Awareness, Treatment and Control of Hypertension in Nigeria: A Systematic Review

International Journal of Medical Science and Public Health Research

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TYPE

Original Research

PAGE NO.

12-62

DOI

10.37547/ijmsphr/Volume06Issue05-03

OPEN ACCESS

SUBMITED

17 March 2025

ACCEPTED

22 April 2025

PUBLISHED

03 May 2025

VOLUME

Vol.06 Issue 05 2025

CITATION

Akeem Ayobami Adewole, Kennedy Oberhiri Obohwemu, Iyevhobu
Oshiokhayamhe Kenneth, Joyce Eberechukwu Idomeh, Sandra
Chinyeaka Nwokocha, Rupali Chauhan, Shubham Sharma, Divya
Motupalli, Mary Akadiri, Funke Abolade Adumashi, Samuel Oluwatosin
Adejuyitan, Oluwadamilola R. Tayo, & Bartholomew Ituma Aleke.
(2025). Awareness, Treatment and Control of Hypertension in Nigeria:
A Systematic Review. International Journal of Medical Science and
Public Health Research, 6(05), 12

–

62.

https://doi.org/10.37547/ijmsphr/Volume06Issue05-03.

COPYRIGHT

© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.

Awareness, Treatment and
Control of Hypertension in
Nigeria: A Systematic
Review

Akeem Ayobami Adewole, MPH

Senior Health Support Trainer, Suomen Avustajapalvelut, Helsinki,
Finland

Kennedy Oberhiri Obohwemu, PhD

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS, Birmingham Campus, United Kingdom; and PENKUP
Research Institute, Birmingham, United Kingdom

Iyevhobu Oshiokhayamhe Kenneth, MPH

Department of Medical Microbiology, Faculty of Medical Laboratory
Science, Ambrose Alli University, Ekpoma, Edo State, Nigeria

Joyce Eberechukwu Idomeh, PhD

Department of Social Works (DSW), College of Education, Psychology
and Social Work, Flinders University, Bedford Park Campus, Sturt
Road, Bedford Park 5042, South Australia; and PENKUP Research
Institute, Birmingham, United Kingdom

Sandra Chinyeaka Nwokocha, PhD

Faculty of Business & Tourism Management, Canterbury Christ
Church University, GBS Partnership, Birmingham, United Kingdom;
and PENKUP Research Institute, Birmingham, United Kingdom

Rupali Chauhan, MPH

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS Partnership, Manchester, United Kingdom

Shubham Sharma, MDS

Independent Researcher, Manchester, United Kingdom

Divya Motupalli, MPHGH

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS Partnership, Manchester, United Kingdom

Mary Akadiri, MSc

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS Partnership, Birmingham, United Kingdom; and
PENKUP Research Institute, Birmingham, United Kingdom

Funke Abolade Adumashi, MSc

Faculty of Health, Wellbeing & Social Care, Pearson, GBS Partnership,
Manchester, United Kingdom; and PENKUP Research Institute,
Birmingham, United Kingdom

Samuel Oluwatosin Adejuyitan, MSc

Doctoral Researcher, School of Business and Creative Industries,

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University of the West of Scotland, United Kingdom; and PENKUP
Research Institute, Birmingham, United Kingdom

Oluwadamilola R. Tayo, MPH

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS Partnership, Leeds, United Kingdom

Bartholomew Ituma Aleke, PhD

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS Partnership, Leeds, United Kingdom

Corresponding Author: Kennedy Oberhiri Obohwemu, PhD

Faculty of Health, Wellbeing & Social Care, Oxford Brookes
University, GBS, Birmingham Campus, United Kingdom; and
PENKUP Research Institute, Birmingham, United Kingdom

Abstract:

Background:

Inadequate hypertension diagnosis and

management in Nigeria is a key contributor to
cardiovascular morbidity and death. To direct
appropriate preventive actions in Nigeria, a better
knowledge of the existing burden of hypertension is
required, including awareness, treatment, and
management. To evaluate the trends of hypertension
throughout the nation's various states, a systematic
review was done.

Methods:

A thorough literature search was conducted using
PRISMA guidelines to find empirical research on
hypertension and obesity in adult Nigerians. In order to
find original publications about the recognition,
management, and control of hypertension in Nigeria
published between 2002 and 2022, PubMed, Scopus,
and CINAHL were used as the major databases. Africa,
Nigeria, awareness, therapy, control, and hypertension
were the main search phrases. To provide for more
research, the bibliographies mentioned in the
indicated papers were investigated. The articles' full
texts were retrieved from a variety of online resources.
This data was gathered using a data extraction form.

Results:

The requirements for inclusion were satisfied by 48
studies from each of the nation's six geopolitical
regions. Regional differences in awareness, treatment,
and control were significant. The awareness of rural
people was lower than that of urban people. The
South-South region has the greatest prevalence of
hypertension. The lowest rates of hypertension
management were seen in the South-West. Even
among respondents who were aware of their condition
and those who were receiving treatment, there was
typically inadequate control of hypertension across the
nation. There were no estimates specific for either
gender.

Conclusion:

Hypertension is only marginally understood, treated,
and controlled. For hypertension patients in Nigeria to
experience improved outcomes, tailored studies are
needed to identify the precise causes of these low
levels.

Keywords:

Hypertension, Awareness, Treatment,

Control, Risk Factors, Nigeria, Africa

Introduction:

Cardiovascular diseases (CVDs) have

emerged as the leading global cause of death, primarily
driven by modifiable risk factors such as tobacco use,
alcohol

consumption,

hypertension

(HTN),

dyslipidaemia, obesity, poor diet, and physical inactivity
(Glovaci et al., 2019; WHO, 2021). Once considered a
problem of high-income countries, CVDs now represent
a major public health concern

in sub-Saharan Africa (SSA), where the dual burden of
infectious and noncommunicable diseases continues to
strain fragile health systems (Minja et al., 2022;
Wekwete et al., 2022).

Nigeria, the most populous country in Africa,
exemplifies this epidemiological transition. Rising
urbanisation and lifestyle shifts have contributed to an
increasing prevalence of HTN and overweight/obesity,
which are now significant contributors to morbidity and
mortality (Issaka et al., 2018; Choukem et al., 2020).
HTN-related conditions such as heart failure, stroke, and
renal disease have become common, often diagnosed
late or not at all. Recent studies highlight the ongoing
challenges in managing hypertension in Nigeria. For
instance, a 2021 meta-analysis revealed that among
Nigerians with hypertension, only 29% were aware of
their diagnosis, 12% were on treatment, and a mere 3%
achieved control (Ogungbe et al., 2024). In a recent
study, over 45% of sudden cardiac deaths were
attributable to hypertensive cardiovascular disease
(CVD), yet only 10% had a prior diagnosis (Danladi et al.,
2025). Similarly, a tertiary hospital in Nigeria reported a
43% case-fatality rate among hypertensive patients
(Danladi et al., 2025).

The burden is compounded by the co-existence of
undernutrition and rising obesity rates, presenting a
unique challenge for public health systems in SSA
(Sahoo et al., 2015; Ajayi et al., 2016). Moreover, ethnic
minority populations who migrate to high-income
countries often exhibit increased CVD risk, suggesting
that environmental and socioeconomic factors play a
substantial role (Vyas et al., 2024; Hossain et al., 2025).

Globally, hypertension (HTN) is responsible for over 10
million premature deaths and more than 218 million

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disability-adjusted life years (DALYs) annually (WHO,
2023). Projections estimate that by 2025, 1.5 billion
people

—

approximately one-third of the global

population

—

will be hypertensive due to rising life

expectancy and obesity (Boateng & Ampofo, 2023). In
high-income countries, advances in HTN management
have led to a 40% reduction in stroke risk and at least
a 25% reduction in myocardial infarction (Dzau &
Balatbat, 2024), but such progress has not been
mirrored in sub-Saharan Africa (SSA) (Nyame et al.,
2024).

Despite the seriousness of the issue, HTN often goes
undiagnosed and undertreated in SSA due to limited
healthcare access, poor awareness, and resource
constraints (Nyaaba et al., 2020). Many studies are
hospital-based, excluding undiagnosed individuals in
the community and leading to underestimates of the
true burden (Agimas et al., 2024; Swambulu et al.,
2024). National estimates suggest HTN prevalence in
Nigeria is 30.6% in urban and 26.4% in rural areas
(Adeloye et al., 2015), yet few comprehensive reviews
have synthesised this data in recent years.

This study aims to systematically review available
literature on HTN in Nigeria

—

focusing on prevalence,

awareness, treatment, and control

—

to guide public

health policy and inform future interventions.

METHODS

Search Strategy

The Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) statement was adhered
to in this systematic review (Page et al., 2021). To
provide a more thorough and up-to-date assessment
and to identify patterns and trends in knowledge,
treatment, and management of HTN in Nigeria, articles
published in the English language between 2002 and
2022 were taken into consideration.

If studies provided HTN prevalence estimates, they

were considered. Studies on obstetrics, pharmacology,
anthropology, reviews, government publications,
protocols, pre-prints, studies conducted outside of
Nigeria, and research on Nigerians who live outside the
country were all excluded. Studies that used medical
testing as part of the pre-selection process for
employment opportunities were also disqualified. The
results of many investigations involving the same group
of patients were combined, although the references
listed distinct publications outlining the incidence of
HTN. Studies that merely employed self-reporting of a
history of HTN without taking a blood pressure reading
were disqualified. Studies that exclusively looked at HTN
prevalence in men or women were excluded as well. The
search was done in English and focused only on English-
language articles.

To

find

empirical

studies

on

HTN

and

overweight/obesity in adult Nigerians, PubMed, Scopus,
and CINAHL were searched. The African Index Medicus,
African Journal Online, WHO Global Cardiovascular
Infobase, and Google Scholar were also looked up. To
increase the number of studies found, the references of
all pertinent research publications were manually
examined.

Subject headings and free text keywords were
incorporated to increase the search's breadth. A search
for papers with the terms "HTN" or "BP" in the title or
abstract was added to the medical topic headings
(MeSH). The names of all 36 states (including FCT,
Abuja) and the country Nigeria were utilised as
additional key search phrases to find articles that cover
the length and breadth of the African nation. The
numerous keywords connected to the pertinent
Boolean operations are shown in Table 1. The search
technique also includes the use of HTN, high blood
pressure (BP), obesity, overweight, div mass index
(BMI), risk factors, and prevalence as keywords. To
include the most articles, all MeSH terms and keywords
were shortened and exploded.

Table 1: Search Terms

S/N

Subject Headings and Keywords

1.

Africa or sub-Saharan Africa or West/Western Africa or Nigeria

2.

Morbidity or Mortality

3.

Disease Burden or Epidemiology

4.

Hospital Admission*

5.

Case Fatality or Case Fatality Rate*

6.

Risk Factors

7.

2 OR 3 OR 4 OR 5 OR 6

8.

HTN or High BP or Cardiovascular Risk* or Hypertensive Heart Disease or
Cardiometabolic Risk*

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9.

Knowle*ge or Awareness or Attitude* or Behavio*r or Practice* or Treatment or
Control

10.

1 AND 7 AND 8 AND 9

11.

