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Population-based prevalence of high blood pressure among adults in an urban slum in Enugu, South East Nigeria

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Abstract

In sub-Saharan Africa (SSA), rapid urbanization and changing lifestyle have modified the profile and pattern of various medical disorders. Apart from high prevalence rates, recent trends with regard to hypertension in Africa include: low levels of awareness, treatment and control. Although a large number of studies provide data about hypertension in SSA, few studies focused on special populations such as urban slum dwellers. The WHO STEP-wise approach to surveillance of noncommunicable diseases was used to access the prevalence of hypertension among adults in one of the urban slums in Enugu. Out of the 811 individuals aged 20 years and above surveyed, 774 (95.4%) cases were analyzed. About 4.7% and 2.7% reported a past history of diabetes and stroke, respectively, whereas 15% had a positive family history of hypertension. The mean (95% confidence interval (CI)) body mass index (BMI) was 23.7 (23.2–24.2) kg m−2 among males and 26.6 (25.7–26.7) kg m−2 among females (P<0.0001). The prevalence of hypertension was 52.5% (95% CI: 48.9–56.0) and 55.4% (95% CI: 49.5–61.3) in males and 50.8% (95% CI: 46.4–55.1) in females (P=0.23). It increased with age peaking at 45–54 years in females and 55 years in males. About 40.1% were aware of their hypertension and 28.8% of those aware had normal blood pressure. In regression analysis, systolic (R2=0.192) and diastolic (R2=0.129) blood pressures increased with age and BMI. The prevalence of high blood pressure among adults in Enugu slums is very high and a cause for concern, and calls for urgent attention.

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References

  1. Omran AR . The epidemiological transition: a theory of the epidemiology of population change. Milbank Q 1971; 83: 731–757.

    Article  Google Scholar 

  2. Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F . Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovascular Disorders 2013; 13: 54. Available at: http://www.biomedcentral.com/1471-2261/13/54 (last accessed 23 July 2014).

    Article  Google Scholar 

  3. Cappuccio FP, Micah FB, Emmett L, Kerry SM, Antwi S, Martin-Peprah R, et al. Prevalence, detection, management, and control of hypertension in Ashanti, West Africa. Hypertension 2004; 43: 1017–1022.

    Article  CAS  Google Scholar 

  4. Ekwunife OI, Aguwa CN . A meta analysis of prevalence rate of hypertension in Nigerian populations. J Public Health Epidemiol 2011; 3 (13): 604–607.

    Google Scholar 

  5. Adebisi OO, Samali A . Poverty and hypertension in Nigerian adults: a barrier to its control and treatment. A review. Uniq Res J Med Sci 2013; 1 (13): 014–020.

    Google Scholar 

  6. Health Systems in Africa Community Perceptions and Perspectives. The Report of a Multi-Country Study. World Health Organization: Geneva, Switzerland, 2012.

  7. Ongeti KW, Ogeng’o JA, Pulei AN, Olabu BO, Gakara CN . Blood pressure characteristics among slum dwellers in Kenya. Glo Adv Res J Microbiol 2013; 2 (4): 080–085.

    Google Scholar 

  8. WHO WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). WHO: Geneva,Switzerland, 2005.

  9. O'Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, et al. on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens 2005; 23: 697–701.

    Article  CAS  Google Scholar 

  10. ICAP Reports 13. International Center for Alcohol Policies, 2003. Available at: http://www.icap.org (last accessed on 29 May 2014).

  11. Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services, 2008. Available at: www.health.gov/paguidelines (last accessed 8 March 2015).

  12. Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue M . Age Standardization of Rates: A New WHO Standard. World Health Organization: Geneva, Switzerland, 2001.

    Google Scholar 

  13. Federal Republic of Nigeria 2006 Population and Housing Census Population Distribution by Age and Sex (State and Local Government Area. National Population Commission Abuja: Nigeria, 2010.

  14. Ulasi II, Ijoma CK, Onwubere BJC, Arodiwe E, Onodugo O, Okafor C . High prevalence and low awareness of hypertension in a market population in Enugu, Nigeria. Int J Hypertens 2011; 2011: 869675: doi:10.4061/2011/869675.

    Article  PubMed  PubMed Central  Google Scholar 

  15. World Health Organisation. Noncommunicable Diseases Country Profiles. Geneva, Switzerland, 2011.

  16. World Health Organisation Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. WHO: Geneva, Switzerland, 2009.

  17. Awoke A, Awoke T, Alemu S, Megabiaw B . Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study. BMC Cardiovasc Disord 2012; 12 (113): 1471–2261.

