Frequency of high blood pressure among the adult population in kebi state

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TYPE

Original Research

PAGE NO.

21-29

DOI

10.37547/tajmspr/Volume07Issue02-03

OPEN ACCESS

SUBMITED

07 December 2024

ACCEPTED

09 January 2025

PUBLISHED

11 February 2025

VOLUME

Vol.07 Issue02 2025

CITATION

Abubakar Danjuma Bundaram. (2025). Frequency of high blood pressure
among the adult population in kebi state. The American Journal of Medical
Sciences and Pharmaceutical Research, 7(02), 21

–

29.

https://doi.org/10.37547/tajmspr/Volume07Issue02-03

COPYRIGHT

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

Frequency of high blood
pressure among the adult
population in kebi state

Abubakar Danjuma Bundaram

PhD student of city university Cambodia, Department of public health,
Cambodia

Abstract:

This Article evaluated the prevalence of High

Blood Pressure and its Associated Factors among the
Adult in an outpatient clinics in Kebbi State Nigeria.
Hypertension, the silent killer, remains a major global
health challenge in this 21st century despite
advancements in technology and increasingly available
therapeutic options. According to a new report from the
World Health Organization, Hypertension is now the
number 1 risk factor for premature death worldwide. It
is preventable, controllable, and treatable, yet, a major
threat to human survival at the global level. It affects
more than one billion people and acts as the most
prevalent risk factor for global mortality, with the
highest prevalence of 27% in the WHO African Region.
Nigeria, the most populous country in this region,
contributes enormously to this burden. The rate is
surging high as people gain more access to fast foods
and live more sedentary lifestyles.This exploratory study
is therefore aimed at assessing the prevalence and
determinants of hypertension among the adult
population in Kebbi State. The state is in the northwest
region, which has one of the highest natality and
mortality rate in Nigeria. Knowing the prevalence of
hypertension and its associated factors in this small unit
of the country will inform the government on the
development of an appropriate measure for its effective
management. This cross-sectional study was carried out
with 270 Hospital outpatient attendees in Kebbi State.
Participants were selected by simple random sampling,
and

a

structured

interviewer-administered

questionnaire was used to obtain data over a period of
three (3) months. Standardized and calibrated
instruments were also used to measure the systotic and
diastolic blood pressure, and other anthropometric
variables such as height, weight, Body Mass Index (BMI)
and multiple div composition indices. Logistic
regression analysis was conducted and statistical
significance was declared at a p-

value ≤0.05. Descriptive

statistical techniques and correlation techniques that

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include correlation analysis, ANOVA and regression
analysis were used to analyse the information. Data
analysis by Statistical Package for Social Science
version 20.0 revealed a prevalence of 28.9%. This is a
signal of a hidden epidemic that requires intense public
enlightenment on healthy lifestyles, enhanced
Community screening programs, early detection
through regular checkups, and a review of current
guidelines on the management of hypertension. Age,
BMI, and level of education were the three factors
identified in this study as having enough covariates to
predict hypertension. Lifestyle modification in the
form of a healthy lifestyle, regular exercise, and
healthy eating habits would reduce hypertension and
its consequent cardiovascular morbidity and mortality
in Kebbi State, northwestern region of Nigeria.

Keywords:

Frequency Of High Blood Pressure, Adult

Population, Nigeria.

Introduction:

High Blood Pressure (Hypertension) is a

systemic disease that affects all races and countries of
the world. It is the most common Non-Communicable
Disease (NCD) with diverse grades of prevalence across
the globe (Ibekwe, 2015).

Hypertension, which is elevated blood pressure (BP),
has been identified globally as the major risk factor for
cardiovascular diseases (CVD) (Hajjar et al., 2006). It is
associated with lethal complications like coronary
artery disease, cerebrovascular accidents, heart, and
renal failure (Henok et al., 2017). Despite being a
preventable illness condition, studies have linked it to
increased morbidity and mortality among adults.
Hypertension is now the number-one risk factor for
death globally (Ayodele, 2018), and it is also one of the
primary risk factors for heart disease and stroke (Arun
et al., 2017).

