Psychosocial Factors Associated with Essential Hypertension among Patients attending a Nigerian Tertiary Hospital

Abstract

Background The aetiological role of psychosocial factos in essential hypertension
continues to be a controversial issue .
Aims To determine the psychosocial factors if any, that are associated with essential
hypertension in adult Nigerians presenting in a Nigerian tertiary hospital.
Method Two hundred and sixty consenting newly diagnosed Nigerians with essential
hypertension attending the cardiology clinic of the University of Ilorin Teaching Hospital
(UITH) Nigeria, were compared with a control group of 240 non-hypertensive subjects with
minor ailments. Data was collected using a self-administered data collection sheet and the
General Health Questionnaire, Version 28 (GHQ-28). Respondents with a GHQ score of 4
and above were interviewed using the Present State Examination (PSE). Psychiatric
diagnosis was based on the criteria of the 10th edition of the International Classification of
Diseases (ICD-10).
Results The study showed that psychosocial factors such as perceived social support,
perceived financial support, fear of job loss and occupational status were not significantly
associated with hypertension. However, a significant proportion of subjects with
hypertension were separated or widowed. A significant proportion of respondents in the
study group had a GHQ score of <4 when compared to those in the control group (those
with minor acute ailments). However, among those with GHQ score above a cut off of 4,
subjects with generalized anxiety disorder (GAD) were more represented among those in
the control than the study group.
Conclusions This is a hospital based study whose findings cannot be generalized. In spite
of this, it was found that psychosocial factors such as perceived social support, perceived
financial support, fear of job loss, marital status and socioeconomic status were not
significantly associated with hypertension among Adult Nigerians with essential
hypertension who presented in a tertiary hospital. Subjects who were separated or
widowed seemed to be more represented among subjects with hypertension. It was
suggested that community based studies would still be needed to confirm or refute these
findings.

Nigerian Journal of Psychiatry Vol. 5 (1) 2007: pp. 26-30