Limit 10 to “2002-2022”

All possibly relevant publications' abstracts were
examined, and complete articles were evaluated.
Records with duplicates were eliminated. Following an
assessment of the titles, articles that were blatantly
unrelated to the topic of interest were deleted. All
possibly pertinent papers' complete texts and abstracts
were examined. If additional items did not meet the
requirements for inclusion, they were deleted.

By dividing the total number of individuals with HTN
(BP 140/90 mmHg and/or usage of antihypertensive
medications) by the total participants in the included
studies, the prevalence of HTN was calculated. By
dividing the total study participants by the HTN
prevalence in the study, the number of individuals with
HTN in each study was calculated.

Data Extraction

The year of publication, study location, study
methodology, participant count, mean age range,
gender distribution, comorbidities, HTN prevalence,
and awareness levels, therapy, or control were all
gathered using a data extraction sheet. These variables
were also retrieved in cases where they were present

and predicted the states of awareness, treatment, and
control. Results from multi-regional research were
broken down wherever it was possible to indicate the
level of awareness, treatment, and control in various
states and areas. When it wasn't possible to separate the
data by state or area, the research was presented as a
whole and the states or regions where it was conducted
were noted.

For their definition of HTN, the majority of studies
employed the threshold of 140/90 mmHg and/or the
usage of antihypertensive medications. In accordance
with current WHO recommendations, a few research still
employed the previous 160/95 mmHg cut-off value.

Quality Assessment

According to prior research, the quality evaluation
standards for studies looking at the prevalence of chronic
illnesses were used (Stanifer et al., 2014; Adeloye et al.,
2017). The representativeness of provided estimates
within the major geopolitical zones and the explicit
explanation of methodologies, procedures, case
ascertainment, and sampling were evaluated for. The
quality of the studies was rated as high (4-5), moderate
(2-3), or low (0-1) (see Table 2).

Table 2: Quality assessment criteria for studies examining prevalence of chronic diseases

Item

Quality criteria

Assessment

Score

Maximum
score

Sampling

Was the sampling
described

and

representative of a
target subnational
population?

Yes

2

2

Not
representative

1

Not described

0

Statistical
analysis

Was the statistical
analysis
appropriate?

Yes

1

1

No

0

Case
ascertainment

Was the procedure
for identification of
cases

clearly

described?

Yes

2

2

Ambiguous

1

Not described

0

Grading

Total (

high (4-5), moderate (2-3), or low quality

(

0-1

))

5

Data Analysis

A narrative strategy was used to analyse the data. The
narrative synthesis found patterns shared by the
different studies, and these themes were investigated to
identify potential factors with significant significance
for Nigeria's attempts to manage HTN.

A meta-analysis of the given data was not possible due
to the heterogeneity of the research designs and the
absence of specified confidence ranges in the majority of
the investigations.

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RESULTS

Search Results

A total of 5,619 articles were found through the searches,
the bulk of which came from the three main databases
(PubMed, Scopus, and CINAHL) (see Table 3).

Table 3: Sources and Number of Studies Retrieved During the Literature Search

S/N

Data Sources

Number of Studies Identified

1.

PubMed

2678

2.

Scopus

1361

3.

CINAHL

1009

4.

WHO Global Cardiovascular Database

276

5.

African Index Medicus (AIM)

123

6.

African Journals Online (AJOL)

82

7.

Google Scholar

54

8.

Google Searches

21

9.

Reference Lists of Relevant Studies

15

3210 papers were checked for indications of a
population-based research on HTN in Nigeria after
duplicates were eliminated. 2023 studies were
disqualified after using the selection criteria. Using the
chosen criteria, 386 full text articles were specifically
examined. Final selections for qualitative synthesis
included 48 studies (see Figure 1).

The vast majority of research were cross-sectional
population-based investigations. A total of 54,215
people were covered by the 48 studies, which were
chosen from across Nigeria's six geographical zones.
South-South was the region with the most studies (17),
followed by South-East and South-West with 10
apiece. The North-East and North-West were each
represented by three studies, while the North-Central
was represented by four. Participants in one nationally
representative research came from various geographic
regions of the nation.

In this study, a variety of populations were covered.
Nationwide, one research was undertaken. Each of the
three types of settings

—

urban, semi-urban, and

rural

—

saw the conduct of 37 research, including 11 in

mixed urban-rural settings. Participants in the
community-based research included in this evaluation
were primarily drawn from market communities and
resided in rural areas. The majority were housewives,
small-time traders, motorcycle riders, artists, local
government employees, and farmers and fishers
(Omuemu et al., 2004; Ofuya, 2007; Adedoyin et al.,
2008; Andy et al., 2012; Asekun-Olarinmoye et al., 2013;
Adebayo et al., 2013; Ezejimofor et al., 2014).

The study's time frame spanned 2003 through 2020. The
majority of the investigations, with the exception of four
(Odili et al., 2008; Amira et al., 2010; Hendriks et al.,
2012; Murthy et al., 2013), were carried out within a
year. 15 of the 48 research were published between
2000 and 2009, 32 between 2010 and 2019, and 1
between 2020 and June 2022. As a result, the annual
rate of output rose gradually from 1.5 in the 2000s to
3.2 in the 2010s before dropping precipitously to 0.1 in
2020

–

2022.

In the research included in this review, the sample sizes
ranged from 75 individuals in a study at a medical school

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Fig. 1. PRISMA Flowchart

in Port Harcourt (Ordinioha, 2013) to 13,504 in a study
conducted at several locations across the nation
(Murthy et al., 2013). The participants' ages ranged
from 15 to 99 years old. Both sexes (male and female)
were represented in every study. More women than
males took part in the majority of the research. The
men were better represented in the community-based
research that focused on farmers, traders, rural
residents, and market communities.

The prevalence of HTN was often greater and more
variable in regional studies (13.2%-55.9%) than it was
in nationally representative samples (46.8-51.6%). The
features of the studies are presented in Appendix 1.

Data Extraction

Appendix 2 summarises the findings of the systematic
review including any factors associated with diagnosis,
treatment, and control where available.

Quality Appraisal

A total of 21 studies received high ratings, while the
remaining 27 received intermediate ratings (Appendix
3).

Data Analysis

1. Hypertension Prevalence

The frequency of HTN varied greatly. Comparing
prevalence rates was challenging because the majority
of them were not age-standardised. The incidence
varied across studies that focused on populations under
40 years old, from 13.8% in a university community in
the Niger Delta area (South-South, Nigeria) to 47% in the
6th battalion army barracks of Ibawa, Abak in Akwa
Ibom (South-South, Nigeria) (Ekanem et al., 2012).
According to research including senior people,
hypertension was more common overall, with a
prevalence of 65% in a rural community in Bayelsa State
(Egbi et al., 2013). There were no estimates for either

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gender.

2. Hypertension Awareness

This review defined awareness as previous knowledge
of a hypertensive state. In rural areas of Cross River
and Akwa Ibom States, awareness levels were lowest
(2.8%). (Andy et al., 2012). The market people in Enugu
has the greatest awareness levels (29.4%). (Ulasi et al.,
2011). Adim, a semi-rural locality in Cross River State,
had awareness levels of 3.1%, while rural villages in
Ilorin had awareness levels of 3.0%. (Hendriks et al.,
2012). According to Omuemu et al. (2004), awareness
levels in Udo, a rural village in Edo State's Ovia South-
West LGA, were 18.55%.

3. Hypertension Treatment Only two studies out of the
48 included in this evaluation assessed this outcome,
demonstrating the paucity of research on treating
hypertension (Omuemu et al., 2004; Hendriks et al.,
2012). In a population-based cross-sectional study in
the remote Edo State village of Udo, 18.5% of
participants were aware of their hypertension
condition, and 77.3% were receiving treatment for it
(Omuemu et al., 2004). Only 2% of participants in rural
settlements in Ilorin were found to be taking anti-
hypertensive drugs, which indicates a poor treatment
rate for HTN (Hendriks et al., 2012).

4. Hypertension Control

In a university town in South-West Nigeria, 14.6% of
those who had HTN had previously received a
diagnosis, but only 4.8% of them had their blood
pressure under control; 6.4% of the responder
population had just received a hypertension diagnosis
(Erhun et al., 2005). In a rural community in Edo State,
of the 77.3% individuals who were receiving
hypertension therapy, 29.4% had appropriate blood
pressure control (Omuemu et al., 2004). Only 3% of
participants in Ilorin's rural areas had blood pressure
readings under 140/90. (Hendriks et al., 2012).

5. Predictive Factors for Hypertension Awareness,
Treatment, and Control

HTN knowledge levels were greater in females,
increased with age, and, notably, reduced with better
educational status in a rural community in Ovia South-
West LGA of Edo State (Omuemu et al., 2004). This
unexpected conclusion may be attributed to the
tendency of people with higher educational levels to
be busier and less able to fit in frequent blood pressure
tests because they are more focused with other things,
such their work. Female sex, hypercholesterolemia,
and hyperuricemia were independently linked to
obesity in a study of healthy individuals in Kaduna
(Wahab et al., 2011). In Ahiazu Mbaisa, Imo State, over
30% of middle-aged individuals frequently drank

alcohol, whereas 23% frequently ate salty foods (Mbah
et al., 2013). These were all linked to risk factors for high
BP along with having a high BMI.

Age, sex, obesity parameters, pulse rate, and localities
in Abia State were the main predictors of high blood
pressure (Ogha et al., 2013). Age, weight, height, waist-
to-hip ratio, BMI, waist-to-hip circumference, and pulse
rate have all been linked to HTN. Except for height, most
of the covariates had a positive correlation with BP.

DISCUSSION

There is a tonne of information available about how
common HTN is in Nigeria. Although prevalence was not
one of the search criteria used in this analysis, various
prevalence levels across areas were reported in certain
publications, many of which support the continued high
incidence. It is crucial to characterise not just the
detection rate but also awareness, treatment, and
control rates, as well as the variables that affect these
rates, in a high prevalence environment like Nigeria. This
would make it possible to develop pertinent,
customised control measures to lessen the effects of
uncontrolled HTN. This detailed study of knowledge,
prevention and control efforts in Nigeria is provided by
this systematic review.

The ageing population, greater urbanisation, poor
lifestyle choices, and the lack of effective national
preventative efforts are likely causes of the significant
and consistent growth in HTN. These findings support
worries that HTN and its associated sequelae may soon
pose the greatest economic and public health hazard in
many African nations, surpassing pandemics of malaria
and other infectious illnesses (Adeloye & Basquill, 2014;
WHO, 2017; Mabuza, 2020).

The frequency of HTN in Nigeria varied significantly by
geopolitical zone, ranging from 25% to 33%, according
to the data. The South-South region has the highest
incidence, at 47%. Adeloye et al. (2021) showed a high
incidence of HTN in the South-East at 33.3%, while
additional research on the geographical pattern of
distribution may be necessary. According to Murthy et
al. (2013), the North-Central has a high incidence of
50.5%. There may be dietary variations in these areas,
especially in the quantity of salt and oil used in cuisine.
Without community strategies to promote healthy
diets, the significant variations in socio-economic
conditions have significant effects on dietary decisions,
especially in urban environments characterised by high
consumption of processed foods (Cappuccio & Miller,
2016; Blüher, 2019; Placzek, 2021). Additionally,
Nigeria's

fluctuating

weather

and

climatic

circumstances have a significant impact on farming and
the types of food crops grown, which may be another

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crucial element in the dietary variations. The findings
showing a greater prevalence of HTN in urban
inhabitants and those who are older are in line with the
results of various other investigations (Twagirumukiza
et al., 2011; Addo et al., 2012; Adeloye & Basquill,
2014; Anchala et al., 2014; Adeloye et al., 2021).