Past studies on Hypertension revealed that it is
responsible for about 50% of CVD worldwide, accounts
for an estimated 45% of deaths due to heart disease,
and 51% of deaths due to stroke (WHO, 2013, Chythra
et al., 2013). The high death rate is estimated to be
equivalent to about 12.8% (7.5 million) of the annual
total deaths in the world (Zarin and Muhammed, 2016)

The burden of hypertension increases with increasing
adult population and globalization. It has been found
to be associated with an unhealthy lifestyle, which
includes tobacco smoking, lack of physical activity, and
alcohol consumption. It is currently ahead of tobacco,
high cholesterol, unhealthy weight, unsafe sex, and
other conditions as a risk factor for global mortality
(Pengpid et al., 2019).

Hypertension is a public health challenge in many
developing countries with a range of prevalence across
regions and countries of the world (Van De Vijver - 2013,
Singh - 2017).

The incidence is on the increase, mainly due to a rise in
risk factors in low- and middle-income countries (WHO,
2019). It has been referred to as a disease of the African
race because of its prevalence on the continent, which
is over 46% among the adult population (Ibekwe, 2015;
Hajjar et al., 2006; Hossain et al., 2011). Despite its high
prevalence among the African population, many
Nigerians are not aware of its associated risks and
implications. A large percentage of the people areyet to
come to terms with the need for regular blood pressure
(BP) checkup, nor do they have access to education and
services required to prevent and treat the disease.
Hence, the prevalence of hypertension continues to rise
in Nigeria despite global advancement in economic and
healthcare system.

A recent survey in Nigeria has revealed that its
prevalence has risen to 35% with its consequential high
mortality rate (WHO, 2017). Unfortunately, most of
these consequences, which are Cardiovascular and
cerebrovascular in nature, are preventable through
control of social determinants of health, which are
responsible for 90% of our health conditions (Magnan,
2017).

Factors associated with the development of
hypertension can be categorized into modifiable and
non-modifiable risk factors. The modifiable risk factors
comprise obesity, physical inactivity, high salt, and sugar
diet,

psychological

stress,

smoking,

alcohol

consumption, and others (WHO, 2013;Ibekwe, 2015).
Non-modifiable factors comprise of age, sex, family
history, and ethnic background (World Heart
Foundation, 2017).All these associated factors are
influenced by the wave of globalization, which is
spreading across the World.

The alarming rate of sudden death has become a
significant public health challenge in Nigeria. Research
has revealed many potential causes of which
hypertension is a kingpin. It has been described as the

“silent killer” because of its asymptomatic appearance

and immense harm to the div in the form of target
organ damage (WHO, 2013). The burden of
hypertension is high in Africa, and due to rapid
population growth and aging, the exact burden on the
continent is still far from being known. Hypertension
prevalence is currently on the increase with the wave of
globalization across Nigeria but many hypertensive
individuals are not aware of their condition (Adeloye,
Basquill 2014).

The “big three” infectious diseases

- Malaria,

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tuberculosis and HIV/AIDS coupled with childhood and
maternal morbidity are still the prominent causes of
mortality within Nigeria and Africa as a whole.
However, the burden of hypertension and other non-
communicable diseases (NCDs) is rapidly increasing to
make Africa a continent of double calamity. The United
Nations (alongside other major public health
stakeholders) has declared NCDs a cause for global
concern.

Recent research has shown that Hypertension is now a
leading risk factor for poor health and is on the rise
among men and women in both rural and urban areas
of Nigeria. Many Nigerians are ignorantly falling victim
to this non-communicable disease despite the fact that
it can be prevented, controlled, and treated. This is due
to lack of understanding of the associated factors.
Assessment of these factors is thus essential in
curtailing the menace of this significant public health
problem.

Relevant past studies in many parts of the world
revealed that it is influenced by the socio-cultural,

gender, genetic and environmental factors as well as
their interactions (Scriabine, 2007; Lydia and Jiang,
2007;WHO,2013). These associated factors vary across
the world and have not been thoroughly assessed in
Kebbi State, which is transiting from rural to urban
figure in the Northwestern part of the Nigeria.

