PREVALENCE AND RISK FACTORS FOR CARDIOVASCULAR DISEASE AMONG HEALTH WORKERS IN SECONDARY AND TERTIARY CENTRES GUSAU, ZAMFARA STATE

PREVALENCE AND RISK FACTORS FOR CARDIOVASCULAR DISEASE AMONG HEALTH WORKERS IN SECONDARY AND TERTIARY CENTRES GUSAU, ZAMFARA STATE

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SUMMARY

Cardiovascular diseases are the number one cause of death globally. An estimated 17.5

million people died from CVDs in 2012, representing 31% of all global deaths and three

quarter of these deaths occur in low and middle income countries.

A cross sectional descriptive study was conducted among health workers in Gusau, Zamfara

state. Four hundred and ten participants were selected from the secondary and tertiary health

centres, an adapted WHO STEPS questionnaire administered, socio-demographic, CVD risk

factors data, blood samples and anthropometric readings were obtained and analysed using

SPSS version 17.

The mean age of the respondents was 33years (±9.6SD) and the overall prevalence of

hypertension was 8.4%, isolated systolic hypertension 17.7%and isolated diastolic

hypertension 11.7%, There was a statistical significant association between systolic blood

pressure with age(OR 2.923, 95%CI 1.664-5.135, P=<0.0001) and vigorous exercise,( OR

1.800, 95%CI 1.033-3.136, P=0.03). The diastolic blood pressure was statistically significant

with age and addition of salt to diet. Other behavioural variables were not significant.

The prevalence of addition of salt to diet (22.9%), use of monosodium glutamate (75.1%) and

sitting more than 6hours at work (43.7) was high. Males were more likely to be obese than

females, however, females were more likely to have abdominal obesity than males.

The percentage of cigarette smoking, blood pressure, obesity and alcohol was comparably

lower than the national NCD survey.

The prevalence of the cardiovascular risk factors; Diabetes mellitus was high (26.6%),

hypertension 8.4% and dyslipidaemia were also low. Obesity and under -nutrition coexist.

The State Ministry of Health and other stakeholders should partner to improve the knowledge

of cardiovascular disease/ risk factors among the health workers.

Key words: Zamfara state, CVD, Health workers, Risk factors

xiii


CHAPTER ONE:

1.0 INTRODUCTION

1.1 Background

Cardiovascular diseases (CVDs) are the number one cause of death globally-: more people

die annually from CVDs than from any other cause. An estimated 17.5 million people died

from CVDs in 2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4

million were due to coronary heart disease (CHD) and 6.7 million were due to stroke.1At

least three quarters of the world's deaths from CVDs occur in low- and middle-income

countries. People in low- and middle-income countries who suffer from CVDs and other non

communicable diseases have less access to effective and equitable health care services which

respond to their needs. As a result, many people in low- and middle-income countries are

detected late in the course of the disease and die at a younger age from CVDs and other non

communicable diseases, often in their most productive years.1,3

Out of the 16 million deaths under the age of 70 due to non communicable diseases, 82% are

in low and middle income countries and 37% are caused by CVDs. Cardiovascular disease

has reached near epidemic proportion in Africa, according to WHO report 2002. The World

Health Organization has reported that the number of disability adjusted life years lost to

cardiovascular disease in sub-Saharan Africa rose from 5.3 million for men and 6.3 million

for women in 1990 to 6.5 million and 6.9 million in 2000, and could rise to 8.1 million and

7.9 million in 2010.³

Among the non-communicable diseases (NCDs), CVDs contributed 48% of all deaths due to

NCDs. In a study conducted in Northern Nigeria it was shown that multiple risk factors do

occur to predispose individuals to CVDs. The multiple risk factors may include high blood

pressure, obesity and physical inactivity. It is worthy to note that risk factors can be very high

in groups thought to be free of them.4 The World Health Organization (WHO) defined

1


(CVDs) as a group disorders of the heart and blood vessels that include coronary heart

disease, cerebrovascular disease, peripheral arterial disease, rheumatic heart disease,

congenital heart disease, deep venous thrombosis and pulmonary embolism.1

The behavioural risk factors of heart disease and stroke are unhealthy diet, physical

inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors

may manifest as high blood pressure, elevated blood sugar, raised blood lipids, overweight

and obesity. These “intermediate risks factors” can be measured in primary health centres and

can indicate an increased risk of developing a heart attack, stroke and heart failure ¹.There are

also a number of underlying determinants of CVDs or "the causes of the causes". These are a

reflection of the major forces driving social, economic and cultural change – globalization,

urbanization and population ageing2,14 Other determinants of CVDs include poverty, stress

and hereditary factors. There is increased incidence of non-communicable diseases (NCDs) in

developing countries; the World Health Organization estimated that CVDs accounted for


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