Association of hypertension with generalized obesity in rural south-western Nigeria

Year 2020, Volume: 4 Issue: 3, 177 - 181, 01.03.2020

Taiwo Raimi , Olatunde Odusan

https://doi.org/10.28982/josam.593387

Cited By: 1

Abstract

Aim: There is a rising prevalence of hypertension worldwide with Africa reported to have the greatest disease burden. Obesity is the major risk factor for hypertension. This study aims to determine the prevalence of hypertension and its relationship with general obesity in rural south-western Nigeria.
Methods: Cross-sectional descriptive survey was conducted in two rural communities in Remo North Local Government area of Ogun State, Nigeria. Four hundred and twelve (412) participants comprising 216 (50%) males, aged 20-70 years, were studied. Participants were screened for generalized obesity and hypertension according to standard protocols. Hypertension was defined according to the seventh report of Joint National Committee on Prevention, Detection, Evaluation and Treatment of high blood pressure (JNC VII). Associations between obesity and hypertension were determined by analysis of variance (ANOVA), Pearson’s correlation and Chi-Square tests.
Results: The mean of all the blood pressure indices (systolic, diastolic and mean arterial blood pressure) increased from first to fourth quartile of body mass index (BMI) (For trend, P<0.001). The prevalence of hypertension was 32.5% (28.6% in males and 36.4% in females). Compared to males, more females had systolic hypertension (45.1% vs 33.5%, P=0.02). The prevalence of hypertension increased with age (P<0.001 for systolic blood pressure (SBP) and diastolic blood pressure (DBP); P=0.019 for isolated systolic hypertension (ISH), and BMI (X2=8.508, P=0.019 [95% CI, 0.001-0.038]). BMI correlated with both systolic and diastolic blood pressures (P<0.001).
Conclusions: The prevalence of hypertension is high and it is positively associated with obesity in the population. Aggressive lifestyle intervention to curb obesity is necessary to prevent hypertension and future cardiovascular disease.

Keywords

Hypertension, Obesity, Cardiovascular diseases, Prevalence

Nijerya'nın kırsal güneyindeki genel obezite ile hipertansiyon ilişkisi

Abstract

Amaç: Dünya çapında hipertansiyon prevelansında bir artış bildirilmekle birlikte, Afrika’nın en yüksek hastalık yüküne sahip olduğu bilinmektedir. Obezite, hipertansiyon için major risk faktörüdür. Bu çalışmada Güneybatı Nijerya’nın kırsal kesiminde hipertansiyon prevalansı ve genel obezite ile ilişkisinin araştırılması amaçlanmıştır.
Yöntemler: Nijerya'nın Ogun Eyaleti, Remo Kuzey Yerel Yönetim bölgesinde iki kırsal toplulukta bir kesitsel tanımlayıcı anket yapılmıştır. Yaşları 20-70 arasında değişen, 216’sını erkeklerin oluşturduğu (%50) toplam 412 hasta incelenmiştir. Katılımcılar, standard protokollere göre genel obezite ve hipertansiyon açısından taranmıştır. Hipertansiyon, Ortak Ulusal Yüksek Tansiyonun Önlenmesi, Saptanması, Değerlendirilmesi ve Tedavisi Komitesi'nin yedinci raporuna göre tanımlanmıştır (JNC VII). Obezite ve hipertansiyon arasındaki ilişki Pearson’un korelasyon testi ve ki-kare testi ile belirlendi.
Bulgular: Tüm kan basıncı endekslerinin ortalaması (sistolik, diyastolik ve ortalama arteriyel kan basıncı) vücut kitle indeksinin (BMI) ilk dördüncü çeyreğinden arttı (Eğilim için P<0,001). Hipertansiyon prevalansı %32,5’tu (erkeklerde %28,6 ve kadınlarda %36,4). Erkek olgulara kıyasla kadınlarda sistolik hipertansiyon daha sık gözlemlenmekteydi (%45,1'e karşı %33,5, P=0,02). Hipertansiyon prevalansı yaşla birlikte artmaktaydı (sistolik kan basıncı (SBP) ve diyastolik kan basıncı (DBP) için P<0,001); izole sistolik hipertansiyon (ISH) ve BMI için P=0,019 (X2=8,508, P=0,019 [% 95 CI, 0,001-0,038]) BMI, hem sistolik hem de diyastolik kan basınçları ile korelasyon gösterdi (P<0,001).
Sonuç: Hipertansiyon prevalansı yüksektir ve popülasyondaki obezite ile pozitif olarak ilişkilidir. Hipertansiyonu ve gelecekteki kardiyovasküler hastalıkları önlemek amacıyla obeziteyi azaltmak için agresif yaşam tarzı müdahalesi gerektirmektedir.

