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Blood Pressure Pattern and Prevalence of Hypertension in a Rural Community in Edo State

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Blood Pressure Pattern and Prevalence of Hypertension in a Rural Community in Edo State JMBR: A Peer-review Journal of Biomedical Sciences December 2006 Vol. 5 No.2 pp-79-86 Blood pressure pattern and prevalence of hypertension in a rural community in Edo State aOmuemu VO, aOkojie OH and bOmuemu CE ABSTRACT This cross-sectional study was carried out in Udo, a rural community in Ovia South-west LGA of Edo state to screen for hypertension and determine blood pressure pattern. Cluster sampling method was used in selecting participants. Data collection was by researcher-administered questionnaire. Blood pressure and anthropometric measurements were determined. A total of 590 respondents with mean age 30.7 ± 14.6 years participated in the study. Mean systolic and diastolic blood pressures were 122.08 ± 15.42 mmHg and 79.54 ± 11.55 mmHg, respectively and increased with age. Males had significantly higher mean SBP and DBP than the females (p < 0.001). Prevalence of hypertension was 20.2%, increased significantly with age and was higher in males than in females (p < 0.001). This study revealed that hypertension is a problem even in the rural areas. Therefore need for intervention programmes targeted at non-communicable diseases like hypertension which is usually symptomless. INTRODUCTION which are harmful and those which are not.2 Hypertension is one of the chronic non- In adults, it is generally agreed that a blood communicable diseases that is being pressure is abnormal when the systolic recognized as an emerging public health pressure is equal to or greater than 140 mmHg problem in the developing countries and diastolic pressure is equal to or greater 3 including Nigeria.1 Defining hypertension can than 90 mmHg. It is not just a disease in itself be arbitrary because there is no clear dividing but also a risk factor for the development of line between normal blood pressure and several cardiovascular, cerebrovascular and renal diseases.4,5 The impact of hypertension raised blood pressure in the general popu- on the lives of people is enormous when lation nor between levels of blood pressure measured in terms of morbidity, mortality and economic loss to the individual, family and KEY WORDS: Blood Presure, Pattern, Hypertension nation as a whole. It significantly impairs life expectancy; the higher the blood pressure, the greater the reduction in longevity. In the Departments of Community Healtha and Medicineb, Framingham cohort, the risk of developing College of Medicine, University of Benin, P.M.B. 1154, coronary heart diseases rose progressively Benin-city, Edo state Nigeria. with increasing systolic pressure or diastolic Correspondence to: Dr. V. O. Omuemu e-mail: pressure both in middle aged and the elderly.6 [email protected] The prevalence of hypertension depends on © CMS UNIBEN JMBR 2006; 5(2): 79-86 80 Journal of Medicine and Biomedical Research the racial composition of the population conducted by the principal investigators. The studied and the criteria used to define the training included standardization of methods condition. Also, in any given population, the of questionnaire administration, measurement proportion of people who are aware of their of blood pressure and anthropometric indices. high blood pressure status is usually low7-10 This was to ensure accuracy, reduce inter- and since the condition is often without symptoms. intra-observer errors and ensure comparability It is in view of this that this study was of blood pressure and study participants' carried out to screen for hypertension and responses. The sphygmomanometers, weighing determine blood pressure pattern in Udo (a scales and meter rule used were all standardized. rural community in Ovia south-west LGA of Blood pressure measurement: The blood Edo state) with the hope that those who are pressure was measured using Accoson hypertensive will benefit by seeking early mercury sphygmomanometer and for management. accuracy the following steps were adopted:2 The individual was rested for at least 5 Materials and methods minutes in a sitting position with the arm This cross-sectional and descriptive study rested on a table such that the middle of the was carried out in Udo which is a rural right arm was about the level of the heart and community. It is one of the 126 communities any tight clothing removed from the arm. The in Ovia South-west LGA of Edo State. Udo is cuff was inflated, palpating the radial artery about 40 km from Benin-city, the state capital and the inflation was continued until 20-30 and about 8 km from Iguobazuwa, the local mmHg above the disappearance of the radial government headquarter. The people are Binis pulse. The stethoscope diaphragm was placed and speak the Edo language. There is a over the brachial artery in the ante-cubital traditional ruling