Earlier studies have categorised high blood pressure
into the following four stages:

STAGE 1 or Prehypertension is 120/80 to 139/89

STAGE 2 or Mild Hypertension is 140/90 to 159/99

STAGE 3 or Moderate Hypertension is 160/100 to
179/109

STAGE 4 or Severe Hypertension is 180/110 or higher
(Vascular Cures).

Hypertension is diagnosed if, when it is measured on
two different days, the systolic blood pressure readings

on both days is ≥140 mmHg and/or the diastolic blood
pressure readings on both days is ≥90 mmHg. (WHO)

Normal Blood Pressure Range

Systolic pressure (mm

Hg)

Diastolic pressure (mm

Hg)

Pressure Range

130

85

High Normal

Blood

Pressure

120

80

Normal Blood Pressure

110

75

Low Normal

Blood

Pressure

Blood Pressure Chart: Low, Normal, High Reading by
Age - Disabled.

Optimal Blood Pressure Level

An optimal blood pressure level is 120/80mmHg or
lower, and high blood pressure is 140/90 mmHg or
higher. Irrespective of age, the lower the blood
pressure, the lower the risk of heart attack, heart
failure, stroke, and kidney disease.

Optimal blood pressure is less than 120/80. In healthy
people, low blood pressure without any symptoms is
not usually a concern and does not need to be treated,
but low blood pressure can be a sign of an underlying
problem -- especially in the elderly -- where it may
cause inadequate blood flow to the heart, brain, and
other vital organs (Suzanne, 2017).

High Blood Pressure Guidelines

The new ACC/AHA guidelines were developed with

nine other health professional organizations and were
written by a panel of 21 scientists and health experts
who reviewed more than 900 published studies. They
are the successors to the Seventh Report of the Joint
National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure
(JNC7), issued in 2003 and overseen by the National
Heart, Lung, and Blood Institute (NHLBI). The new
guidelines

–

the first comprehensive set since 2003

–

lower the definition of high blood pressure to account
for complications that can occur at lower numbers and
to allow for earlier intervention. The new definition will
result in nearly half of the U.S. adult population (46
percent) having high blood pressure, with the greatest
impact expected among younger people.

Additionally, the prevalence of high blood pressure is
expected to triple among men under age 45 and double
among women fewer than 45. However, only a small

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increase is expected in the number of adults requiring
antihypertensive medication (Paul et al., 2017). High
blood pressure should be treated earlier with lifestyle
changes and in some patients with medication

–

at

130/80 mm Hg rather than 140/90

–

based on new

American College of Cardiology (ACC) and American
Heart Association (AHA) guidelines for the detection,
prevention, management and treatment of high blood
pressure.

Blood pressure categories in the new guideline are:

Normal: Less than 120/80 mm Hg;

Elevated: Systolic between 120-129 and diastolic less
than 80;

Stage 1: Systolic between 130-139or diastolic between
80-89;

Stage 2: Systolic at least 140 or diastolic at least 90 mm
Hg;

1.

Sexi. Male

ii. Female

2.

Age (years)

I 18-28 ii.29-38 iii. 39-48 iv. 49-58

v. 59-68 vi.

69-78 vii. >78

3.

What tribe are you?

i. Hausaii. Fulani iii. Kabawa iv. Dakarkari v. Kambari
vi. Specify

4.

Marital status

i. Single ii. Married iii. Separated

iv. Divorced

v. Widowed

5.

Current Employment / Engagement status.,

i. Employed

ii. Student

iii.

Unemployed iv. Retired

6.

If employed

i. Civil servant ii. Business

man/woman

iii. Farmer iv Daily labourer v.

Specify,,,

7.

What is your level of education?

i. No formal education ii. Arabic education iii. Primary
education iv. O-level education v. A-level education
vi. Undergraduate education vii. Graduate education

viii. Postgraduate education,

8. Average monthly income / Grade level i less than
N50000 ii N50000 -N100000

iii more than N100000 , ,

Section II; Health Habits and Family History

9. Have you ever been diagnosed of Hypertension?
i. No ii. Yes,

10.