Although prior predictions, with a 5% disparity in 2010
(Adeloye et al., 2015) and 2% in 2020 (Adeloye et al.,
2021), clearly show a diminishing prevalence gap
between men and women, no sex-specific estimates of
HTN prevalence were published in this research. There
has been evidence that women have a somewhat
greater frequency of HTN than males (Murthy et al.,
2013; Adeloye et al., 2021). There may be a connection
between the increased frequency of HTN in women
with the rise in obesity, decline in physical inactivity,
and bad eating habits (Owolabi et al. 2017; Mahumud
et al., 2021; Gaesser & Angadi, 2021). In addition,
women seem to experience severe mental,
psychological, and emotional repercussions from
Nigeria's growing security issues, with frequent panic
episodes likely having a negative impact on many
people's general cardiovascular health (Amusan &
Ejoke, 2017; Kendrick & Isaac, 2021). Additionally, it is
important to keep in mind that women are more likely
to take part in community medical outreach initiatives,
which might result in selection bias and significantly
greater prevalence reported for women (Adeloye et
al., 2015).

Results from this review indicate that knowledge of
hypertension state is often low. The highest degree of
awareness was 29.4%. These rates are lower than
those in other African nations like South Africa and
Zimbabwe, where they are above 30%. (Goverwa et al.,
2014; Adeniyi et al., 2016; Owolabi et al., 2017).
Reducing the burden of cardiovascular disease involves
addressing the comparatively small rates of
awareness, treatment, and management of HTN in
Nigeria. In comparison to North America and Europe,
where temporal assessments have indicated an
increase in awareness from 20 years ago, when levels
were similar to those now reported in Africa, to the
current pace of over 65%, the levels in Africa are far
lower (McAlister et al., 2011). Since it was discovered
that HTN had a significant role in morbidity and death
in these nations, intensive education efforts on HTN
have been credited with the majority of this increased
awareness. While the diverse nature of the research
designs in this evaluation prevented the creation of a
temporal trend, Tanzania, a country that had
numerous consecutive trials, did not experience any
change. It is feasible that more knowledge and thus
increased awareness would result from a comparable
recognition of HTN as the primary cause of mortality.

Our research discovered significantly higher treatment
rates in North Africa than it did anywhere else on the
continent. It's likely that these high standards of care are
influenced by the existence of healthcare coverage in
nations like Tunisia, which encompasses both treatment
and diagnostic services. Universal health care coverage
has improved HTN diagnosis and management in
industrialised countries like the USA, resulting in a
decrease in HTN-related hospitalizations and fatalities
(Joynt et al., 2013). In nations like South Africa that
strive to achieve universal health care, the situation
with HTN may improve. Nationalized health insurance is
still out of reach in various regions of Africa. The
majority of Africans pay for their own medical expenses,
which are somewhat supplemented by a few free
services provided by the government and donor
organisations. These organisations primarily target the
treatment of infectious diseases, with HIV/AIDS control
efforts receiving the largest chunk of this financing (Bala
& Kang'ethe, 2021; Bloom et al., 2022). This necessitates
the development of more creative methods for funding
chronic non-communicable illness care throughout the
continent.

The research taken into account for this evaluation
showed generally poor control rates of HTN. The South-
West has the lowest control levels. Even in states with
high treatment rates, BP control was difficult to achieve.
The definitive determinant of outcomes, control, cannot
be assured by HTN therapy. Numerous research from
diverse locations that were included blamed various
variables for the ineffective BP management. These may
typically be categorised as flaws in the healthcare
system,

patient

noncompliance,

and

doctors'

indifference to treating HTN. Examples of typical health
system flaws impeding the attainment of control include
the absence of anti-hypertensive medicines at medical
facilities and the great distance to the facilities as
documented in several research. On the other hand,
stated competing priorities and a lack of time are
common patient and physician variables that
exacerbate the issue.

Directions for Future Research

Discussions of the developments in awareness, therapy,
and management of HTN were confounded by the cross-
sectional character of the research included in this
review. To investigate the patterns of HTN status,
monitoring or follow-up cohorts must be conducted.

Future research must examine the variables that lead to
the high frequency of HTN in Nigeria. Studies should
provide internationally comparable prevalence rates to
enable comparisons across age groups, sexes, regions,
and time periods worldwide. Such study is necessary for
creating and devising affordable awareness and

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International Journal of Medical Science and Public Health Research

preventive programmes that would assist people in
getting over these obstacles.

Studies should also expand on the advantages of
earlier research, such as the utilization of nationally
representative

and

high

sample

sizes.

The

environmental variables that may influence the
development of predictors of CVDs might be
effectively characterised by longitudinal studies of
immigrants from Nigeria beginning at the time of
relocation to industrialised countries.

Considering that there is presently a dearth of study in
these areas, it is equally important to investigate HTN
knowledge, diagnosis, and management as well as CVD
risk factors.

Strengths and Limitations

The heterogeneity of the studies included in this
review made further analysis challenging. Variations in
population

characteristics,

BP

measurement

procedures, and overall research designs are reflected
in the variability between studies.

This review was challenging due to the scarcity of high-
quality, sizable, and comparable research. Although
the data show that perhaps the prevalence estimates
of HTN and overweight/obesity are high, it was not
able to establish a direct connection between temporal
trends and rising HTN and overweight/obesity
prevalence.

The

analysis,

interpretation

and

comparability of the data were restricted by the lack of
estimates that were sex- and age-specific.

The majority of research studies neglected to examine
the reasons that related to the nation's present HTN
situation, necessitating a thorough investigation of
these issues in order to guide treatments and policy.
Non-random participant selection in several of the
research was another flaw (Ulasi et al., 2011; Ugwaja
et al., 2015).

Only 10 of the 48 studies that were examined in this
review were carried out in the Northern areas, and
information on prevalence by age, sex, and geographic
location was not consistently supplied. Although the
reason for this is unclear, it has been noted in previous
literature (Adeloye et al., 2016; Adeloye et al., 2017;
Adeloye et al., 2021) and may be an indication of the
region's general potential for research.

The study's positives, such as the substantial number
of papers it found, its robust methods, and its supply
of thorough measures of awareness, management,
and control of HTN in Nigeria, more than offset these
drawbacks to a great extent.

CONCLUSION

To lessen the consequences of hypertension (HTN) in
Nigeria, effective and comprehensive national
population prevention initiatives are required.
Occupational health programs should aim to raise
workers' knowledge of health issues generally,
encourage healthy behavior, test for risk factors, and
implement integrated non-communicable disease
(NCD) control. It is important to promote interventions
to lower blood pressure in low-income nations, such as
health education, exercise breaks at work, staff training,
and the establishment of regulations. Health promotion
interventions have improved food habits, physical
activity, and weight reduction (Spring et al., 2021). The
nation's several states should create or update their
coordinated NCD policies and strategies, carry out WHO
STEPS risk factor surveys, and improve primary care for
NCD patients. As a basic preventive measure, there is a
need to boost health promotion in the populace.
Additionally, more public health education is required to
raise hypertension awareness and its consequences.
Communities around the nation need to implement
programs to manage hypertension, and there has to be
an increase in the number of population-based
detection methods for NCDs and cardiovascular disease
(CVD) risk factors. The adoption of healthy lifestyles,
such as weight management, exercise, a sodium-
reduced diet, and moderate alcohol use, should be
emphasized in primary preventive programs as an
efficient way for HTN prevention and control. In order
to reduce HTN affliction and death in young adults,
beginning HTN screening should be implemented
nationwide. The best way to stop an outbreak of HTN is
to increase knowledge, control, and treatment of the
condition while also promoting healthy lifestyle
adoption and maintenance among Nigerians. To follow
developments and shifts in HTN status and to build
national policies to limit HTN outbreaks, Nigeria should
also conduct frequent national health surveys that
include accurate assessment of HTN status.

Nigeria's successful initiatives and programs will
encourage and direct other African nations to
implement these HTN screening and awareness-raising
preventive programs. Research is also required to
determine the causes of regional variations in the HTN
prevalence as well as the reasons why some regions of
the nation lack urban-rural inequalities. Another issue
that has to be addressed is the absence of empirical
information to evaluate national trends. HTN is
becoming more of a problem in Nigeria. The lack of
therapy and awareness is confirmed by this systematic
study. Most importantly, the degree of control is
appalling, indicating that diagnosis and therapy do not
ensure achieving control goals. This circumstance
explains why HTN patients in the nation have poor

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International Journal of Medical Science and Public Health Research

results. Patient variables are significant control factors,
even if health system considerations play a significant
role in maintaining this scenario. To enhance patient
outcomes with HTN, research and policy must be
specifically adapted to the gender and geographic
distribution of these characteristics. On a continent
where the focus has up to now been on the
management of severe infections, it is also necessary
to establish customized chronic care models.

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

FUNDING

This research did not receive any grant from funding
agencies in the public, commercial, or not-for-profit
sectors.

ACKNOWLEDGEMENT

The authors would like to acknowledge the
management and technical staff of PENKUP Research
Institute, Birmingham, United Kingdom for their
excellent assistance and for providing medical
writing/editorial support in accordance with Good
Publication Practice (GPP3) guidelines.

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APPENDIX

Appendix 1: Study Characteristics

S/

N

Author

Study

Year

Location

Geopolitica

l Zone

Study Design

Sample

Size

Study

Setting

1.

Adebayo et al. 2013 Ipetumodu,

Edunabon, and
Moro
Communities
in Ife North,
Osun State

South-West Community-

based

cross-

sectional study

1,000

Rural

2.

Adedoyin et al. 2008 Ile-Ife, Osun

State

South-West Community-

based

cross-

sectional study

2,097

Semi-
urban

3.

Adedoyin et al. 2012 Maiduguri,

Borno State

North-East Population-

based,

cross-

sectional study

1,004

Semi-
urban

4.

Adika et al.

2011

Wilberforce
Island, Bayelsa
State

South-
South

Descriptive
cross-sectional
study

100

Urban

5.

Agaba et al.

2014 Jos,

Plateau

State

North-
Central

Descriptive
cross-sectional
study

883

Urban

6.

Akinbodewa et
al.

2014 Akure

&

Ondo,

Ondo

State, Nigeria

South-West Descriptive

cross-sectional
study

1,183

Mixed

7.

Akpa et al.

2008 Port Harcourt,

Rivers State

South-
South

Descriptive
cross-sectional
study

207

Urban

8.

Akpan et al.

2015 Akwa

Ibom

State

South-
South

Population-
based

cross-

sectional study

1,568

Urban

9.

Amira et al.

2010 Lagos State

South-West Descriptive

cross-sectional
study

1,368

Urban

10. Amole et al.

2008 Ogbomoso,

Oyo State

South-West Descriptive

cross-sectional
study

400

Mixed

11. Andy et al.

2012 Cross River &

Akwa

Ibom

States

South-
South

Population-
based

cross-

sectional study

3,869

Rural

12. Asekun-

Olarinmoye et
al.