    Google Scholar 

  18. Musinguzi G, Nuwaha F . Prevalence, awareness and control of hypertension in Uganda. PLoS ONE 2013; 8 (4): e62236; doi:10.1371/journal.pone.0062236.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Tesfaye F, Byass P, Stig W . Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic. BMC Cardiovasc Disord 2009; 9 (39): 1471–2261.

    Google Scholar 

  20. Pereira M, Lunet N, Azevedo A, Barros H . Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–975.

    Article  CAS  Google Scholar 

  21. Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N . Epidemiology of hypertension in low-income countries: a cross-sectional population-based survey in rural Uganda. J Hypertens 2011; 29: 1061–1068.

    Article  CAS  Google Scholar 

  22. Ezeala-Adikaibe B, Liu Y, Lemogoum D, Anisiuba BC, Kamdem MK, Kaptue J, et al. Central haemodynamics reveal significant potential for prevention in Black hypertensive patients born and living in sub-Saharan Africa. Artery Res 2012; 6: 41–48.

    Article  Google Scholar 

  23. Hendriks ME, Wit FW, Roos MT, Brewster LM, Akande TM, de Beer IH, et al. Hypertension in Sub-Saharan Africa: cross-sectional surveys in four rural and urban communities. PLoS One 2012; 7 (3): 12.

    Article  Google Scholar 

  24. World Health Organization Cameroon Burden of Diabetes (CamBoD) Project: Baseline Survey Report. World Health Organisation: Geneva, Switzerland, 2004.

  25. Poulter NR, Khaw KT, Hopwood BE, Mugambi M, Peart WS, Rose G, et al. The Kenyan Luo migration study: observations on the initiation of a rise in blood pressure. BMJ 1990; 300: 967–972.

    Article  CAS  Google Scholar 

  26. Oluyemi EA, Akinlua AA, Adenuga AA, Adebajo MB . Mineral contents of some commonly consumed Nigerian foods. Eur J Scientific Res 2005; 6 (2): 11–15.

    Google Scholar 

  27. M’Buyamba-Kabangu JR, Lepira B, Lijnen P, Tshiani K, Fagard R, Amery A . Intracellular sodium and the response to nitrendipine or atenolol in African blacks. Hypertension 1988; 11: 100–105.

    Article  Google Scholar 

  28. Touyz RM, Milne FJ, Reinach SG . Platelet and erythrocyte Mg2+, Ca2+, Na+, K+ and cell membrane adenosine triphosphatase activity in essential hypertension in blacks. J Hypertens 1992; 10: 571–578.

    Article  CAS  Google Scholar 

  29. Wyatt SB, Akylbekova EL, Wofford MR, Coady SA, Walker ER, Andrew ME, et al. Prevalence, awareness, treatment, and control of hypertension in the Jackson heart study. Hypertension 2008; 51 (3): 650–656.

    Article  CAS  Google Scholar 

  30. Okafor CI, Gezawa ID, Sabir AA, Raimi TH, Enang O . Obesity, overweight, and underweight among urban Nigerians. Niger J Clin Pract 2014; 17 (6): 743–749.

    Article  CAS  Google Scholar 

  31. WHO Global InfoBase. Available at: http://www.who.int/ncd_surveillance/infobase/, accessed on 14 December 2014.

  32. World Health Organization. Reducing Risks, Promoting Healthy Life. World Health Report. World Health Organization: Geneva, Switzerland, 2002.

  33. Stamler J, Elliott P, Appel L, Chan Q, Buzzard M, Dennis B, et al for the INTERMAP Research Group,. Higher blood pressure in middle-aged American adults with less education—role of multiple dietary factors: The INTERMAP Study. J Hum Hypertens 2003; 17: 655–775.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We acknowledge the leaders of Agu-Abor and Ugbodogwu communities for their support, and to Miss Loveth Emmanuel, Secretary, Neurology and EEG services, Mount Carmel Hospital Enugu, for her help in the office.

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Correspondence to B A Ezeala-Adikaibe.

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Ezeala-Adikaibe, B., Orjioke, C., Ekenze, O. et al. Population-based prevalence of high blood pressure among adults in an urban slum in Enugu, South East Nigeria. J Hum Hypertens 30, 285–291 (2016). https://doi.org/10.1038/jhh.2015.49

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