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

Abstract

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  1:2.3. 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