The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria
Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
,
Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
,
Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
,
Department of Public Health, Central Michigan University, Mount Pleasant, Michigan, USA
,
Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
,
Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
,
Department of Public Health, Central Michigan University, Mount Pleasant, Michigan, USA
1 Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
2 Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
3 Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
4 Department of Public Health, Central Michigan University, Mount Pleasant, Michigan, USA
5 Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
6 Department of Family Medicine, Federal University Teaching Hospital, Owerri, Nigeria
7 Department of Public Health, Central Michigan University, Mount Pleasant, Michigan, USA
Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P -value of < 0.05 was used as the criterion for statistical significance. Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001); and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.
KeywordsHypertensionUndiagnosed HypertensionRisk FactorsRural Community
World Health Organization (2011) Causes of Death 2008: Data Sources and Methods. Geneva. https://www.who.int/docs/default-source/gho-documents/world-health-statistic-reports/en-whs2011-full.pdf
World Health Organization (2013) A Global Brief on Hypertension: World Health Day. Geneva.
Carey, R.M. and Whelton, P.K. (2018) Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Annals of Internal Medicine, 168, 351-358. https://doi.org/10.7326/M17-3203
Yoon, S.S., Gu, Q., Nwankwo, T., Wright, J.D., Hong, Y. and Burt, V. (2015) Trends in Blood Pressure among Adults with Hypertension: United States, 2003 to 2012. Hypertension, 65, 54-61. https://doi.org/10.1161/HYPERTENSIONAHA.114.04012
Mahdi, A., Armitage, L.C., Tarassenko, L. and Watkinson, P. (2021) Estimated Prevalence of Hypertension and Undiagnosed Hypertension in a Large Inpatient Population: A Cross-Sectional Observational Study. American Journal of Hypertension, 34, 963-972. https://doi.org/10.1093/ajh/hpab070
Mahwati, Y., Nurrika, D. and Latief, K. (2022) The Determinants of Undiagnosed Hypertension among Indonesian Adults: A Cross-Sectional Study Based on the 2014-2015 Indonesia Family Life Survey. Journal of Preventive Medicine and Public Health, 55, 60-67. https://doi.org/10.3961/jpmph.21.500
Manimunda, S.P., Atayuru, P.S., Benegal, V., Nagalia, B., Rao, M. and Persala, K.S. (2011) Association of Hypertension with Risk Factors and Hypertension Related Behaviour among the Aboriginal Nicobarese Tribe Living in Carnicobar Island. Indian Journal of Medical Research, 133, 287-293.
Lim, O.W. and Yong, C.C. (2019) The Risk Factors for Undiagnosed and Known Hypertension among Malaysians. The Malaysian Journal of Medical Sciences, 26, 98-112. https://doi.org/10.21315/mjms2019.26.5.9
Szuba, A., Marthynowicz, H. and Zatonska, K. (2011) Prevalence of Hypertension in an Example of Polish Population Baseline Assessment from the Prospective Cohort “Pons” Study. Annals of Agricultural and Environmental Medicine, 18, 260-264.
