saharan Africa (SSA) face a double burden of non-communicable diseases (NCDs) and communicable diseases. As high blood pressure (BP) is a common global cardiovascular (CV) disorder associated with high morbidity and mortality, the relationship between gradients of BP and other CV risk factors was assessed in Abia State, Nigeria. Methods Using the WHO STEPwise approach to surveillance of chronic disease risk factors, we conducted a population-based cross-sectional survey in Abia state, Nigeria from August 2011 to March 2012. Data collected at various steps included: demographic and behavioral risk factors (Step 1); BP and anthropometric measurements (Step 2), and fasting blood cholesterol and glucose (Step 3). Results Of the 2983 subjects with complete data for analysis, 52.1% were females and 53.2% were rural dwellers. Overall, the distribution of selected CV disease risk factors was diabetes (3.6%), hypertension (31.4%), cigarette smoking (13.3%), use of smokeless tobacco (4.8%), physical inactivity (64.2%) and being overweight or obese (33.7%). Presence of hypertension, excessive intake of alcohol, smoking (cigarette and smokeless tobacco) and physical inactivity occurred more frequently in males than in females (p<0.05); while low income, lack of any formal education and use of smokeless tobacco were seen more frequently in rural dwellers than in those living in urban areas (p<0.05). The frequency of selected CV risk factors increased as BP was graded from optimal, normal to hypertension; and high BP correlated with age, gender, smokeless tobacco, overweight or obesity, annual income and level of education. Conclusion Given the high prevalence of hypertension in this part of Nigeria, there is an urgent need to focus on the reduction of preventable CV risk factors we have observed to be associated with hypertension, in order to effectively reduce the burden of NCDs in Africa.
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Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord 2013; 13:54. [PMID: 23915151 PMCID: PMC3750220 DOI: 10.1186/1471-2261-13-54] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/31/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Inadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. METHODS The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. RESULTS Thirty-eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. CONCLUSION There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.
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Affiliation(s)
- James Kayima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Achilles Katamba
- Clinical Epidemiology Unit, Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Elli Leontsini
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
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Ulasi II, Tzur S, Wasser WG, Shemer R, Kruzel E, Feigin E, Ijoma CK, Onodugo OD, Okoye JU, Arodiwe EB, Ifebunandu NA, Chukwuka CJ, Onyedum CC, Ijoma UN, Nna E, Onuigbo M, Rosset S, Skorecki K. High population frequencies of APOL1 risk variants are associated with increased prevalence of non-diabetic chronic kidney disease in the Igbo people from south-eastern Nigeria. Nephron Clin Pract 2013; 123:123-8. [PMID: 23860441 DOI: 10.1159/000353223] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension. One such region is south-eastern Nigeria, and therefore we sought to quantify the association of APOL1 risk alleles with CKD in this region. METHODS APOL1 risk variants were genotyped in a case-control sample set consisting of non-diabetic, CKD patients (n = 44) and control individuals (n = 43) from Enugu and Abakaliki, Nigeria. RESULTS We found a high frequency of two APOL1 risk alleles in the general population of Igbo people of south-eastern Nigeria (23.3%). The two APOL1 risk allele frequency in the CKD patient group was 66%. Logistic regression analysis under a recessive inheritance model showed a strong and significant association of APOL1 two-risk alleles with CKD, yielding an odds ratio of 6.4 (unadjusted p = 1.2E-4); following correction for age, gender, HIV and BMI, the odds ratio was 4.8 (adjusted p = 5.1E-03). CONCLUSION APOL1 risk variants are common in the Igbo population of south-eastern Nigeria, and are also highly associated with non-diabetic CKD in this area. APOL1 may explain the increased prevalence of CKD in this region.
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Affiliation(s)
- Ifeoma I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, Enugu Campus, Enugu, Nigeria
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Sadeghi M, Shiri M, Roohafza H, Rakhshani F, Sepanlou S, Sarrafzadegan N. Developing an appropriate model for self-care of hypertensive patients: first experience from EMRO. ARYA ATHEROSCLEROSIS 2013; 9:232-40. [PMID: 23970918 PMCID: PMC3746943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/22/2013] [Indexed: 12/03/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure. METHODS In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented. RESULTS The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness. CONCLUSION The model can be implemented at a national scale.
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Affiliation(s)
- Masoumeh Sadeghi
- Associate Professor, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoor Shiri
- Vice-chancellery for Health, Department of Health Education, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Assistant Professor, Department of Mental Health AND Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Rakhshani
- Professor, Health Education and Promotion Bureau, Ministry of Health, Tehran, Iran
| | - Sadaf Sepanlou
- PhD Candidate, Tehran University of Medical Sciences, Tehran, Iran
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Wang H, Zhang X, Zhang J, He Q, Hu R, Wang L, Su D, Xiao Y, Pan J, Ye Z. Factors associated with prevalence, awareness, treatment and control of hypertension among adults in Southern China: a community-based, cross-sectional survey. PLoS One 2013; 8:e62469. [PMID: 23671599 PMCID: PMC3650037 DOI: 10.1371/journal.pone.0062469] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 03/20/2013] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to investigate factors associated with prevalence, awareness, treatment and control of hypertension in southern China. A cross-sectional, population-based survey was conducted in 180 villages across 15 counties in southern China from July to November 2010. Totally, 17437 persons completed all of the questionnaires, measurement examination and blood specimen collection. Adjusted rate of hypertension was 22.59% (95%CI: 22.52%-22.66%), for men 23.36% (95%CI: 23.25%-23.47%) and for women 21.77% (95%CI: 21.68%-21.86%). Multivariate logistic regression showed that old age, education attainment, alcohol use, diabetes, obesity, high TC and high TG were associated with hypertension. Among the hypertensive individuals, 54.33% were aware of their hypertension, and 46.34% were currently taking antihypertensive medication, but only 18.26% had their blood pressure controlled. Among all the hypertensive subjects, awareness was more common in those who were female, living in the urban, old age, low education attainment, diabetes, overweight, obese, Low HDL-C. Among the subjects aware of their diagnosis of hypertension, medication treatment was more common in those living in the urban, old age, nonsmoker and diabetes. Among the individuals who receiving medication treatment, controlled hypertension were less common in those living in the urban, young age, low education attainment, overweight and obese. Despite high rate of hypertension, awareness, treatment and control of hypertension still need to be strengthened.
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Affiliation(s)
- Hao Wang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinwei Zhang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jie Zhang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qingfang He
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ruying Hu
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Lixin Wang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Danting Su
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyuan Xiao
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jin Pan
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Zhen Ye
- General office, Health Bureau of Zhejiang Province, Hangzhou, Zhejiang, China
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