2013 Alajue

and

Ibokun, Osun
State

South-West Community-

based,
descriptive
cross-sectional
study

259

Rural

13. Awosan et al.

2013 Sokoto,

Sokoto State

North-West Descriptive,

cross-sectional
study

390

Semi-
urban

International Journal of Medical Science and Public Health Research

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International Journal of Medical Science and Public Health Research

14. Bello-Ovosi et

al.

2017 Kawo, Kaduna

State

North-West Population-

based

cross-

sectional study

181

Urban

15. Chukwuonye et

al.

2013 Abia State

South-East Population-

based

cross-

sectional study

2,983

Mixed

16. Egbi et al.

2013 Yenegoa,

Bayelsa State

South-
South

Population-
based

cross-

sectional study

231

Rural

17. Ejim et al.

2006 Enugu, Enugu

State

South-East Population-

based

cross-

sectional study

858

Rural

18. Ekanem et al.

2012 Abak, Akwa

Ibom State

South-
South

Descriptive
cross-sectional
study

442

Semi-
urban

19. Ekpe & Elemi 2016 Adim, Cross

River

South-
South

Population-
based

cross-

sectional study

824

Rural

20. Ekwunife et al. 2009 Nsukka,

Enugu State

South-East Population-

based

cross-

sectional study

756

Mixed

21. Emerole et al.

2007 Owerri,

Imo

State

South-East Descriptive

cross-sectional
study

241

Urban

22. Erhun et al.

2003 Ile-Ife, Osun

State

South-West Descriptive

cross-sectional
study

1,000

Semi-
urban

23. Ezejimofor et

al.

2014 Rivers State

South-
South

Community-
based

cross-

sectional study

2,028

Rural

24. Funke et al.

2013 Jos,

Plateau

State

North-
Central

Descriptive
cross-sectional
study

340

Urban

25. Hendriks et al. 2012 Ilorin, Kwara

State

North-
Central

Population-
based

cross-

sectional study

2,678

Rural

26. Ibekwe et al.

2015 Oghara, Delta

State

South-
South

Descriptive
cross-sectional
study

272

Rural

27. Idris et al.

2020 Lagos, Lagos

State

South-West Community-

based

cross-

sectional study

215

Mixed

28. Ige et al.

2013 Ibadan,

Oyo

State

South-West Descriptive

cross-sectional
study

525

Urban

29. Mbah et al.

2012 Nsukka,

Enugu State

South-East Population-

based

cross-

sectional study

200

Semi-
urban

30. Murthy et al.

2013 Nationwide

Multi-
Zonal

Population-
based

cross-

sectional study

13,504

Mixed

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31. Odili et al.

2008 Benin,

Edo

State

South-
South

Retrospective
study

501

Urban

32. Ofuya

2007 Port Harcourt,

Rivers

South-
South

Population-
based

cross-

sectional study

200

Rural

33. Ogah et al.

2012 Umuahia, Abia

State

South-East Population-

based

cross-

sectional study

2,983

Mixed

34. Oghagbon et al. 2007 Ilorin, Kwara

State

North-
Central

Population-
based

cross-

sectional study

281

Urban

35. Oguoma et al.

2015 Kwale, Delta

State

South-
South

Population-
based

cross-

sectional study

417

Mixed

36. Okafor et al.

2014 Enugu, Enugu

State

South-East Population-

based

cross-

sectional study

775

Urban

37. Oladapo et al.

2005 Egbede, Oyo

State

South-West Descriptive

cross-sectional
study

2,000

Rural

38. Olisa

&

Oyelola

2009 Maiduguri

North-East Descriptive

cross-sectional
study

500

Semi-
urban

39. Omorogiuwa et

al.

2008 Ekpoma, Edo

State

South-
South

Descriptive
cross-sectional
study

1,200

Urban

40. Omuemu et al. 2004 Edo State

South-
South

Community-
based

cross-

sectional study

590

Rural

41. Ordinioha

2013 Port Harcourt,

Rivers State

South-
South

Descriptive
cross-sectional
study

75

Urban

42. Ordinioha

&

Brisibe

2013 Omoku, Rivers

State

South-
South

Descriptive
cross-sectional
study

106

Mixed

43. Oyeyemi

&

Adeyemi

2013 Maiduguri,

Borno State

North-East Population-

based

cross-

sectional study

292

Semi-
urban

44. Ugwuja et al.

2015 Igbeagu,

Ebonyi State

South-East Population-

based

cross-

sectional study

267

Rural

45. Ulasi et al.

2010 Enugu, Enugu

State

South-East Population-

based

cross-

sectional study

1,458

Mixed

46. Ulasi et al.

2011

Enugu, Enugu
State

South-East Population-

based

cross-

sectional study

688

Mixed

47. Wahab et al.

2006 Katsina,

Katsina State

North-West Population-

based

cross-

sectional study

300

Urban

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48. Wokoma et al.

2011

Barako, Rivers
State

South-
South

Descriptive
cross-sectional
study

152

Rural

Appendix 2: Data Extraction Table

S

/

N

Author

Study

Year

Study

Objective

Sampling

Strategy

Outcomes

Findings

Comments

1
.

Adebay
o et al.

2013

To
ascertain
the
frequency
of HTN in
individuals
living

in

the South-
West
Nigerian
villages of
Ipetumodu
,
Edunabon,
and Moro.

Using

a

multistage
proportionate
stratified
random sample
approach over a
6-month period,
1000

persons

between

the

ages of 15 and
90

were

recruited.

Prevalence
of HTN

Based on the 140/90
mmHg criteria, the
prevalence of HTN
was 26.4% (Male:
27.3%;

Female:

25.4%). Based on
the 160/95 mmHg
criteria,

the

prevalence of HTN
was 11.8% (Male:
13.5%;

Female:

10.1%).
Significantly
favourable
relationships were
found

between

certain
anthropometric
obesity markers and
blood pressure.

In

all

three

communities, there
was found evidence
of an upward trend
in the prevalence of
HTN. Additionally,
in this cohort, there
was a strong positive
connection between
anthropometric
obesity markers and
BP.

2
.

Adedoyi
n et al.

2008

To find out
how
common
and
prevalent
HTN

is

among the
adult
population
in

the

historic
semi-urban
area of Ile-
Ife, South-
West
Nigeria.

Through

a

multistage
cluster sample
approach, 2097
people over the
age of 20 were
enlisted in the
door-to-door
survey.

Prevalence
of HTN

Using the cut-off
threshold of BP
higher than or equal
to 140/90 mmHg,
22.1% had isolated
systolic HTN and
14.5% had isolated
diastolic HTN. For
blood

pressure

levels more than or
equal to 140/90
mmHg and 160/95
mmHg,
respectively,

a

male-to-female
ratio of 1.7:1 and
1:5 was seen. As
people aged, the
frequency of HTN

The estimates of the
prevalence of HTN
revealed in this
study were greater
than

those

discovered in the
majority of other
investigations
conducted

in

Nigeria,

other

countries in West
Africa, and among
African Americans.

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rose from young to
elderly individuals.

3
.

Adedoyi
n et al.

2012

To find out
how
common
HTN and
obesity are
as
preventabl
e
cardiovasc
ular

risk

factors in a
low-
income
semi-urban
area

of

Northeast
Nigeria.

A

multi-stage

cluster sampling
strategy

was

used to draw in
1004

persons

aged 20 and
older.

Prevalence,
Awareness,
Treatment
and Control
of HTN

40.3, 25.2, 15.4, and
3.8% of people had
pre-HTN,

HTN,

were overweight, or
were obese. The
odds ratios for HTN
were 2.75 (1.25-
6.04)

and

1.62

(0.068-3.82),
respectively, with a
95%

confidence

interval for obese
individuals
compared to normal
weight

and

overweight patients.

The most common
cardiovascular risk
factors

in

the

research population
were PreHTN and
HTN in that order.
Participants

who

were obese had a
relative risk for HTN
that was around
three times higher
than those who were
normal weight and
roughly two times
higher than those
who

were

overweight.

4
.

Adika et
al.

2011

To
measure
non-
academic
staff
members'
understand
ing

of

HTN in a
university
setting in
Nigeria's
Bayelsa
State.

For the study,
100 participants
were recruited.
With a mean age
of 38.4, there
were

53%

females

and

47% men.

Awareness
of

HTN

aetiology,
risk factors
and
prevention

The majority of
employees (73%)
believed excessive
thinking, worry, or
stress to be the
cause

of

heart

disease,

whereas

27% were unable to
understand this fact.
59% of them were
able to identify the
possibility of a
genetic basis for
HTN. Despite the
fact

that

the

majority

of

respondents (72%)
were

able

to

recognise that a
high-salt diet is a
risk factor for HTN,
high-fat

diet,

smoking,

and

alcohol use were
each found to be
responsible by 80,
45, and 43% of
respondents,
respectively,
demonstrating

Employees

who

were not academics
have

inadequate

HTN expertise. The
solution to effective
control

and

treatment of the
health and financial
burden of HTN
remains
strengthening

the

div of information
on the condition.

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insufficient
understanding

of

risk

factors.

A

further 30% were
unaware that HTN
cannot be cured
once in a lifetime,
and 65% did not
realise that HTN
maintenance is for
life. About 80% and
75%

of

the

participants shown
sufficient
knowledge

on

regular drug intake,
BP monitoring, and
measurement,
however 80% did
not understand the
need of weight loss
techniques

for

treating HTN.

5
.

Agaba et
al.

2014

To assess
the

risk

factors for
NCDs and
the
prevalence
of

those

conditions
among
students at
a
university
in

Jos,

Nigeria.

All university
staff

received

invitations to the
University
Health

Clinic

for screenings
using

the

STEPwise
approach

to

NCDs
recommended
by the World
Health
Organization.
Ultimately, 883
people

were

hired.

Awareness
of

risk

factors

of

NCDs.

The most frequent
NCD risk factors
included
dyslipidemia,
inactivity, and poor
fruit and vegetable
intake.

Others

included smoking
cigarettes, drinking
alcohol, and being
obese. The most
prevalent NCD was
HTN, which was
followed

by

diabetes

mellitus

and chronic renal
disease.

The

prevalence of NCDs
showed no gender-
specific differences.

The study found that
NCDs and the risk
factors for them are
quite common in this
group.

Workplace

policies are required
to encourage the
healthier lifestyles
lifestyles.

6
.

Akinbod
ewa et
al.

2014

To
quantify
classic
CKD risk
variables,
pre-HTN

There

were

1,183 adults in
total

(M:F,

0.63:1) in the
study.

Their

biographical

Prevalence,
treatment
and control
of pre-HTN
and HTN.

Pre-HTN

was

prevalent in 32.3%
of the participants,
whereas HTN was
found in 43.4% of
them; 6.2% of the

The population of
Ondo State, Nigeria,
has

a

high

prevalence of pre-
HTN

and

established

CKD

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risk
factors,
and
proteinuria
correlation
s.

information,
past

use

of

cigarette
smoking,
alcohol, herbal
remedies,
NSAID

use,

diabetes,

and

HTN

were

gathered.

patients

reported

having ever had
diabetes; 4.5% had
smoked; 68.3% had
used herbs; and
44.1% had used
NSAIDs.
Haematuria

was

detected in 1.7% of
the

individuals,

whereas 25.9% of
the subjects had
proteinuria. Age and
blood

pressure

significantly
correlated

with

proteinuria.

risk factors. Pre-
HTN

sufferers

should regularly be
tested for CKD and
appropriate referral
done

to

a

nephrologist

for

early treatments.