system with the headship fossa and the cuff deflated, allowing the being referred to as 'Iyasere'. The people are mercury to fall gradually, about 2 mmHg per mainly engaged in agricultural activities second. The first sound (Korotkoff 1) was especially crop farming. taken as the systolic blood pressure and the The study population included all males extinction of all sounds (Korotkoff 5) as the and females aged 15 years and above who are diastolic blood pressure. The blood pressure resident in the community. The minimum was recorded to the nearest 2 mmHg. Two sample size was calculated using the formula blood pressure readings were taken at an for calculating sample size for a descriptive, interval of 15 minutes and the mean of the cross-sectional study N = pq/(E/1.96)2 where two readings taken as the individual's blood p = prevalence of hypertension = 11.2%7 and pressure measurement. q = 1 - p. The minimum sample size was 153, The blood pressure pattern in the study however, a total of 590 respondents participated population was classified using the WHO/ISH in the study. defined criteria for blood pressure and 3 A cluster sampling method was carried out hypertension: using a quarter as a sampling unit. Two out of the nine quarters were selected by simple SBP (mmHg) DBP (mmHg) random sampling (balloting) and all males and Normal < 130 < 85 females aged 15 years and above in the High-normal 130-139 85-89 selected quarters were included in the study. Mild (Grade I) 140-159 90-99 Pretested, interviewer-administered ques- Moderate (Grade II) 160-179 100-109 tionnaire was the tool for data collection. Severe (Grade III) >180 > 110 Interviewers had a common training programme © CMS UNIBEN JMBR 2006; 5(2): 79-86 ≤ Blood pressure pattern and prevalence of hypertension in a rural community in Edo State 81 Height measurement: The height was variable. Age, sex, marital status, educational measured with a measuring tape, the subject status, body mass index (BMI), smoking, standing erect without shoes and the back alcohol drinking were the independent against a wall. Head coverings were removed. variable. Stepwise selection was used for This was recorded in meters to two decimal model building and the significant T value points. Parallax effect in height measurement 0.100 was selected criteria for removal at each was avoided by fitting the measuring tape with step of the regression. a sliding head-piece at right angles to the upright, which was lowered onto the subject's Results 11 head. The demographic profile of the respondents Weight measurement: The body weight is shown in Table 1. A total of 590 respondents was measured with a simple bathroom scale were involved in the study in Udo community, with light clothes and without shoes. This comprising of 355 (60.2%) males and 235 was recorded in kilogrammes to one decimal (39.8%) females. The mean age of the point. Scale adjustment error in weight respondents was 30.7 ± 14.6 years. The mean measurement was avoided by adjusting the systolic blood pressure (SBP) for the total pointer to zero (with a knob in the weighing population was 122.08 ± 15.42 mmHg and scale) before placing and weighing each this increased with age. The diastolic blood subject. The zero was checked each day and pressure (DBP) for the total population was the calibration assessed by reference to an 79.54 ± 11.55 mmHg and this also increased individual of known weight. Also the scale with age. Mean SBP for the male respondents was placed on a firm horizontal surface. was 124.54 ± 14.81 mmHg and was signifi- Smokers included those who smoked cantly higher than that for the females, 118.37 regularly and at least one cigarette on the ± 15.61 mmHg (t = 4.78, p < 0.001). The mean average during the previous 30 days while DBP was significantly higher for the male non-smokers were lifetime abstainers and respondents (81.50 + 10.67 mmHg) than for occasional smokers. the female respondents (76.58 ± 12.20 Alcohol drinkers included individuals mmHg), t = 5.07, p < 0.001. It was also noted who took any amount of alcohol while non- that below the age of 45 years, the mean SBP drinkers included only abstainers. was higher in males than in the females and Physical activity was assessed using open- as from 45 years onwards, the females had a ended questions inquiring about average higher mean SBP. (Table 2) The same was also activity during work and leisure time and was observed for the mean DBP. (Table 3). 12 classified into 3 groups: Table 4 shows the blood pressure pattern Not active physically: desk top jobs, petty of the study population classified according trading Moderately active physically: house- to the WHO/ISH criteria. Overall, 63.7% of the hold chores, hawking, tailoring, walking to study population had normal blood pressure school or place of work. with the males having a lower proportion of Very active physically: farming/field work, such individuals than the females.
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