RISK FACTORS OF HYPERTENSION AMONG NURSES IN IMO STATE

CHAPTER ONE

INTRODUCTION

Background of the study

Hypertension is one of the most frequent modifiable risk factor for cardiovascular disease (CVD) and death in the society. Its global prevalence has geometrically increased in recent years. It is estimated that at least eight hundred million adults have hypertension globally, a figure that is projected to increase to 1.5 billion by the year 2025, and that hypertension is directly or indirectly associated with more than nine million deaths yearly.(Ike 2008)

Sub-Saharan African countries Nigeria inclusive along with other low- and low-middle income countries are disproportionally affected by this epidemic of hypertension and consequential cardiovascular disease, as they account for more than 80% of global deaths from cardiovascular disease. According to the World Health Organization (WHO), in 2008 sub-Saharan Africa had the highest prevalence of hypertension, with almost 46% of adults aged 25 and older affected in the region.

However, there are criticisms about the accuracy of such estimates as asserted by the world health organization of the prevalence of hypertension in sub-Saharan Africa because they have usually been based on imputed calculations, which may be biased and skewed against or in favour of any region. Further assessments of hypertension prevalence using directly measured blood pressure (BP) and identification of potentially modifiable causes are therefore needed in the region.

Nigeria, a developing country in West Africa, has not been spared by the global epidemic of hypertension. Between 1994 and 2003, the 10-year change showed that the prevalence of hypertension increased by two- to five-fold in rural and urban men and women in Nigerian. The age-adjusted prevalence rate of hypertension moved from 24.4% to 37.2% in men and from 20.1% to 37.5% in women. The hypertension prevalence rate of up to 47.5% was reported in a self selected urban population in Nigeria. This may have been caused by the rapid urbanization associated with the alarming rates of obesity, physical inactivity, diabetes, increased salt consumption, and tobacco consumption amongst Nigerians. The monitoring of the trends of hypertension and correlation is important to evaluate the effectiveness of interventions implemented to slow the rise in the disease occurrence among men and women in Nigeria. This nationwide survey aimed in determining the current prevalence rate and the risk factors of hypertension in the Nigerian population living in urban areas. This will help improve the effectiveness of current control strategies and plan for future cost effective interventions.

Hypertension, also known as high or raised blood pressure (BP) is a global public health challenge. Hypertension is a chronic medical condition in which the BP in the arteries is elevated. The higher the pressure in blood vessels the harder the heart has to work in order to pump blood, thus making the heart to work too hard. It is popularly known as the “silent killer,” because it has no specific sign and symptoms in the initial stage. Hypertension is the most important modifiable risk factor for cardiovascular disease. Hypertension cuts across every social class. Both lower income groups and higher income groups may be at increased risk of developing hypertension. The etiology of hypertension is multi-factorial. Aside genetic factors; several behavioral and socioeconomic factors can put an individual at risk. Metabolic risk factors like obesity, diabetes and raised blood lipids, can also contribute to the development of hypertension and its complications. Lifestyle modification is very important for the prevention and management of hypertension. According to the World Health Organization (WHO), the prevalence of hypertension is highest in the African Region at 46% of adults aged 25 years and above, while the lowest was found in the American region High prevalence of hypertension has been reported in some recent studies conducted in Nigeria. Hypertension is one of the most common non-communicable diseases in Nigeria and indeed most West African countries. Hypertension and its complications constitute approximately 25% of emergency medical admissions in both urban and rural hospitals/health centers in Nigeria. It is the most frequently diagnosed cardiovascular disorder in Nigeria. Hypertension is rarely accompanied by any symptom and its identification is usually through screening, or when seeking medical attention for an unrelated problem. Screening, ideally not only detects hypertension, but also the basis for education and therapy.

 1.2. Statement of the general problem

The prevalence of hypertension in both the rural and urban areas of the country has increased geometrically over the years which have resulted to several illnesses and ultimately untimely death. the menace of hypertension has significantly reduced the productivity of the Nigerian workforce as people with history of hypertension tend not to always give in their best as a resu;t of stress which could aggravate; this has significantly affected the GDP of the nation and has led to the inability of the workforce of the nation to reach her potential.

Aims and objectives of the study

The major aim of the study is to examine the risk factors of hypertension among Nurses in Imo state. Other specific objectives of the study include;

1. To examine the prevalence of hypertension in Nigeria.
2. To assess the level of awareness of the disease among the hypertensive patients identified during the study.
3. To determine the steps taken to reduce hypertension among the Nigerian populace.
4. To recommend ways of reducing the risk factors of hypertension among Nurses in Nigeria.

Research questions

1. What are the risk factors of hypertension among Nurses in Imo state?
2. What is the prevalence of hypertension in Nigeria?
3. What are the ways of reducing the risk factors of hypertension among nurses in Nigeria?

Significance of the study

The study of hypertension grades, the level of awareness of hypertensive status and associated risk factors has provided information on the current trends of hypertension in Imo State, South-East Nigeria. Assessment of modifiable risk factors from the study will serve as a basis for formulation and implementation of strategies that may reduce these risks factors in the Nigerian populace. It will also sensitize the primary care physicians to identify high risk patients for appropriate counselling, timely intervention and referral when necessary thereby preventing complications of hypertension and avoidable death. Information derived from the study will possibly serve as a resource for the development of   a policy directed towards hypertension prevention and control in Nigeria.