If yes when?

i. <1 month

ii. 1 month

–

1year iii. >1 year ago,,

11.

Were you given drugs by your physician? i. Yes

ii. No, iii Not applicable

12.

How often do you take your drugs?

i. Regularly

ii. Occasionally iii. Whenever you feel

your BP is high

iv. I never used the

drugs,v. Not applicable

13 Do you have any close relative who was/is
suffering from hypertension?

i. Yes ii. No iii. Not sure,

14. If the answer is yes, who among your relatives?

i. Father

ii. Mother

iii. Sibling

iv.

Father’s sibling v. Mother’s sibling Child vi. Father’s

parents

vii. Mother’s parents viii. Sibling’s child

15.

Have you ever smoked cigarette?

i. Yes

.ii. No Not applicable

16.

If the answer is yes, please tell us at what age

did you start smoking or snuffing

I.10-19 ii.20-39

iii. 40-49

iv.

50-59

v. >60

17.

On average how many cigarettes do you smoke

in a day?

i. 1-5

ii. 5-10 iii. 10-15

iv. >15

18.

Do you take alcohol?

i. Yes

ii. No

19.

If the answer is yes, how many bottles do you

consume in a day?

i. 1-2

ii. 3-5 iii.>5,

20.

Do you take/chew Kola nut /Chat?

I. Yes

ii. No

21. Do you have diabetes/ are you diabetic i. Yes i.
No,

Section iii; Nutrition and Diet Information

22.

How often do you take soft drink- coke, fanta,

pepsi, Maltina,Kunnnu ,sobo etc

At least once daily

ii Every other day

iii

weekly ……

23. How often do you take sugar containing food

–

Bread, buscuit snacks or any fast food

i. At least once daily ii Every other day

iii

weekly

24. How many maggi cube/sachet does your family
include in a Pot of soup/stew?

i. 1

ii. 2

iii. 3

iv. 4

v. 5

vi. >5…………….,

25.

Do you add raw magi or salt to your food?

i. Yes ii. No

26.

Do you normally add Yaji (pepper and salt) to

your food?

i. Yes ii.No.,,,,2,,,,,,,

27. If yes, how often do you add Yaji (pepper and
salt) to your food?

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i. Always ii. Sometimes iii. Once in a while
/Occasionally.,,

28.

How often do you consume fruits and

vegetables? …fruits and vegetables,

i. <1time /day. ii. 1 time/dayiii. 2 times/day

iv.

>3times/day…

29. Do you take Attayi (stimulant) i. Yes iii .No,,,, iii, Not
applicable,

Section Iv; PHYSICAL ACTIVITY

30. Do you engage in any physical activity or sport (e.
g Walking, Running, Skating)

Grinding ,pounding, sweeping, jugging

31. If yes, how many minutes of physical activities do
you perform/ day?

i. less than 30 min / day ii 30 min / day iii. More than 30
min /day

32. How many hours do you spend daily sitting down at
work or with TV programs, Video games or computer I
<30 min ii30-59 min iii.60-89 min iii. >90min

33. For how many hours do you sleep/night

i.<6hrs/ day ii 6- 9hrs / day iii. >10hrs/night,

ANTHROPOMETRIC MEASURMENTS

Anthropometry
No

Reading 1

Reading 2

Average

1

Height

__________

_________

2

Weight

__________

_________

3.

Waist
circumference

__________

_________

4.

Hip circumference __________

_________

5

Blood pressure

_________

_________

6. Body Mass Index

–

BMI

7. Waist Hip Radio-WHR

CONCLUSIONS

This study recorded a high prevalence of hypertension
(28.9%). The high prevalence outcome is consistent
with the past literature but signals a hidden epidemic
and is indicative of the high susceptibility of Kebbi
people to many cardiovascular and other blood
pressure-related diseases. If confirmed with more
nationally representative studies, the finding calls for a
systematic routine health screening and regular
checkups as well as interventions promoting healthy
lifestyles in Nigeria. Early discovery of hypertension
will improve prospects and decrease cardiovascular
risk and end organ damage as reported by Sadi (2013).
Lifestyle modification such as regular exercise, healthy
lifestyle and eating can reduce hypertension and its
consequent cardiovascularmorbidity and mortality in
Kebbi State, in the northwestern region of Nigeria.

