SUMMARY

Hypertension or high blood pressure is a leading cause of cardiovascular disease (CVD) worldwide. The proportion of the global burden of disease attributable to hypertension has significantly increased from about 4.5 per cent in 2000 to 7 per cent in 2010. This makes hypertension the single most important cause of morbidity and mortality globally and highlights the urgent need of action to address the problem.

Aim of the study was to assess level of awareness and knowledge, determine the prevalence,

modifiable and non-modifiable risk factors of hypertension among civil servants in Kano State. Cross-sectional descriptive study was conducted in which 520 respondents were recruited using multi-stage                      sampling     technique.    Modified    WHO-STEPS    semi-structured     interviewer administered questionnaire was adapted for the study. Data was collected on Knowledge, socio-demographics, Behavioural, Physical (Anthropometric measurements) and biochemical variables. Blood pressure was measured and 5mls of blood was collected to determine the blood sugar and lipid profile. Data was analysed using Epi-info version 3.5.4.

Of the 520 respondents, males were 438(84.2%) while 82(15.8%) are females. The age of respondents ranged from 18- 65 with a mean of 43 ± 9.9- years. Highest level of education was 170 (32.7%) and median income of N50,000 (N12,000-350000). The prevalence of Systolic and Diastolic hypertension were 138(26.5%) and 183(35.2%), diabetes mellitus 30(5.8%), Obesity 48(9.2%) and overweight 142(27.3%). Generally knowledge of determinants and risk factors was poor among respondents as only 0.8% had a good knowledge. Being male and hypertensive (OR: 1.14; 95% CI: 0.66-1.98), being diabetic and hypertensive (OR: 1.92; 95% CI: 0.90-4.09), being older than 40years and having systolic hypertension (OR: 4.80; 95% CI: 2.81-8.21), being a current smoker and hypertensive (OR: 1.80; 95% CI: 1.04-3.12) were found to be significant risk factors for hypertension a major cardiovascular disease. Multivariate analysis revealed being older than 40 years (AOR: 4.10; 95% CI: 2.44 - 7.11), having BMI >30(AOR: 2.47; 95% CI: 1.57 - 3.66), lack of physical activity (AOR: 2.31; 95% CI: 1.24 - 5.04), high serum uric acid (AOR: 3.21; 95% CI: 1.55- 6.59) as independent risk factors of hypertension.

xiv

The study revealed low level of knowledge on hypertension which is a major cardiovascular risk factor among study participants. A BMI greater than 30(obesity), lack of vigorous physical activity were the major modifiable risk factor while age greater than 40 years was found to be the non-modifiable risk factor of hypertension among the civil servants of Kano State. It is recommended that Sensitization Campaigns of civil servants to embark on regular medical checkups and exercises.

Key Words: Hypertension, Prevalence, Determinants, Cardiovascular Disease, Civil servants, Kano

xv

CHAPTER ONE

INTRODUCTION

Cardiovascular diseases are illnesses that involve the blood vessels (veins, arteries and

capillaries) or the heart, or both - diseases that affect the cardiovascular system. Cardiovascular

disease (CVD) is any abnormal condition of the heart or blood vessels (arteries, veins) such as

coronary heart disease (CHD), stroke, peripheral vascular disease, congenital heart disease,

endocarditis, and many other conditions. Many cardiovascular diseases are preventable.

Hypertension is a chronic medical condition in which the blood pressure in the arteries is

elevated. It contributes to the burden of heart disease, stroke, kidney failure, and premature death

and disability. Hypertension rarely causes symptoms in the early stages and many people are

undiagnosed.1

1.1 Background of the Study

Hypertension or high blood pressure is a leading cause of cardiovascular disease (CVD)

worldwide.2 The proportion of the global burden of disease attributable to hypertension has

significantly increased from about 4.5 per cent in 2000, to 7 per cent in 2010.3-4 This makes

hypertension the single most important cause of morbidity and mortality globally and highlights

the urgent need of action to address the problem.5 Hypertension was mainly associated with

more affluent regions of the world. However, the condition is increasingly emerging in low and

middle-income countries (LMICs)6-7 where health resources are scarce and stretched by a high

burden of infectious diseases such as Malaria, Tuberculosis and HIV, where awareness and

treatment levels on hypertension control are still very low.7

1

Currently, the global burden of hypertension is greatest in Low and Middle-Icome Countries

where it affects about 1 in every 5 of the adult population.8 By 2025, almost 3 out of every 4

people with hypertension will be living in LMICs. The absolute numbers affected by