7
.

Akpa et
al.

2008

To assess
the level of
blood
pressure
manageme
nt among
HTN
patients
being
treated at
the
University
of

Port

Harcourt
teaching
hospital's
specialised
medical
outpatient
clinic
(MOPD).

Patients

who

were

being

treated for HTN
alone

or

with other
conditions at the
UPTH
cardiology
clinic served as
the

study's

participants.
Over the course
of the trial,
consecutive
patients

who

provided
informed
permission were
enlisted as study
participants.

HTN control All

research

participants had an
average

systolic

blood pressure of
14919.33mmHg
and an average
diastolic

blood

pressure

of

93.4813mmHg. 50
individuals in total
(24.2%)

had

managed

blood

pressure that was
less

than

140/90mmHg.

Low numbers of
hypertensive
individuals

were

able to maintain
appropriate

blood

pressure levels. To
maximise

the

benefits

of

antihypertensive
medication, it is
necessary to identify
and address the
obstacles to optimal
blood

pressure

management.

8
.

Akpan et
al.

2015

To
ascertain
the
frequency
of HTN as
well as its
correlates
in

Akwa

Ibom
State,
Nigeria's
rural and

The state's three
senatorial
districts

were

divided into two
urban and two
rural areas at
random.

Prevalence,
Awareness,
Treatment
and Control
of HTN

The mean arterial
BP, systolic blood
pressure,

and

diastolic

blood

pressure were all
greater in rural
people than in urban
people. In contrast
to urban areas, rural
areas had a much
greater frequency of
HTN.

HTN

In Nigeria's rural
villages,

the

frequency of HTN
has

changed

epidemiologically.
These epidemiologic
trends show that the
previously observed
difference in the
frequency of HTN
between urban and
rural

groups

is

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urban
areas.

incidence

was

independently
predicted by age,
BMI,

and

proteinuria.

steadily
disappearing,
necessitating

the

urgent
implementation of
preventative efforts.

9
.

Amira et
al.

2010

In an urban
area

of

Lagos,
Nigeria,
obesity
prevalence
will

be

assessed,
along with
its
association
to HTN.

Every

World

Kidney

Day

from 2006 to
2010, Ikeja, the
administrative
centre of Lagos
state in South-
West

Nigeria,

performed

a

population-
based screening
for CKD risk
factors.

All

volunteers who
were older than
18 years old
were enlisted.

Prevalence,
Awareness,
Treatment
and Control
of HTN

Obesity

and

overweight

were

prevalent in 32.7%
and

22.2%

of

people,
respectively.

The

prevalence

of

obesity was highest
in the age period of
45 to 54 years, and it
was

greater

in

women than in men,
with a rate of 29.5%
in women vs 15.7%
in males. HTN was
prevalent in 33.3%
of the population,
with rates greatest
in people over 65
(58%). The risk of
getting HTN was
2.59 times higher in
obese participants.
39

participants

(3.6%) experienced
proteinuria,

with

4.9%

of

obese

people and 2.4% of
non-obese people
experiencing it.

According to this
study, obesity and
HTN

are

very

common in Lagos.
An important
independent
HTN risk factor is
obesity. As a result,
coordinated efforts
should

be

undertaken to stop
this unhealthy trend
by

encouraging

health education that
places a focus on the
related risk factors
for obesity, such as
eating patterns and
weight increase.

1
0
.

Amole
et al.

2008

To
ascertain
the HTN
and obesity
prevalence
among
people
presenting
to

the

Baptist
Medical
Centre in
Ogbomoso

400 adults who
were at least 18
years old were
sought

out.

Participants
filled

out

a

standardised
questionnaire as
well

as

measures

of

their

blood

pressure

and

weight.

Prevalence
of HTN and
obesity

The prevalence of
obesity

overall,

according to WC,
was 33.8% (men:
8.9%;

women:

53.8%).

Women

spend a lot more
time sitting down
compared to men
(62.4% vs. 50.8%, p
0.05).

In

the

majority

of

instances (85.2%, p

In this scenario, it
was discovered that
women

had

a

disproportionately
high prevalence of
abdominal obesity,
which was linked to
HTN,

sedentary

lifestyles,

and

calorie-dense diets.

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, Nigeria,
as
measured
by

waist

circumfere
nce (WC),
and

to

further
ascertain if
there was
any
relationshi
p between
abdominal
obesity and
HTN.

> 0.05), families of
obese

people

preferred

high-

energy meals. HTN
was

present

in

50.5% of the study
population overall,
with no appreciable
difference between
males and females
(52.0% for men vs.
49.3% for women, p
> 0.05). However,
HTN

prevalence

was 60.0% in the
subgroup of obese
persons.

1
1
.

Andy et
al.

2012

To
evaluate
the impact
of HTN on
public
health in
rural areas
of
Nigeria's
Niger
Delta.

The community
of Okoyong in
the

Odukpani

Local
Government
Area

was

chosen as the
site for the study
of rural Efiks in
Southern Cross
River

State.

Select

fishing

communities in
the

Eastern

Obolo

Local

Government
Area in the
Akwa

Ibom

State region of
the

country

called Obolos
were
researched. At a
few settlements
in the mostly
agricultural
community of
Obot Akara, the
rural
Annangs/Ibibio
s of Akwa Ibom
State

were

researched.

Prevalence
of HTN

The prevalence of
obesity

overall,

according to WC,
was 33.8% (men:
8.9%;

women:

53.8%).

Women

spend a lot more
time sitting down
compared to men
(62.4% vs. 50.8%, p
0.05).

In

the

majority

of

instances (85.2%, p
> 0.05), families of
obese

people

preferred

high-

energy meals. HTN
was

present

in

50.5% of the study
population overall,
with no appreciable
difference between
males and females
(52.0% for men vs.
49.3% for women, p
> 0.05). However,
HTN

prevalence

was 60.0% in the
subgroup of obese
persons.

2.8% of people have
heard

of

HTN

before. 914 people,

Even though obesity
and smoking are
extremely rare in
these two states
(Cross River and
Akwa Ibom), HTN
is

already

a

significant

public

health burden in
rural areas.

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or 23.6% of the
population,

had

HTN; 31.2% of men
and

18.1%

of

women. HTN was
more

common

among 479 (25.5%)
Ibibio/Annangs,
287 (25.6%) Efiks,
and 130 (14.9%)
Obolos than in the
other ethnic groups.
17.2%

of

the

population as a
whole, 17.5% of
men, and 16.9% of
women,

had

preHTN (P=.66).

1
2
.

Asekun-
Olarinm
oye et al.

2013

To find out
how
common
HTN is in
two rural
villages in
Nigeria's
Osun
State.

This population-
based

cross-

sectional
descriptive
study included a
consenting adult
population from
the Alajue and
Obokun

rural

areas

in

southwest
Nigeria who had
shown up for the
screening
procedure.

Prevalence
of HTN

HTN was prevalent
(13.16%). While 11
(4.2%) only had
isolated

diastolic

HTN,

seventeen

(6.6%) only had
isolated

systolic

HTN. 48 (18.5%)
had

ever

used

antihypertensive
medications on a
regular basis, while
236

(91.1%)

engaged in daily
exercise lasting at
least 30 minutes. A
family history of
HTN was reported
by four individuals
(1.6%).

The

respondents'
average div mass
index (BMI) was
23.4 4.9 kg/m2, and
51 (19.6%) had a
BMI between 25
and

29.9;

30

(11.5%) had a BMI
under 30.

In

the

study

population,

HTN

was quite prevalent.
It is strongly advised
to step up primary
preventive measures
to

stop

this

development

in

Nigerian
communities.

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1
3
.

Awosan
et al.

2013

To
evaluate
the eating
habits, way
of

life,

nutritional
condition,
and
prevalence
of

HTN

among
Sokoto's
businesspe
ople.

From November
to

December

2012,

390

dealers chosen
by a multistage
sample process
participated in a
cross-sectional
descriptive
survey.
Participants had
anthropometric
and

blood

pressure
measures,

as

well

as

questionnaire
distribution.

Prevalence
and Control
of HTN

The participants had
a prevalence rate of
unhealthy

dietary

habits: 50.7% ate
their largest meal at
dinner,

49.9%

snacked frequently,
66.7%

consumed

fatty foods, 27.1%
and 33.0% drank
fruit

juice

and

carbonated
beverages at least
three times per
week, and 56.0 and
58.8%

consumed

less

than

three

servings of fruits
and vegetables per
week or none at all.
Additionally, 50.7%
have a sedentary
lifestyle,

5.2%

smoke

cigarettes

now, and 10.8%
drank

alcohol

during the last 30
days. Similar to this,
there

was

a

significant
prevalence of HTN
(29.1%),

obesity

(28.1%),

and

overweight (28.9%)
among the subjects.

According to this
study, there is a
significant
prevalence of bad
eating and lifestyle
choices

among

Sokoto traders, as
well as a high
incidence

of

overweight, obesity,
and

HTN.

The

promotion of good
eating habits and
lifestyle, particularly
among high risk
populations,

is

encouraged through
health education and
other interventions.

1
4
.

Bello-
Ovosi et
al.

2017

To
evaluate
the
prevalence
and
correlation
s of HTN
and
diabetes
mellitus
(DM) in a
city

in

North-
West
Nigeria.

Interviews and
HTN and DM
screenings were
conducted with
adults

who

participated in a
medical
outreach
programme and
were 18 years of
age or older.
Blood pressure,
blood sugar, and
anthropometry
were assessed
using

Prevalence
of HTN and
DM

HTN

and

DM

prevalence

rates

were 55.9% and
23.3%, respectively.
Age over 40 and
being a woman
were related to risk
factors for HTN and
DM, respectively (p
0.05).

Systolic

hypertension

and

age (r = 0.18, p =
0.02),

diastolic

hypertension

and

div mass index (r
= 0.16, p = 0.03),

Due to the high
incidence of HTN
and DM in the study
group, population-
based public health
initiatives aiming at
lowering their risk
factors must be
developed

and

implemented.

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standardised
equipment and
procedures.

blood glucose and
waist circumference
(r = 0.19, p = 0.02)
all showed modest
correlations.

1
5
.

Chukwu
onye et
al.

2013

To look at
the
incidence
of
abdominal
obesity in
Nigeria's
Abia State.

Communities in
the state's three
senatorial zones
were used to
find

research

participants.
The

Stepwise

Approach

to

Surveillance of
Chronic Disease
Risk

Factors

developed

by

the

World

Health
Organization
was

applied.

Additionally,
pertinent
information
such

as

the

anthropometric
measures

and

div mass index
were gathered.

Prevalence
of HTN

Body mass index
data showed that
11.12% of people in
the population were
obese. It was 7.73%
for

males

and

14.37% for women,
respectively. In the
general population,
abdominal obesity
was

prevalent

(21.75%). It was
3.2% for males and
39.2% for women,
respectively.

Nigeria has a high
rate of abdominal
obesity, which has to
be watched since it
raises the risk of
cardiovascular
disease.

1
6
.

Egbi et
al.

2013

To
ascertain
HTN
prevalence
and contri
buting
elements in
the
Ogboloma
communit
y

in

Nigeria's
Bayelsa
State.