Hypertension is a universal public health challengeand
has an associationwith Age, gender, ethnicity, Family
history, socioeconomic status, lifestyles, diabetes
mellitus,frequency of fruits and vegetable intakes, high
consumption of salt and sugar, low level of physical
exercise, overweight and obesity

The confirmation of a positive relationship of
hypertension with increasing age supports the fact that
age is an independent risk factor for hypertension and
appropriate measures of response are required to

ensure wellness in a growing population.

Identified disparity of prevalence among sex
distribution points to the fact that sex-specific
intervention is still relevant in combating non-
communicable diseases of which hypertension is a
leading challenge The observed increasing prevalence of
hypertension with rising BMI depicts that overweight
and obesity are good predictors of hypertension. The
odds of developing hypertension was found to be 2
times more among those in the overweight/obese
category.

The negative relationship of income and hypertension in
this study calls for recongnition of income status as part
of effective prevention strategies in the management of
Hypertension in Kebbi State.

The influence of family history on hypertension is a
reflection of the fact that blood relatives tend to have
many of the same genes that can predispose a person
to high blood pressure. Also, they tend to have exposure
to similar social determinants as opined by Sadi (2013).

There is a clear relationship between routine sodium
chloride intake and blood pressure levels as observed
from the outcome of the study which indicated a linear
relationship with raw salt intake and in Magi and Yaji.

About one-third of the respondents (28.9%) were
hypertensive. The public health repercussion of this
discovery is that one in every three adults in Birnin Kebbi
is at-risk of cardiovascular ailment (s).

Hypertension is, therefore, a huge public health threat

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to the population of Kebbi State. It is largely a
concealed epidemic with a low rate of awareness,
ineffective Primary, Secondary and Tertiary preventive
measures.

The rate at which hypertension is rising in the public is
not coordinated with an appropriate strategic
response by the health system in Africa. Globally,
hypertension and cardiovascular disease, in general,
deserve improved attention from policymakers at
local, national and international levels. Strategies to
raise the awareness of the public on the magnitude of
the situation and scale-up implementation of universal
health care are of utmost importance to decrease the
up-surging but avoidable consequences of elevated
blood pressure.

The relatively low differential in prevalence among all
categories of income earners is because Kebbi is a rural
state with a low standard of living and so the effect of
income disparity is not magnified. Income status
determines the choice of lifestyles and exposure to
social determinants such as stress. This study showed
that the income distributions and hypertension were
nonlinear like some past studies indicating that
elevated levels in low income as well as in high-income
groups (Sadi, 2013).Nevertheless, the relationship
between socioeconomic status (SES) and hypertension
has been reported by many researchers with
conflicting results. (Lenget al 2015).

The prevalence of hypertension by self-report and
physical measurement was 21.5% and 27.4%,
respectively. Several-fold difference between the two
measures indicates that a significant number of the
population was not aware of their hypertension status
which calls for appropriate and timely intervention.

Education plays a significant role in public health
awareness. In this study, the level of education was
found to be one of the variables that can significantly
predict the occurrence of hypertension. Low
awareness is expected in a population where about
78% did not complete tertiary education (Table
4.4).This calls for enhanced health literacy on
prevention and control of hypertension.In the present
study, being -female was more likely to be
hypertensive. This finding isnot in line with most
previous research reports

2.2% of those that have been previously diagnosed
with hypertension were observed to be hypertensive
despite using the anti-hypertensive drug. This shows
their Hypertensive conditions were not under control
and may be indicative of non-adherence or drug
failure.

The relative correlation of Hypertension by diagnosis
and response confirms the reliability of data and

affirms the validity of the outcome.

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