Keywords

Hipertansiyon, Obezite, Kardiyovasküler hastalıklar, Prevalans

References

• 1. World Health Organization. A Global Brief On Hypertension (2013). https://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/ (Accessed April 2019)
• 2. Forouzanfar MH, Liu P, Roth GA, Marie Ng, Biryukov S, Marczak. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115mmHg, 1990-2015. JAMA. 2017;317 (2):165-82.
• 3. World Health Organization. Raised Blood Pressure. https://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/ (Accessed April 2019)
• 4. Akinlua JT, Meakin R, Umar AM, Freemantle N. Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review. PLoS ONE. 2015;10(10):e0140021. doi:10.1371/journal. pone.0140021.
• 5. Ogah OS, Okpechi I, Chukwuonye, II, Akinyemi JO, Onwubere BJ, Falase AO, et al. Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review. World J Cardiol. 2012;4(12):327-40.
• 6. Okwuonu CG, Ojimadu NE, Chimezie OJ, Madudonu U, Ogbulafor N, Ogah OS. Awareness of blood pressure status, undiagnosed hypertension and proteinuria among adults in Umuahia, South-East Nigeria. Sahel Med J. 2016;19:82-8.
• 7. Oluyombo R, Akinwusi PO, Olamoyegun MO, Ayodele OE, Fawale MB, Okunola OO, et al. Clustering of cardiovascular risk factors in semi-urban communities in south-western Nigeria. Cardiovasc J Afr. 2016;27(5):322-7.
• 8. Egbi OG, Ogoina D, Oyeyemi A. Prevalence of hypertension and associated factors in a rural community in Bayelsa State Int J Res Med Sci. 2018;6(4):1106-13.
• 9. World Health Organization. Obesity and Overweight (2018). www.who.int/mediacentre/factsheets/fs311/en/ [accessed May 2019]
• 10. Movahed MR, Lee JZ, Lim WY, Hashemzadeh M, Hashemzadeh M. Strong independent association between obesity and essential hypertension. Clin Obes. 2016;6(3):189-92.
• 11. Nagai M, Ohkubo T, Murakami Y, Takashima N, Kadota A, Miyagawa N, et al. Secular trends of the impact of overweight and obesity on hypertension in Japan, 1980-2010. Hypertens Res. 2015;38(11):790-5.
• 12. Patel SA, Ali MK, Alam D, Yan LL, Levitt NS, Bernabe-Ortiz A, et al. Obesity and its Relation With Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions. Global Heart. 2016;11(1):71-9.e4.
• 13. Vuvor F. Correlation of body mass index and blood pressure of adults of 30 & 50 years of age in Ghana. J Health Res Rev. 2017;4(3):115-21.
• 14. Zhang M, Zhao Y, Wang G, Zhang H, Ren Y, Wang B, et al. Body mass index and waist circumference combined predicts obesity-related hypertension better than either alone in a rural Chinese population. Sci Rep. 2016;6:31935.
• 15. Gao W, Qiao X, Wang Y, Wan L, Wang Z, Wang X, et al. The Interactive Association of General Obesity and Central Obesity with Prevalent Hypertension in Rural Lanzhou, China. PloS one. 2016;11(10):e0164409.
• 16. Jayawardana N, Jayalath W, Madhujith WMT, Ralapanawa U, Jayasekera RS, Alagiyawanna S, et al. Aging and obesity are associated with undiagnosed hypertension in a cohort of males in the Central Province of Sri Lanka: a cross-sectional descriptive study. BMC Cardiovasc Disord. 2017;17(1):165.
• 17. Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, et al. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment--a position paper of the The Obesity Society and The American Society of Hypertension. Obesity (Silver Spring, Md). 2013;21(1):8-24.
• 18. Odusola AO, Stronks K, Hendriks ME, Schultsz C, Akande T, Osibogun A. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers, Glob Health Action, 2016;9:1, 29041.
• 19. WHO Technical Report Series-854. Physical Status: The use and interpretation of Anthropometry. WHO Geneva 1995.
• 20. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of high blood pressure: The JNC VII report. JAMA. 2003;289:2560-72.
• 21. Oladapo OO, Falase AO, Salako L, Sodiq O, Soyinka K, Adedapo K. Prevalence of cardiometabolic risk factors among a rural Yoruba south-western Nigerian population: a population- based survey. Cardiovascular J Afr. 2010;21:26-31.
• 22. Iloh G, Amadi A N, Nwankwo B O, Ugwu V C. Obesity in adult Nigerians: A study of its pattern and common primary co-morbidities in a rural Mission General Hospital in Imo state, south-eastern Nigeria. Niger J Clin Pract. 2011;14:212-8.
