Case finding for hypertension in young adult patients attending a Missionary Hospital in Nigeria

RI Ekore, IO Ajayi, A Arije

Abstract

Objectives: This study was carried out to search for cases of undetected hypertension in young adult male and nonpregnant female patients (18 – 44years) attending a catholic mission hospital in Ibadan, Nigeria so as to provide evidence for routine blood pressure checks in this age group. It also sought to determine risk factors present in those found to be hypertensive and to detect complications of hypertension, if present.

Methods: Semi-structured questionnaire was administered and physical examination was carried out on the eligibles. Laboratory analysis of blood and urine was done for the consenting subjects with confirmed hypertension. A descriptive, hospital-based cross-sectional study, which took place at the Out-Patients Department of St. Mary’s Catholic General Hospital, Eleta, Ibadan. Consecutive young adult male and non-pregnant female patients aged18 – 44 years attending the hospital for the first time between February 2007 and August 2007, that met the inclusion criteria and consented to participation.

Data Analysis: Frequency distribution was done to describe the data, while cross-tabulation, t-test, chi-square test and oneway ANOVA were done to explore association between variables as appropriate.

Results: Out of the 405 subjects that participated in the study, 124(30.6%) were hypertensive. The mean age of the subjects was 31.6 ±6.9 years. A total of 154 (38%) were male and 251(62%) female. Mean BMI was 23.7±4.3 kg/m2. The study revealed that age, occupation, body mass index, waist circumference and hip circumference were  significantly associated with high blood pressure. Clinical evidence of target end-organ damage seen include left ventricular hypertrophy in 22(17.7%) congestive cardiac failure in 3(2.4%), retinopathy in 5(4.0%), nephropathy in 12(26.1%) and transient ischaemic attack in 1(0.8%).

Conclusion: Undetected cases of hypertension, with complications and target end-organ damage, exist in young adults in Ibadan and family physicians and other primary care physicians, especially in Nigeria, should pay attention to case finding for hypertension in this age group.