Gudina, E.K., Yadani, M. and Sahilu, A. (2013) Prevalence of Hypertension and Its Risk Factors in Southwest Ethiopia: A Hospital Based cross Sectional Survey. Integrated Blood Pressure Control, 6, 111-117. https://doi.org/10.2147/IBPC.S47298
Birlew, T. and Alemseged, F. (2015) Risk Factors for Hypertension among Adults. An Analysis of Survey Data on Chronic Non-Communicable Diseases at Gilgel Gibe Field Research Centre, South Western Ethiopia. Science Journal of Public Health, 3, 281-290. https://doi.org/10.11648/j.sjph.20150302.29
Basu, S. and Millett, C. (2013) Social Epidemiology of Hypertension in Middle Income Countries: Determinants of Prevalence, Diagnosis, Patients and Control in the WHO SAGE Study. Hypertension, 62, 18-26. https://doi.org/10.1161/HYPERTENSIONAHA.113.01374
Adeloye, D., Basquill, C., Adremi, A.V., Thompson, J.Y. and Obi, F.A. (2015) An Estimate of the Prevalence of Hypertension in Nigeria: A Systemic of Review and Meta Analysis. Journal of Hypertension, 33, 230-242. https://doi.org/10.1097/HJH.0000000000000413
Ogah, O.S., Okpechi, I., Chukwuonye, I.I., Akinyemi, J.O., Onwubere, B.J.C., Falase, A.O., et al. (2012) Blood Pressure, Prevalence of Hypertension and Hypertension Related Complications in Nigerian Africans: A Review. World Journal of Cardiology, 4, 327-340. https://doi.org/10.4330/wjc.v4.i12.327
Ekwunife, O.I. and Aguwa, C.N. (2011) A Meta Analysis of Prevalence Rate of Hypertension in Nigerian Populations. Journal of Public Health and Epidemiology, 3, 604-607. https://doi.org/10.5897/JPHE11.104
Akinlua, J.T., Meakin, R. and Freemantle, N. (2015) Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review. PLOS ONE, 10, e0140021. https://doi.org/10.1371/journal.pone.0140021
Guerrero-Díaz, D.V., Hernández-Vásquez, A., Montoya-Rivera, W.C., Rojas-Roque, C., Chacón Díaz, M.A. and Bendezu-Quispe, G. (2021) Undiagnosed Hypertension in Peru: Analysis of Associated Factors and Socioeconomic Inequalities, 2019. Heliyon, 7, e07516. https://doi.org/10.1016/j.heliyon.2021.e07516
Haider, M.R. and Gupta, R.D. (2022) Inequalities in Undiagnosed Hypertension among Adult Population in Bangladesh: Evidence from a Nationally Representative Survey. High Blood Pressure & Cardiovascular Prevention, 29, 57-64. https://doi.org/10.1007/s40292-021-00488-0
Kanj, H., Khalil, A., Kossaify, M. and Kossaify, A. (2018) Predictors of Undiagnosed and Uncontrolled Hypertension in the Local Community of Byblos, Lebanon. Health Services Insights, 11, 1-7. https://doi.org/10.1177/1178632918791576
Bharati, D.R., Nnadi, P., Yamma, T.V., Lokeshmaran, A., Agarwal, L., Singh, J.B., et al. (2012) Prevalence and Covariates of Undiagnosed Hypertension in the Adult Population of Pudu-Cherry in South India. Nepal Journal of Epidemiology, 2, 191-199. https://doi.org/10.3126/nje.v2i2.6576
Shukla, A.A., Madan, T., Thakkar, B.M., Parmar, M.M. and Shah, K.H. (2015) Prevalence and Predictors of Undiagnosed Hypertension in an Apparently Healthy Western Indian Population. Advances in Epidemiology, 2015, Article ID: 649184. https://doi.org/10.1155/2015/649184
Ataklte, F., Erqou, S., Kaptoge, S., Taye, B., Echouffo-Tcheugui, J.B. and Kengne, A.P. (2015) Burden of Undiagnosed Hypertension in Sub-Saharan Africa: A Systematic Review and Meta Analysis. Hypertension, 65, 291-298. https://doi.org/10.1161/HYPERTENSIONAHA.114.04394
Dejenie, M., Kerie, S. and Reba, K. (2021) Undiagnosed Hypertension and Associated Factors among Bank Workers in Bahir Dar City, Northwest, Ethiopia, 2020. A Cross-Sectional Study. PLOS ONE, 16, e0252298. https://doi.org/10.1371/journal.pone.0252298
Getachew, F., Dirab, A. and Solomon, D. (2018) Prevention of Undiagnosed Hyper-tension and Associated Factors among Residents in Gulele Sub-City, Addis Ababa, Ethiopia. Journal of Community Medicine and Health Education, 8, 1-5.
Bushara, S.O., Noor, S.K., Elmadhoun, W.M., Sulaiman, A.A. and Ahmed, M.H. (2015) Undiagnosed Hypertension in a Rural Community in Sudan, Association with Some Features of Metabolic-Syndrome; How Serious Is the Situation. Renal Failure, 37, 1022-1026. https://doi.org/10.3109/0886022X.2015.1052951
Banigbe, B.F., Itanyi, I.U., Ofili, E.O., Ogidi, A.G., Patel, D. and Ezeanolue, E.E. (2020) High Prevalence of Undiagnosed Hypertension among Men in North Central Nigeria: Results from the Healthy Beginning Initiative. PLOS ONE, 15, e0242870. https://doi.org/10.1371/journal.pone.0242870
Gyang, M.D., Danjuma, S.A., Gyang, B.Z., Sule, H. and Musa, D. (2018) Correlates of Undiagnosed Hypertension among Health Care Workers in Secondary Health Facility in North Central Nigeria. Highland Medical Research Journal, 18, 280-285.
