Prevalence of Hypertension among adults aged 40 years and above in Ahiazu Mbaise, Imo State, Nigeria

Introduction: This study was aimed at determining the prevalence of hypertension among adults aged 40 years and above in a rural Nigerian Population. Materials and Methods: Semi-structured questionnaires were completed by random selected rural dwellers. Aneroid sphygmomanometer was used to measure their blood pressure measurement. The mean of two separate blood pressure measurements was taken in each individual in a sitting position after about 5 minutes of rest. Data were analyzed using Statistical Package for Social Sciences computer software version 21.0 for windows. Total sample of 320 rural dwellers were recruited for the study. Result: The result indicated that 116 were males while 204 were females. The mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) of participants were 138.5 ± 19.9mmHg and 80.6 ± 13.9mmHg respectively. The overall prevalence of hypertension in the population was found to be 51.3%. The prevalence of hypertension in this study is 56.9% in males and 48.0% in females. Conclusion: The fi nding of this study indicated need for specifi c interventions, focusing upon providing large scale population screening for hypertension and adequate blood pressure control to mitigate the mortality and morbidity associated with hypertension especially in the rural areas. Research Article Prevalence of Hypertension among adults aged 40 years and above in Ahiazu Mbaise, Imo State, Nigeria Ebirim CIC1*, Udujih OG1, Dozie UW1, Agbaka CA2, Orji SM1, and Anaele CC1 1Department of Public Health, Federal University of Technology Owerri, Nigeria 2Eastern Summit Specialist Clinics, 37 Orlu Road, Amakohia Imo State, Nigeria Received: 03 May, 2018 Accepted: 14 May, 2018 Published: 15 May, 2018 *Corresponding author: Ebirim Chikere Ifeanyi Casmir, Department of Public Health, Federal University of Technology.P.M.B 1526, Owerri, Nigeria, Tel: +2348038870206, +2347089439208, Email:


Introduction
Hypertension or high blood pressure is a serious condition that affects adults and two -third of people over 65 years.
Blood pressure is the force of blood as it pumps through your arteries. The more blood your heart pumps and the narrower your arteries are, the higher the blood pressure. Normal blood pressure is defi ned as an average systolic blood pressure of 120mmHg and an average diastolic pressure of 80mmHg.
Systolic pressure measures the pressure in arteries when your heart beats. Diastolic pressure measures the pressure between beats [1]. According to Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC7), the blood pressure levels of individuals are grouped into four classes: (i) normal blood pressure (systolic blood pressure less than 120mmHg and diastolic blood pressure less than 80mmHg), (ii) pre-hypertension (systolic pressure between 120 and 139mmHg or diastolic pressure between 80 and 89mmHg), (iii) stage 1 hypertension (systolic pressure between 140 and 159mmHg or diastolic pressure between 90 and 99mmHg), and (iv) stage 2 hypertension (systolic pressure ≥160mmHg or diastolic pressure ≥100mmHg) [1].
Hypertension is the most common noncommunicable disease in Nigeria. Hypertension and its complications constitute approximately 25% of emergency medical admissions in urban hospitals in Nigeria. It is the most frequently diagnosed cardiovascular disorder in Nigeria [2]. Uncontrolled hypertension is associated with serious endorgan damage including heart disease, stroke, blindness and renal disease etc. The relationship between blood pressure (BP) and risk of cardiovascular disease events is continuous, consistent, and independent of other risk factors. The higher the BP, the greater is the chance of heart attack, heart failure, stroke, and kidney diseases [3]. Hypertension is of serious concern because it can be asymptomatic so many people with hypertension do not know initially and do not seek the help of a doctor. Therefore, the detection and control of hypertension is a major public health challenge in both developed and developing countries.
The aim of this study was to determine the prevalence and pattern of hypertension in a rural Nigerian population. The researcher also used the opportunity to advice and counsel adults in Ahiazu Mbaise L.G.A, of Imo State, Nigeria on how they can prevent and manage hypertension.

Materials and Methods
This study is a cross-sectional survey which intends to determine the prevalence and pattern of hypertension Hypertension is defi ned as blood pressure above 140/90 mmHg.
Permission to conduct the study was requested and obtained from the university, informed verbal and written consent was obtained from participants. Confi dentiality of information was maintained throughout the study. Data collected were edited and coded. It was thereafter imputed into the computer for analysis using statistical package for social sciences (SPSS) version 21.0. Tables were used to present frequency distribution and pattern of hypertension morbidity. Charts were used to present remarkable observations, also histogram and scatter diagram were used to show signifi cant relationship between variables. Statistical signifi cance for association was tested using Chi-square and P-value less than 0.05 was considered statistically signifi cance.

Prevalence of hypertension among the participant
The overall prevalence of hypertension in this study was 51.3% as presented in fi gure 1. The result indicated a higher prevalence for male 56.9%, when compared to females 48.0% as shown in fi gure 2. The mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) of participants were 138.5 ± 19.9mmHg and 80.6 ± 13.9mmHg respectively. Figure 3 indicated a linear relationship between systolic blood pressure and age. Also fi gure 4 indicated a linear relationship between diastolic blood pressure and age.

Discussion
The overall prevalence of hypertension amongst the study population was 51.3%. This is actually something to worry about as there are many complications that come with it like stroke and cardiac failure. This prevalence is high compared with others studies in south east Nigeria. This higher prevalence   [5]. In another study conducted at Enugu a prevalence of 42.2% was reported among traders [6]. In a cross-sectional study in a theological institution in Umuahia also in Southeast Nigeria, Ike found a prevalence of 28.3% among college's entire population of 85 subjects which included both students, academic and non-academic staff [7]. Ajayi et al. (2016), found an overall prevalence of 33.1% amongst adults aged 18 years and above residing in Ibadan, Oyo State [2]. Also Ezekwesili et al. (2016), reported a prevalence of 22.8% among residents aged 17years and above living in major cities of Anambra state [3].
The fi ndings of this study revealed that hypertension is more prevalent in males (56.9%) than in female (48.0%).
This maybe as a result of the type of lifestyle men indulge in, smoking and excessive alcohol consumption are more prevalent in men than in women. This higher prevalence for male is also reported in other studies [8]. Ajayi et al. (2016), indicated a higher prevalence in male than female (male 36.8% and female 31.1%) amongst residents of Ibadan, Oyo State [2].
Onwubere et al, also reported that hypertension was commoner in the males than in females (50.2% vs. 44.8%) [5]. Also the study is in agreement with the fi ndings of Ahaneku et al who reported hypertension was higher in males compared with their female counterparts (49.3% vs 42.3%) [4]. Furthermore a study among traders in Enugu city buttressed the point that more males were hypertensive than females (46.3% vs 37.7%) [6]. However Ezekwesili et al reported a higher prevalence in female than in male residents of major cities in Anambra State (male 22.01% and female 23.5%) [3].
This study indicated that the prevalence of hypertension increases with age, with participant aged 80 years and older having the highest prevalence (66.7%) of hypertension. This is not surprising because it has been established that age is a predisposing factor for the development of essential hypertension [8]. The fi ndings of this study is in line with those of Olatinbosun, Kaufman, Cooper and Bella, (2000) which found that age is a risk factor for the development of hypertension in the urban black population in Nigeria [9].