All

qualified

respondents wer
e

randomly

selected

from

the group. BP,
anthropometry,
clinical history,
and
sociodemograp
hic information
were recorded.

Prevalence
of HTN, risk
factors for
HTN

HTN was present in
50.4% of cases,
while pre-HTN was
observed in another
41.2%. Age, BMI,
waist-hip

ratio,

hyperglycemia, and
smoking

were

factors connected to
HTN in a univariate
study.

On

multivariate
analysis,

only

smoking and age
remained
significant.

In this remote area,
HTN and Pre-HTN
were very common.
HTN

was

significantly
predicted

by

smoking and age.
Therefore,

rural

areas and smokers
should be the focus
of HTN screenings
and

treatment

programmes.

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1
7
.

Ejim et
al.

2006

To
determine
the
prevalence
of the main
cardiovasc
ular-
related risk
factors in
middle-
aged and
elderly
people in a
rural
communit
y

in

Nigeria
who

are

both male
and female
and
between
the ages of
40 and 70.

Eight hundred
families in total
were chosen at
random, and all
of the adults in
these
households
between

the

ages of 40 and
70 were chosen
for the study.
858 people in
total
volunteered to
participate and
showed up at the
health centres
for the research.
70.4%

of

respondents
responded.

Prevalence
of

major

cardiovascul
ar

risk

factors.

The prevalence of
the

various

cardiovascular risk
factors

was

as

follows among the
858 subjects: HTN
was present in 398
(46.4%),

general

obesity as measured
by BMI was present
in

257

(30%),

abdominal obesity
was present in 266
(31%)

and

dysglycemia

was

present in 38 (4.4%)
and
hypercholesterolem
ia was present in 32
(3.7%). While the
other

conditions

were more common
in women, HTN and
dysglycemia were
more common in
males. Only HTN (p
=

0.17)

and

hypercholesterolem
ia (p = 0.13) did not
show a gender-
related correlation
that was statistically
significant. The age
group

of

participants with the
highest

CVD

prevalence and risk
factors was 65 to 70.

Rural communities
are

seeing

an

increase

in

the

prevalence of CVD
risk factors. HTN
and obesity are more
prevalent in the rural
population than the
other cardiovascular
risk factors that are
frequently
evaluated.

Larger

community health
awareness initiatives
are necessary given
the effects of these
adverse

outcomes

and the general lack
of awareness of
them.

1
8
.

Ekanem
et al.

2012

To
ascertain
high
BP prevale
nce in

a

Nigerian
semi-urban
neighbour
hood.

An

extensive

questionnaire
that

included

anthropometric
measures was
used to gather
the data.

Prevalence
of HTN

As a consequence of
the study, 47.0% of
the population had
elevated

blood

pressure
(>140/90mmHg).
Age, sex, greater
income,

more

family

members

living in the home,
everyday smoking
habits,

regular

alcohol use, and

The necessity for
intervention

and

preventative
measures to stop the
impending
pandemic of HTN in
this

particular

neighborhood and
Nigeria in general
cannot be overstated
because elevated BP
is highly prevalent in

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BMI all revealed an
elevated risk for
high blood pressure
on a univariate
level.

However,

participants

who

slept

for

at

minimum

eight

hours

per

day

demonstrated

a

protective

effect

against elevated BP.

this

semi-urban

neighbourhood.

1
9
.

Ekpe &
Elemi

2016

To
ascertain
the
frequency
of HTN in
the remote
communit
y of Adim
in

the

Nigerian
state

of

Cross
River.

Respondents
were chosen at
random from a
group of 20 to
65-year-olds.

Prevalence
of HTN

Only

5

(3.1%)

individuals

knew

they

had

hypertension. There
were

19.9%

of

people with HTN.

HTN

was

very

common in this
neighbourhood.
Since

many

Nigerians reside in
rural areas and HTN
is

a

major

cardiovascular risk
factor,

decisive

action must be made
to

battle

this

pandemic.

2
0
.

Ekwunif
e et al.

2009

To
evaluate
the
prevalence
of

HTN

and

its

identificati
on,
treatment,
and
manageme
nt in the
city

of

Nsukka in
South-East
Nigeria.

South-East

Prevalence,
Awareness,
Treatment
and Control
of HTN

HTN

prevalence

was 21.1%. Men
were more likely
than women to have
high blood pressure.
Both in males and in
women, systolic and
diastolic

blood

pressure increased
with

age.

In

individuals

with

elevated

blood

pressure, high blood
pressure

was

discovered in 40.3%
of men and 24.7%
of

women,

respectively. Only
5.0%

of

hypertensive males
and

17.5%

of

hypertensive female
s had their blood
pressure

under

The

findings

indicated ineffective
HTN identification,
management,

and

control.

This

emphasises

the

requirement for a
thorough analysis of
HTN as well as other
cardiac

diseases'

prevalence

in

Nigeria.

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control, compared
to 23.7% and 17.5%
of those with high
blood

pressure,

respectively. HTN
prevalence

in

Nigeria and Africa
was comparable to
other research.

2
1
.

Emerole
et al.

2007

To
calculate
the

staff

members'
heart risk
scores at
the Federal
University
of
Technolog
y

in

Owerri,
Imo State,
Nigeria.

At the Federal
University

of

Technology,
Owerri (FUTO),
Imo

State,

Nigeria, a total
of 100 senior
and 141 junior
staff members
were chosen at
random.

Age,

heredity, BMI,
smoking,
exercise,
calculation

of

serum
cholesterol,
systolic blood
pressure,

and

sex were all
recorded using a
questionnaire.

Prevalence
of
cardiovascul
ar

risk

factors

In terms of gender
composition, family
history of CVD,
tobacco
consumption,

or

serum cholesterol,
there

were

no

appreciable
differences between
both the older and
younger employees.
The age distribution
values among senior
personnel

were

much greater.

It is highly advised
to implement health
education
campaigns aimed at
improving lifestyle.

2
2
.

Erhun et
al.

2003

To
ascertain
the
frequency
of HTN in
an Ile-Ife,
Osun
State,
university
communit
y.

Adults over the
age of 21 who
were employed
by the university
at the time of the
study

as

academic

or

non-academic
employees
made up the
study
population. Out
of 5000 people
chosen from all
of

the

university's
faculties

and

service

Prevalence
of HTN

The

respondent

population's overall
crude

prevalence

was 21%. 16% of
them were already
taking medication
for their condition.
The study found no
conclusive evidence
of a link between
coffee intake and
HTN (p>0.05). In
individuals

with

more than three
children,

the

prevalence

was

32%; in subjects
with eye problems,

The population has
to be made more
aware

of

the

condition and some
other
cardiovascular-
related risk factors,
and

self-

measurement

BP

equipment should be
made available or
encouraged to be
owned.

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divisions, 1000
respondents'
agreement was
acquired after
being informed
of the study's
goal.

A

standardised
questionnaire
was utilised to
conduct

an

interview with
them,

gather

basic
demographic
and
socioeconomic
information,
and determine
any history of
HTN.

diabetics,

and

subjects

who

consumed local kola
nuts, it was 18.6%,
1.9%, and 7.4%,
respectively.

2
3
.

Ezejimo
for et al.

2014

To
calculate
the burden
of HTN in
a region of
Nigeria
called the
Niger
Delta that
is heavily
contaminat
ed with gas
and oil.

2,028

locals

(aged 18 to 80)
were enlisted.
Anthropometric
measurements,
lifestyle

and

sociodemograp
hic

variables,

cardiovascular
comorbidities,
and

the

prevalence and
risk of HTN
were
investigated and
compared
between the two
groups.

Prevalence
of HTN

37.4%

of

the

subjects had high
blood pressure. 51
percent

of

participants came
from places with oil
pollution. Only 15%
of

individuals

mentioned having
HTN

in

their

families.
Individuals in the
adjusted model who
lived in oil-polluted
regions had a nearly
5-fold higher risk of
developing

HTN

than

participants

who lived in areas
without pollution.

An elevated risk of
HTN may be linked
to

exposure

to

oil/gas

pollution.

The results require
more investigation
in

longterm

investigations.

2
4
.

Funke et
al.

2013

To

look

into staff
members'
attitudes
and
behaviours
about BP
monitoring

The hospital's
344 staff were
chosen using the
stratified
sampling
approach.

A

systematic
questionnaire

Awareness,
attitudes,
and
practices
towards
HTN

10.3%

of

respondents

had

never had their
weight examined,
and more than half
of

respondents

seldom

monitor

their blood pressure

A change in health
professionals'
attitudes

about

routine

blood

pressure checks will
aid

in

early

diagnosis, effective

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International Journal of Medical Science and Public Health Research

and weight
control, as
well

as

their
patterns of
blood
pressure
and div
mass index
(BMI).

was used to
collect
information
about
educational
background,
profession,
monitoring of
blood pressure
and weight, and
physical
assessment for
both

blood

pressure

and

div

mass

index.

(apart from when
they are sick). Only
29.5%

of

respondents

had

normal

blood

pressure, whereas
36.6%

of

respondents

had

HTN. Only 21% of
respondents thought
they

were

overweight, despite
the fact that a
sizable

majority

(72%) were either
overweight

or

obese. Comparing
obese and non-
obese

patients,

obese people were
more likely to have
hypertension.
Obesity

was

independently
correlated with both
female sex and
physical inactivity.

care, and problems
avoidance.

2
5
.

Hendrik
s et al.

2012

To
evaluate
HTN
prevalence
and
factors that
influence
BP in four
SSA
population
s,
including
urban
Namibia
and
Tanzania
as well as
rural
Nigeria
and Kenya.

By

randomly

assigning
geographic
regions,
stratified
random samples
were created.

Prevalence
of HTN

19.3%

of

rural

Nigerians, 21.4% of
rural

Kenyans,

23.7% of urban
Tanzanians,

and

38.0% of urban
Namibians had age-
standardized
prevalences

of

HTN. According to
those with HTN,
grade 2 or grade 3
HTN

(180/110

mmHg) made up
between

29.2%

(Namibia)

and

43.3% of all cases
(Nigeria). Between
2.6% in Kenya and
17.8% in Namibia,
HTN

was

controlled.

BMI

was
an independent pre

HTN was the most
often noted CVD
risk factor across
both urban and rural
SSA areas, and it
will continue to add
to the region's rising
CVD

burden.

Alarmingly

poor

levels

of

HTN

control. In order to
stop the growing
CVD pandemic, the
health care systems
in SSA must be
strengthened.

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dictor of BP level in
all research groups,
where

the

prevalence

of

obesity (defined as a
BMI 30) ranged
from

6.1%

in

Nigeria to 17.4% in
Tanzania.

2
6
.

Ibekwe
et al.

2015

In order to
assess

if

there is any
correlation
between
these risk
factors and
socio-
demograph
ic
characteris
tics, it was
necessary
to
quantify H
TN
prevalence
and

its

modifiable
factors in a
remote
neighbour
hood
(Oghara,
Delta
State,
Nigeria).

For the study, a
total of 272
respondents
were

chosen

using

cluster

sampling. Data
were gathered
using

a

questionnaire
that

was

administered by
the interviewer.

