Hypertension in a Rural Community in Rivers State; Niger Delta Region of Nigeria: Prevalence and Risk Factors

RESUMO

Background: Hypertension, a known independent and major risk factor for cardiovascular disease which was initially considered to be rare in sub Saharan Africa (SSA), is now a serious endemic threat and an important public health issue. Different studies in SSA have reported higher prevalence of hypertension in urban compared to rural areas. However more recent studies from the rural areas show an increasing pattern in hypertension prevalence. This may be attributed to the rapid 'westernization' of lifestyle in the rural Africa. Only few rural surveys have been conducted in the Nigeria oil-rich Niger Delta region necessitating this study with the aim of determining the hypertension prevalence and risk factors.Methods: This was a rural community-based cross-sectional study involving 500 adults. A questionnaire administered by face-to-face interview was used to assess socio-demographic characteristics of the subjects. Medical history such as prior knowledge of blood pressure status and family history of hypertension were all elicited by the questionnaire. Height and weight measurement were done and body mass indices (BMI) calculated as weight in kilogram divided by the square of height in meters.Results: There were 156 males and 344 females with male to female ratio of 12.3. The overall mean age was 41.32±17.0. The mean age for males was 42.84±17.8 and that for females was 40.62±16.6. The prevalence of hypertension in this rural community was 20.2 %. The overall mean systolic blood pressure was 1 2 0.4 6 ± 21.59mmHg (M a l e s123.57±20.41mmHg; females 119.05±22.36 mmHg; p= 0.04) and the mean diastolic blood pressure was 73.86±12.63mmHg (Males 75.52±13.03mmHg; females 73.25±12.3 mmHg; p=0.502). The prevalence was found to be higher in males than females though not statistically significant (Males 20.5%; Females 20.1%; X 0.651; p = 0.72). There was a progressive increase of hypertension prevalence with age. (X for trend = 69.434; p < 0.001). Pearson and Spearman' rho correlation analysis revealed that age, marital status, occupation, educational status and BMI correlated with hypertension in the study subjects while logistic regression analysis showed that BMI and age were the only positive predictors of hypertension in this study .Conclusion: Hypertension and its risk factors, which were initially rare in the rural sub Saharan Africa, is now on the increase in addition to high burden of communicable diseases in this region. The increasingly high 'westernization of lifestyle' may be part of the explanation for this. Hence there is need for an organized and deliberate health campaign and regular screening with adequate management in order to both reduce the incidence of hypertension and to prevent hypertension associated morbidity and mortal