Sumaila, F.G., Abbas, S.I., Shittu, A. and Abba, M.A. (2016) Prevalence of Undiagnosed Hypertension and Its Risk Factors among Health Care Workers of Some Selected Hospitals in Dutse Jigawa State, North Western Nigeria. Advances of Science for Medicine, 1, 19-23.
Bello-Ovosi, B.O., Asuke, S., Abdulrahman, S.O., Ibrahim, M.S., Ovosi, J.O., Ogunsima, M.A., et al. (2018) Prevalence and Correlation of Hypertension and DM in an Urban Community in North—Western Nigeria. The Pan African Medical Journal, 29, Article 97. https://doi.org/10.11604/pamj.2018.29.97.14191
Obagha, C.E., Danladi, B., Kamateeka, M., Chori, B.S., Ogbonnaya, U., Maduka, D., Nguku, P., Osunkwo, D.A. and Odili, A.N. (2022) Unmet Needs of Hypertension Care in Nigeria: Results of the Community Action against Non-Communicable Diseases (COMAAND) Project Preintervention Survey. Blood Pressure Monitoring, 27, 27-32. https://doi.org/10.1097/MBP.0000000000000561
Ekanem, U.S., Opara, D.C. and Akwaowo, C.D. (2013) High Blood Pressure in a Semi-Urban Community in South-South Nigeria: A Community Based Study. African Health Sciences, 13, 56-61. https://doi.org/10.4314/ahs.v13i1.8
Onwuchekwa, A.C., Mezie-Okoye, M.M. and Babatunde, S. (2012) Prevalence of Hypertension in Kegbara-Dere, a Rural Community in the Niger Delta Region, Nigeria. Ethnicity and Disease, 22, 340-346.
Andy, J.J., Peters, E.J., Ekrikpo, U.E., Akpan, A.A., Unadike, B.C. and Ekot, J.U. (2012) Prevalence and Correlates of Hypertension among the Ibibio/Annangs, Efiks and Obolos: Across Sectional Community Survey in Rural South-South Nigeria. Ethnicity and Disease, 22, 335-339.
Vincent-Onabajo, G.O., Adaji, J.O. and Umeonuka, C.I. (2017) Prevalence of Undiagnosed Hypertension among Traders at a Rural Market in Nigeria. Annals of Medical and Health Sciences Research, 7, 97-101.
Okpechi, I.G., Chukwuonye, I.I., Tiffin, N., Madukwe, O.O., Onyeonoro, U.U., Theophilus, I.U., et al. (2013) 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, 8, e73403. https://doi.org/10.1371/journal.pone.0073403
Oyewole, O.O. and Oritogun, K.S. (2012) Pre-Hypertension and Hypertension in Adolescence: How Much Does It Occur in a Nigerian community? West African Journal of Medicine, 31, 71-75.
Asekun-Olarinmoye, E.O., Akinwusi, P.O., Adebimpe, W.O., Isawumi, M.A., Hassan, M.B., Olowe, O.A., et al. (2013) Prevalence of Hypertension in the Rural adUlt Population of Osun State, South-Western Nigeria. International Journal of General Medicine, 6, 317-322. https://doi.org/10.2147/IJGM.S42905
Klinis, S., Tsimtsious, Z., Arkate, A. and Galanakis, C. (2014) Patient Beliefs and Attitudes towards Hypertension and Its Treatment: A Rural Practice Pilot Study. Romanian Journal of Internal Medicine, 52, 27-29.
Long, E., Ponder, M. and Bernard, S. (2018) Knowledge, Attitudes and Beliefs Related to Hypertension and Hyperlipidaemia Self Management among Africa-American Men Living in the South-Eastern United States. Patient Education and Counseling, 100, 1000-1006. https://doi.org/10.1016/j.pec.2016.12.011
Osuala, E.O., Oluwatosin, A.O., Osuala, F.N. and Ibe, S.N.O. (2016) Perceptions and Thirst for Knowledge Regarding Hypertension among Rural Dwellers in Isunjaba, Imo State, Nigeria: A Qualitative Study. Health, 8, 1603-1615. https://doi.org/10.4236/health.2016.814157
National Population Commission (2006) Nigeria: Nigeria Population Census of Nigeria-2006.