Prevalence
of HTN and
modifiable
risk factors

HTN
prevalence was
21.0%, although the
prevalence of HTN
risk factors that may
be

changed,

including as obesity,
smoking,

and

alcohol use, was
15.8%, 43.4%, and
18.8%, respectively.
Both HTN and
alcohol

use

(p

0.001) and HTN and
smoking (p 0.001)
showed

a

statistically
significant
correlation. (p <
0.001).

Smoking

and

socio-

demographic
factors were highly
correlated.

The

study

discovered

a

significant
prevalence

of

modifiable

risk

factors for HTN.
This

emphasises

how important it is
to take preventative
steps and encourage
lifestyle
modifications

in

order to stop the
growing NCD and
HTN outbreak.

2
7
.

Idris et
al.

2020

To
ascertain
NCD
prevalence
and predis
posing
factors
among
inhabitants
of Lagos,
Nigeria's
Ijegun-
Isheri

215 participants
who

were

sequentially
recruited as part
of a population
preventive
health
programme
participated in a
population-
based

cross-

sectional survey.

Prevalence
of

NCDs

and
associated
risk factors

Diabetes was 4.6%
more common than
HTN (35.3%), and
dyslipidemia

was

47.1%

more

common. Smoking
prevalence

was

41.3%,

alcohol

intake was 72.5%,
and

physical

activity was 52.9%
among NCD risk
factors. Age 60

Diabetes,
dyslipidemia,

and

HTN are all very
common, as are the
risk factors that go
along with them.
This underlines the
demand

for

more research and
policy
implementation guid
elines to address the
burden of NCDs in

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Osun
neighbour
hood.

years

and

dyslipidaemia were
the independently
significant
predictors of HTN.
Diabetes

was

independently
predicted by age 60
years.

Smoking,

being

employed,

being

physically

active, and being
older than 60 were
all

independent

predictors

of

dyslipidemia.

Nigeria's
metropolitan
neighbourhoods.
These methods must
be

neighborhood-

specific, addressing
the

major

risk

variables in order of
importance.

2
8
.

Ige et al. 2013

To outline
the
prevalence
of a few
NCDs and
the

risk

behaviours
that

go

along with
them in a
Nigerian
university
communit
y.

In

order

to

choose

the

respondents, a
two-stage
sampling
method

was

used.

Four

departments
were chosen at
random from a
list

of

all

departments in
each of the 15
University
faculties in the
first step, which
entailed

the

basic

random

sample

of

departments. In
the second step,
a

systematic

sample of the
listed
employees from
each

chosen

department was
taken;

ten

employees were
therefore chosen
out of the 60
departments
chosen in stage
one. Structured
self-

Prevalence
of NCDs

While 67.4% of
people reported at
least

one

risk

behaviour
(unhealthy

eating

96%,

sedentary

lifestyle

27.4%,

excessive alcohol
use

5.1%,

and

smoking

1.9%),

27.6%

had

previously received
a diagnosis for at
least

one

NCD

(HTN

21.5%,

diabetes

11%,

cancer 2.9%). No
discernible
difference by sex or
age was seen in the
29.9% of people
who

displayed

several

risky

behaviours.

The

incidence of NCDs
was

considerably

greater in those
above the age of 40,
notably for HTN.
Only 7% of people
thought they were at
risk for NCDs. The
perception of risk
for one or more
NCDs was shared

It has been shown
that there is a large
NCD

burden and

unhealthy practices
despite low self-
perceived

risk,

which necessitates
quick action..

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administered
questionnaires
were used to
gather data.

by those who had
parents with NCDs
and those who had
NCDs themselves,
but not by those
who engaged in
multiple

risk

behaviours.

2
9
.

Mbah et
al.

2012

To identify
the
incidence
and

risk

factors for
HTN
among
middle-
aged
people in
Ahiazu
Mbaise
Local
Governme
nt

Area,

Imo State,
Nigeria.

Males

and

females (40–60
years old) were
chosen

at

random from the
two villages to
serve as the
participants.

Prevalence
and

risk

factors

of

HTN

A larger percentage
of

female

participants
(20.0%) than male
subjects

(12.5%)

were reported to
have HTN (32.5%).
25.0%

of

the

participants

were

either overweight or
obese. Less than
half

of

the

respondents
(30.0%)

reported

drinking

alcohol

frequently,

while

23.0%

reported

eating salty foods
frequently.

These

were all identified
as potential causes
of

high

blood

pressure.

Since HTN care
requires
preventative
measures,

the

general population
should be made
aware

of

HTN

predictors, notably a
high

BMI

and

unhealthy food and
lifestyle choices.

3
0
.

Murthy
et al.

2013

To analyse
HTN
prevalence
and
associated
risk
variables,
including
ethnicity,
in a sample
of Nigerian
adults who
were
chosen for
a survey on
visual
impairmen
t

from

A

nationally

representative
sample of 13591
participants
aged 40 years
was

obtained

using a multi-
stage, stratified,
cluster random
sample

with

probability
proportional to
size techniques.
13504 (99.4%)
of them had a
blood pressure
reading.

Prevalence
of HTN and
associated
risk factors.

There were 44.9%
of people who had
HTN. Age, gender,
living in an urban
area, and BMI all
increased
independently

of

one

another

(p

0.001). The ethnic
group

with

the

highest HTN
prevalence

was

the Kanuri.

The high frequency
of HTN in Nigeria is
alarming and shows
that the effects of
connected

poor

health, along with
the

associated

monetary and costs
to

society

and families and the
nation of Nigeria,
are unavoidable.

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International Journal of Medical Science and Public Health Research

across the
country.

3
1
.

Odili et
al.

2008

To assess
how
doctors
adhere to
the

JNC

VII,
WHO/ISH,
and ESH
guidelines
and their
role in the
prevention
and control
of HTN.

Cross-sectional
study

Prevalence,
Treatment
and Control
of HTN

The grade 2 group
had the greatest
prevalence of HTN
(36%). Men were
less affected (40%)
than women (60%)
were.

Diabetes

mellitus was the
most prevalent co-
morbid

condition

(18%). The highest
rates

of

co-

morbidity

were

found in Grades 2
(34%) and 3 (34%).
A

two-drug

combination

was

being taken by 49%
of the participants,
whereas 14% were
receiving
monotherapy. The
anti-hypertensive
medication

most

frequently
administered (31%)
was

a

calcium

channel

blocker,

followed

by

a

diuretic

(30%).

Diuretics were the
most

popular

medication
combination (74%).
In HTN, there was
no proof of div
weight control.

The doctors in this
facility

fairly

followed

the

instructions,
however it doesn't
seem

like

they

suggested lifestyle
changes to their
hypertension
patients.

3
2
.

Ofuya

2007

To
ascertain
the
prevalence
of

HTN

among
adults

in

Nigeria's
Niger
Delta.

While

the

female
participants
were

chosen

from

two

markets in the
hamlet

where

the institution
was located, the
male research
group

was

Prevalence,
Awareness,
Treatment
and Control
of HTN

HTN was more
common in men
than in women
(16% in men and
12% in women).
Male BMI averaged
22.7

kg/m2,

whereas

female

BMI averaged 23.8
kg/m2.

There is a need for
HTN

control

and prevention
measures. Lifestyle
changes and risk
factors, such as a
high BMI, should be
promoted.

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composed

of

commercial
motorcycle
riders

who

frequented the
campus area.

3
3
.

Ogah et
al.

2012

To
ascertain
the
prevalence
and causes
of

high

blood
pressure in
the South-
East
Nigerian
state

of

Abia.

The

research

subjects

were

chosen ad hoc
from one rural
and one urban
local
government
region,

one

senatorial zone,
and each of the
three senatorial
zones (LGA).

Prevalence
and
determinant
s of HTN

The BMI of women
was

substantially

greater than that of
males. Similar to
how

the

waist

circumference was
greater in women,
the

waist-to-hip

ratio

was

only

noticeably higher in
urban women than
in rural women.
Systolic

HTN

affected 31% of
participants overall
(33.5% of males and
30.5% of women).
In the city, there was
a

statistically

different sex gap.
Conversely,
diastolic HTN was
present in 22.5% of
the

population

(25.4% of women
and

23.4%

of

males). The best
predictors of BP
were

age

and

indicators

of

obesity.

Both rural and urban
environments in the
research had a high
frequency of HTN.
Age, sex, indicators
of obesity, and pulse
rate were the main
drivers of blood
pressure

in

the

subjects.

3
4
.

Oghagb
on et al.

2007

To
ascertain
the
prevalence
of

HTN

and related
factors
among
paid Ilorin,
Kwara
State,

A screening was
conducted for
the
identification of
HTN among the
staff members in
collaboration
with the health
services
division of a soft
drink
manufacturing

Prevalence
of HTN and
associated
variables

HTN

affected

27.1%

of

the

population,

with

men

having

a

frequency of 28.4%
and

females

of

22.9%. Females had
considerably greater
mean SBP and DBP.
Age and BMI both
enhanced

the

prevalence of HTN.

In Ilorin, Nigeria,
the prevalence of
HTN is high, with
males being more
likely to have the
disease. In female
employees, the BP
rise

is

more

pronounced. In order
to

reduce

the

morbidities that are
connected

with

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Nigerian
employees.

firm and the
Federal
Secretariat
Complex

in

Ilorin, Nigeria.
These

staff

members
received
thorough
briefings on the
main points of
the show and the
necessity

of

fasting on the
day they were to
be aired.

Age and SBP, DBP,
and

BMI

were

linked. 13.2% of the
population

was

obese, with males
making up 5.3% and
females 7.8%. Both
sexes had a 1.5%
prevalence

of

diabetes mellitus,
which was similar.

obesity, which is on
the rise in Nigerian
society,

early

intervention

is

necessary.

3
5
.

Oguoma
et al.

2015

To
determine
CVD
prevalence
and
predictive
factors as
well

as

how
availability
of

CVD

risk
screening
varies by
poverty
level and
educationa
l
attainment
and

how

this affects
the diagno
sis of the
condition i
n rural and
urban
Nigerian
adults.

Using a two-
stage

cluster

sampling
approach,
researchers
examined

a

culturally ethnic
group of people
who resided in
both rural and
urban areas. All
18-year-old
pupils

from

certain
secondary
schools

were

sampled

for

each

cluster.

Other
participants in
each

cluster

were signed up
through

town

halls, primary
health

care

facilities,

and

school grounds.

Prevalence
of CVD risk
factors

Prediabetes

was

present in 4.9% of
the

population,

diabetes in 5.4%,
HTN in 35.7%, low
HDL in 17.8%,
hypertriglyceridemi
a

in

23.2%,

hypercholesterolem
ia in 38.1%, and
central obesity in
52.2%

of

the

population. Other
CVD risk variables
did not demonstrate
statistically
significant
difference

across

income levels, with
the exception of
total cholesterol and
HDL.

It

was

statistically
significant

that

participants

with

"university

and

postgraduate
degrees" had more
exposure to BP and
sugar

levels

monitoring

than

those from other
educational
backgrounds.

According to this
study,

a

sizable

percentage of adult
Nigerian migrants
from the rural and
urban areas carry
modifiable

CVD

risk factors. While
the prevalence of
CVD risk factors
was not impacted by
economic level, it
did alter access to
CVD risk screening.
At all societal levels,
there is a need for
access to risk factor
diagnosis.

3
6
.

Okafor
et al.