• 23. Kunutsor S, Powles J. Descriptive Epidemiology of blood pressure in a rural adult population in Northern Ghana. Rural and Remote Health 2009;9:1095.
• 24. Midha T, Idris MZ, Saran RK, Srivastav AK, Singh SK. Prevalence and determinants of hypertension in the urban and rural population of a north Indian district. East Afr J Public Health. 2009;6:268-73.
• 25. Singh N, Rahman SJ. A study on the prevalence and awareness of hypertension among women in the reproductive age group and the factors contributing to it in a rural area of Jorhat district, Assam. Int J Community Med Public Health. 2017;4(9):3473-8.
• 26. Ahaneku GI, Osuji CU, Anisiuba BC, Ikeh VO, Oguejiofor OC, Ahaneku JE. Evaluation of blood pressure and indices of obesity in a typical rural community in eastern Nigeria. Ann Afr Med. 2011;10:120-6.
• 27. World Health Organization. Non-communicable disease country profile. https://www.who.int/nmh/countries/nga_en.pdf?ua=1 (accessed May 2019)
• 28. Olatunbosun ST, Kaufman JS, Cooper RS, Bella AF. Hypertension in a black population: prevalence and biosocial determinants of high blood pressure in a group of urban Nigerians. J Human Hypertens. 2000;14:249-57.
• 29. Ogah OS, Madukwe OO, Chukwuonye II, Onyeonoro UU, Ukegbu AU, Akhimien MO, et al. Prevalence and determinants of hypertension in Abia State Nigeria: results from the Abia state non- communicable diseases and cardiovascular risk factors Survey. Ethn Dis. 2013;23:161-7.
• 30. Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence and Risk Factors of Prehypertension and Hypertension in Southern China. PloS one. 2017;12(1):e0170238.
• 31. The Systolic Hypertension in the Elderly Programme Cooperative Research Group (SHEP). Implications of the systolic hypertension in the elderly programme. Hypertension. 1993;21:335-43.
• 32. Opadijo OG, Salami TA, Sanya EO, Omotoso AB. Systolic hypertension in adult Nigerians with hypertension. J Coll Physicians Surg Pak. 2007;17:8-11.
• 33. Asekun-Olarinmoye E, Akinwusi P, Adebimpe W, Isawumi M, Hassan M, Olowe O, et al. Prevalence of hypertension in the rural adult population of Osun State, south-western Nigeria. Int J Gen Med. 2013;6:317-22.
• 34. Adedoyin RA, Mbada CE, Balogun MO, Martins T, Adebayo RA, Akintomide A, et al. Prevalence and pattern of hypertension in semi urban community in Nigeria. Eur J Cardiovasc Prev Rehabil. 2008;15:683-7.
• 35. Onwubere BJC, Ejim EC, Okafor CI, Emehel A, Mbah AU, Onyia U, et al. Pattern of Blood Pressure Indices among the residents of a rural community in South East Nigeria. Int J Hypertens. 2011;2011:621074.
• 36. Wilking SV, Belangerb A, Kannel WB, D’Agostino RB, Steel K. Determinants of Isolated Systolic Hypertension. JAMA. 1988;260:3451-5.
• 37. Adediran O, Akintunde AA, Edo AE, Opadijo OG, Araoye AM. Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria. J Cardiovasc Dis Res. 2012;3(3):191–196.
• 38. Ulasi II, Ijoma CK, Onodugo OD. A community-based study of hypertension and cardiometabolic syndrome in semi-urban and rural communities Nigeria. BMC Health Serv Res. 2010;10:71.
• 39. Amole IO, OlaOlorun AD, Odeigah LO, Adesina SA. The prevalence of abdominal obesity and hypertension amongst adults in Ogbomoso, Nigeria. Afr J Prim Health Care Fam Med. 2011;3(1):188.
• 40. Amole IO, OlaOlorun AD, Owolabi AO. Prevalence of obesity and hypertension among adults in Ogbomoso, Nigeria. Internet J Med Update 2011;6(2).
• 41. Gao W, Qiao X, Wang Y, Wan L, Wang Z, Wang X, et al. The Interactive Association of General Obesity and Central Obesity with Prevalent Hypertension in Rural Lanzhou, China. PloS one. 2016;11(10):e0164409.
• 42. Dua S, Bhuker M, Sharma P, Dhall M, Kapoor S. Body mass index relates to blood pressure among adults. North Am J Med Sci. 2014;6(2):89-95.
• 43. Samsamshariat SZ, Sakhaei F, Salehizadeh L, Keshvari M, Asgary S. Relationship between Resistin, Endothelin-1, and Flow-Mediated Dilation in Patient with and without Metabolic Syndrome. Adv Biomed Res. 2019;8:16.
• 44. Yang B, Li M, Chen B, Li T. Resistin involved in endothelial dysfunction among preclinical Tibetan male young adults. J Renin Angiotensin Aldosterone Syst. 2016;13(4):420-5.