Ahaneku, G.I., Osuji, C.U., Anisiuba, B.C., Ikeh, V.O., Oguejiofor, O.C. and Ahaneku, J.E. (2011) Evaluation of Blood Pressure and Indices of Obesity in a Typical Rural Community in Eastern Nigeria. Annals of African Medicine, 10, 120-126. https://doi.org/10.4103/1596-3519.82076
AUDIT (2017) Alcohol Use Disorder Identification Test (AUDIT). https://nida.nih.gov/sites/default/files/files/AUDIT.pdf
(2017) Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire(IPAQ)-Short-Form 2014. https://biobank.ndph.ox.ac.uk/showcase/ukb/docs/ipaq_analysis.pdf
YouthRex (2017) International Physical Activity Questionnaire-Short Form. https://www.youthrex.com.>2017<IPAQ-TM
Ward, M. (2016) Health Enhancing Physical Activity (HEPA) Promotion in Health Care Settings—Policy, Practice & Evidence. Supplement-Health Enhancing Physical Activity (HEPA), 13-14. https://www.panh.ch/hepaeurope/materials/Case_study_report_Final_Aug2016.pdf
Nordestgaard, B. (2017) A Test in Context: Lipid Profile Fasting versus None Fasting. Journal of the American College of Cardiology, 70, 1635-1646. https://doi.org/10.1016/j.jacc.2017.08.006
Vasanth, S., Jihwan, P., Asieh, G., Lazo, M., Quispe, R., Guallar, E., et al. (2017) Fasting versus Non-Fasting and Low-Density Lipoprotein Cholesterol Accuracy. Circulation, 137, 10-19. https://doi.org/10.1161/CIRCULATIONAHA.117.030677
Driver, S.L., Martin, S.S., Gluckman, T.J., Clary, J.M., Blumenthal, R.S. and Stone, N.J. (2006) Fasting or Non Fasting Lipid Measurements: It Depends on the Question. Journal of the American College of Cardiology, 67, 1227-1234. https://doi.org/10.1016/j.jacc.2015.12.047
Onuoha, F.M., Ebirim, C.C., Ajonuma, B.C., Alabi, N.A., Eseigbe, P. and Okezue, O.S. (2016) Correlation between Central Obesity and Blood Pressure in an Adult Nigerian Population. Journal of Insulin Resistance, 1, a16. https://doi.org/10.4102/jir.v1i1.16
Owolabi, E.O., Goon, D.T. and Adeniyi, O.A. (2017) Central Obesity and Normal Weight-Central Obesity among Adults Attending Healthcare Facilities Buffalo City Metropolitan Municipality, South Africa: A Cross-Sectional Study. Journal of Health, Population and Nutrition, 36, Article No. 54. https://doi.org/10.1186/s41043-017-0133-x
Okubadejo, N.U., Ozoh, O.B., Ojo, O.O., et al. (2019) Prevalence of Hypertension and Blood Pressure Profile Amongst Urban-Dwelling Adults in Nigeria: A Comparative Analysis Based on Recent Guideline Recommendations. Clinical Hypertension, 25, Article No. 7. https://doi.org/10.1186/s40885-019-0112-1
Oguejifor, O.C., Onwuke, C.H. and Odenigbo, C.U. (2012) Dyslypidema in Nigeria: Prevalence and Pattern. Annals of African Medicine, 11, 197-202. https://doi.org/10.4103/1596-3519.102846
Iloh, G.U.P. and Amadi, A.N. (2014) Essential Hypertension in Adult Nigeria in a Pre Care Clinic: A Cross Sectional Study on the Prevalence and Associated Family Socio-Biological Factors in Eastern Nigeria. European Journal of Preventive Medicine, 2, 81-89. https://doi.org/10.11648/j.ejpm.20140206.11
Lastra, G., Syed, S., Kurukulasuriya, L.R. and Manrique, C. (2014) Type 2 Diabetes Mellitus & Hypertension: An Update. Endocrinology and Metabolism Clinics of North America, 43, 103-122. https://doi.org/10.1016/j.ecl.2013.09.005