2014

To
estimate
the

Simple random
sampling

was

used to choose

Prevalence,
Awareness,
Treatment

With

a

strong

female

gender

preponderance, the

Among

these

apparently healthy
adult

citizens,

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prevalence
of obesity
and

its

connection
to

blood

pressure
among
urban
adults
living

in

the Enugu
metropolit
an.

four areas of the
city, and then
consenting
people between
the ages of 18
and 70 were
sequentially
recruited.

and Control
of HTN

individuals
had high obesity
prevalence (21.2%).
Age-related burdens
rose,

with

the

middle-aged group
being most affected.
The likelihood of
acquiring obese rose
as age approached
40.

Positive

association, greater
BMI

among

hypertensive
people,

and

significant burden
of raised BP among
obese subjects all
point

to

a

connection between
BP and BMI.

obesity was of a
significant

size.

Increased BP is
related to obesity.

3
7
.

Oladapo
et al.

2005

To
evaluate
and
describe
the
prevalence
of various
cardiovasc
ular-
related risk
factors in a
rural
Yoruba
communit
y in South-
West
Nigeria's
sub-
Saharan
adult
population.

A list created by
field
enumerators
contained

a

systematic
random
sampling

of

houses. Adults
who

were

eligible

were

chosen

as

responders on a
consistent basis.
Per home, no
more than three
respondents
were

chosen.

After receiving
training

in

fundamental
interviewing
techniques and
accepted
procedures for
taking physical
measures,
community
health extension
workers
(CHEW)

Prevalence
of
cardiometab
olic

risk

factors

With blood pressure
over 140/90 mmHg,
20.8%

of

the

responders

had

hypertension.
42.3% of the men
and 36.8% of the
women had blood
pressure

below

130/85

mmHg;

2.5% had diabetes;
1.9%

had

hypertriglycerideae
mia; 43.1% had low
HDL-C; 3.2% were
physically inactive;
and 1.7% smoked
cigarettes. A total of
12.9%

of

the

participants had at
least one CVD risk
factor.

The findings of this
study clearly imply
that cardiometabolic
risk

factors

are

prevalent in this
rural community and
that

the

epidemiological
shift does not only
affect

urban

residents. This is a
call to action for the
treatment of CVD as
well as other NCDs
in the organization
of health services.

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gathered

the

study's data. The
WHO STEPS
survey's
instruments
were used and
modified for the
local conditions.

3
8
.

Olisa &
Oyelola

2009

To
examine
utilisation
of herbal
medication
among
hypertensi
ve patients.

The

study's

recruitment
process
employed
simple random
sampling. The
clinic

record

office

was

contacted

to

recruit

every

other

patient

who

dropped

down their card
in order for the
files

to

be

handed out.

Use

of

herbal
medicine for
HTN control

Age was linked to
more frequent usage
of herbal remedies
(P 0.05). 47.5% of
respondents
reported

co-

administering
herbal medications
with
antihypertensive
drugs, of which
33.33%

utilised

herbs

having

antihypertensive
action. The majority
of

responders

(71.15%)

used

herbal medications
secretly from their
doctors. 21.04% of
respondents
reported

co-

administration

of

herbal medications
and allopathic drugs
to

have

had

clinically obvious
adverse effects. The
reasons stated for
stopping the herbal
medications were
side effects noticed
(3.79%),
improvements

in

clinical
circumstances
(3.03%), reported
ineffectuality of the
herbal

treatment

(1.52%),

and

directions from the

Patients

with

hypertension
frequently

co-

administered herbal
medications together
with

allopathic

medications,

thus

healthcare providers
need to be watchful
and ask patients
about their use of
herbal medications
when gathering their
medical history.

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health practitioner
(21.15%).

3
9
.

Omorog
iuwa et
al.

2008

In order to
compare
the

risk

variables
between
the
younger
employees
and senior
employees
in

the

setting, it
was
necessary
to rank the
risk factors
for HTN in
a
university
setting in
Ekpoma,
Edo State,
Nigeria.

All

of

the

university's
faculties

and

service
divisions were
used to pick
1,600 academic
and

non-

academic staff
members

at

random,

who

might be senior
or

junior

personnel.

Risk factors
of HTN

The total crude
prevalence

was

33%,

whereas

junior

employees

had a prevalence of
23.8% and senior
staff

had

a

prevalence

of

38.93%. In this
study, the male
senior staff had a
substantially higher
mean diastolic HTN
of 158.3 4.5. In this
study, kolanut was
the main risk factor,
and its effects were
more noticeable in
the senior staff.
Extra salt, alcohol,
cigarette smoking,
and

sex

were

additional

risk

factors.

The

study

demonstrated

the

significance

of

ranking

HTN

predictors so

that

adequate awareness
campaigns may be
planned to reduce
those risks and, as a
consequence,
marginalise

the

catastrophic effects
of HTN and its
complications.

4
0
.

Omuem
u et al.

2004

To
evaluate
the degree
of
knowledge
about high
blood
pressure,
therapy,
and control
in a rural
population
in Nigeria's
Edo State.

Participants
were

chosen

through cluster
sampling, and a
researcher-
administered
questionnaire
was utilised to
gather the data.

Awareness,
Treatment
and Control
of HTN

HTN

prevalence

was 20.2%. 18.5%
of the hypertensives
knew they had high
blood

pressure.

Females had higher
awareness, which
rose with age and
fell with increasing
educational
attainment. Of those
who were aware of
their issue, 77.3%
were

receiving

treatment, and of
those, 29.4% had
their blood pressure
under control.

According to the
study, this rural
population has poor
levels of knowledge
of

high

blood

pressure and its
management.
Therefore, the need
for

consistent,

population-based
HTN

screening

programs is
important.

4
1
.

Ordinio
ha

2013

To
determine
the

According to the
study, this rural
population has

Prevalence,
Awareness,
Treatment

The study found
that

this

rural

community had low

Due in large part to
their

improved

health-seeking

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prevalence
of

HTN

and

its

modifiable
risk factors
among the
lecturers at
the
University
of

Port

Harcourt
Medical
School.

poor levels of
knowledge

of

high

blood

pressure and its
management.
Therefore, the
need

for

consistent,
population-
based

HTN

screening
programs is
important.

and Control
of HTN

levels of awareness
of

high

blood

pressure status and
control.

Routine

population-based
HTN

screening

programmes

are

thus

urgently

needed.

behaviour and active
lifestyles, medical
school

instructors

had

a

lower

frequency of HTN
than the general
population.

4
2
.

Ordinio
ha

&

Brisibe

2013

To find out
how
common
HTN

is

among the
traditional
leaders of a
communit
y in Rivers
State,
Nigeria,
and

to

identify its
modifiable
risk
factors.

The study found
that this rural
population
knows

little

about

blood

pressure
problems

and

how to treat
them.
Therefore, it is
crucial to have
reliable,
population-
based

HTN

screening
programmes.

Prevalence
of HTN and
its
modifiable
risk factors

The mean systolic
and diastolic blood
pressures in the
study

population

were 149 and 98
millimetres

of

mercury,
respectively.

The

HTN
prevalence was
68.9%.

The

majority (63.01%)
of the chiefs who
had

HTN were

conscious of their
condition and were
taking medication to
treat it (50.68%).
There

were

no

underweight chiefs,
and the majority
were

either

overweight
(51.89%) or obese
(26.42%). Almost
all of the chiefs
(92.45%)

used

alcohol frequently,
and 24.53% smoke
cigarettes right now.

Compared to the
general population,
traditional

leaders

had

a

greater

frequency of HTN.
Their advanced age
and acculturation are
likely to blame for
this.

4
3
.

Oyeyem
i

&

Adeyem
i

2013

To
investigate
the
association
between
risk factors

Workers were
sourced

from

places

of

employment
with

various

levels

of

Prevalence,
Awareness,
Treatment
and Control
of HTN

Women were more
likely to be obese, to
report having a
diagnosis

of

a

component of the
metabolic

Adults in Nigeria
who were employed
had low levels of
physical

activity,

which

was

associated

with

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for CVD
and
physically
active
behaviours
in an adult
working
population
in
Maiduguri,
Nigeria.

occupational
engagement. In
Maiduguri,
North-East
Nigeria,

six

workplaces
totaling

more

than

100

people were
purposefully
hired

from

institutions
supported by the
federal or state
governments.

syndrome, and to be
less

physically

active than males (p
0.05).

When

compared to those
who described their
job as moderately or
highly

active,

individuals
with sedentary
lifestyles
were likely

to

collect less minutes
of MVPA (p 0.001).
BMI,

heart

rate, waist
circumference, and
blood pressure were
all

negatively

correlated with the
health-improving
moderate-to-
vigorous physical
activity (MVPA) (p
0.05).

harmful CVD risk
factors.

In

Maiduguri, Nigeria,
encouraging
physical activity that
improves health may
be crucial for the
prevention

and

management

of

CVD among the
employed
population.

4
4
.

Ugwuja
et al.

2015

To
ascertain
the
prevalence
and causes
of HTN in
the

rural

communit
y

of

Igbeagu, in
South
Eastern
Nigeria.

No

clear

sampling
strategy

was

provided.

Prevalence,
Awareness,
Treatment
and Control
of HTN

Incidence of HTN
was 23.2%. HTN
was correlated with
age,

red

meat

intake, BMI, and the
proportion

of

children

in

the

family. Only age
and

BMI

were

identified

as

independent

risk

variables for HTN
by

regression

analysis.

Although

the

frequency of HTN
and its risk factors
were consistent with
other

studies

conducted

in

Nigeria, it is still
unclear how the
frequency

of

children

in

a

household and HTN
are

related.

To

reduce the high HTN
prevalence in

this

population, efforts
are required.

4
5
.

Ulasi et
al.

2010

To
quantify
the
prevalence
of

the

cardiometa
bolic
syndrome
(CMS) in
relation to

To

ensure

proportionate
representation,
2/3

of

respondents
were

chosen

from the semi-
urban

region,

while the last
third was chosen

Prevalence,
Awareness,
Treatment
and Control
of HTN

In

the

HTN

population,

the

prevalence of CMS
increased to 34.7%
and

24.7%,

respectively, from
the

general

prevalence of 18%
in the semi-urban
community

and

The high frequency
of CMS, particularly
in the population
with HTN, in semi-
urban

areas

emphasises

the

double burden of
illness in emerging
nations. The lesson
is

that

non-

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HTN

in

semi-rural
and rural
population
s in South-
East
Nigeria.

from the rural
community.

10% in the rural
community.
Hyperglycemia,
abdominal obesity,
and
hypertriglyceridae
mia all had higher
prevalence rates in
the

general

population in both
communities
combined than in
the

hypertensive

groups, which were
respectively 21.2%,
55.0%, and 31.3%.
Every other co-
morbidity, with the
exception of low
HDL

cholesterol,

was greater in the
hypertensive group
than it was in the
general population.

communicable
illnesses

should

not be overlooked
while diseases are
being dealt with in
these nations.

4
6
.

Ulasi et
al.

2011

To find out
how
common
HTN is in a
market
neighbour
hood

in

Enugu,
Nigeria.

No

clear

sampling
strategy

was

provided.

Prevalence
of HTN

42%

of

the

population

who

underwent
screening

for

hypertension

was

used to estimate
prevalence. Of this
group, 70.6% were
unaware of their
hypertension prior
to the test. More
males than females
had hypertension.
HTN