CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Hypertension is a significant medical issue all through the world due to its high commonness and its relationship with expanded danger of cardiovascular illness. It is one of the major risk factors for cardiovascular mortality, which accounts for 20-50 percent of all deaths. The World Health Organization (WHO) attributes hypertension to be the leading cause of cardiovascular mortality. Half of the current health burden in developing nations is attributable to non-communicable diseases. By 2020 it is projected that non-communicable diseases (NCD) including, hypertension, will outstrip communicable diseases as the leading cause of death. Demographic changes, expanding urbanization and way of life changes are a portion of the factors adding to the expanding weight of hypertension. In spite of the fact that hypertension is normal, promptly noticeable and effectively treatable, it is typically asymptomatic and regularly prompts deadly complexities whenever left untreated.
The connection between blood pressure and danger of cardiovascular disease occasions is persistent, reliable and free of other hazard factors. The higher the blood pressure, the more noteworthy the possibility of myocardial dead tissue, cardiovascular breakdown, stroke and kidney malady. Even a mild increase in blood pressure is considered a threat, leading to cardiovascular diseases (CVD). This mild rise may lead to prehypertension stage and often is ignored as it is asymptomatic. Individuals with prehypertension hold more than threefold risk for developing hypertension and CVD in the future when compared to individuals with normal/optimal BP.
Prevalence of hypertension has been increasing in the West African States including Nigeria. In high-income countries, the prevalence of hypertension has declined due to strong public health policies and widely available diagnosis and treatment. However, in low and middle-income countries, the disease burden of hypertension has increased over the past decade (Shanthi Mendis, 2013).
The severity of hypertension in Nigeria is high and as yet growing, we despite everything cannot state with conviction the specific severity. In the past 20 years, there has been an increase in hypertension research in Nigeria, as several community based prevalence studies have been conducted (Ogah, Okpechi, Chukwuonye, Akinyemi, Onwubere, Falase, 2012). There is therefore a need for current estimates of the prevalence of hypertension in the country to effectively quantify this burden and prompt appropriate response as previous countrywide estimates have been based on a review of fewer studies, mostly based on at least 160/95mmHg (Ogah, Okpechi, Chukwuonye, Akinyemi, Onwubere, Falase, 2012).
1.2 Statement of the Problem
One significant issue influencing the reaction to the weight of hypertension in Nigeria is that the awareness, treatment and control of hypertension have been low (Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. 2013). Consequently, many who live with high blood pressures end up in health facilities with cardiovascular complications, including heart failures, ischemic heart disease and strokes (Ogah, Adebiyi, Oladapo, Adekunle, Oyebowale, Falase, 2012). In fact, research findings show that high blood pressure is diagnosed in many people as an incidental finding when admitted for unrelated ailments (Perkovic, Huxley, Wu Y, Prabhakaran, MacMahon, 2007). This obviously has resulted in high morbidities and mortalities from hypertension in Nigeria, and reports still show that there is yet to be a nationwide measure to facilitate regular screening and detection of high blood pressures. The WHO reiterated the requirement for improved awareness on hypertension towards lessening the general weight of the illness, particularly at national and community levels, as this was the focal point of the 2013 WHO day (WHO, 2013).
Additionally, there is also a high economic burden as a consequence of hypertension and associated cardiovascular complications in Nigeria (Abegunde, Mathers, Adam, Ortegon , Strong, 2007), demonstrated by direct costs, for example: the cost of antihypertensive medications, administrative fees, laboratory fees and other out-of-pocket health expenditures, and indirect costs, such as: loss of savings from repeated healthcare expenses, hospital waiting times and work absenteeism (Ukwaja KN, Onyedum CC. Reaction to Ilesanmi OS et al. 2013). In a study of 250 patients in Igbo-Ora, southwest Nigeria, for instance, the mean monthly cost of treatment was reported to be about 10 United States Dollars (USD) and this is relatively high in a community in which majority of the population live on an income below 2 USD per day (Ilesanmi OS, Ige OK, Adebiyi AO 2012). Furthermore, some reports have shown that the actual mean monthly cost could be more than this, as the study did not consider retreatment visits which could be up to five visits per patient within 6 months (Ukwaja, Onyedum, Reaction to Ilesanmi, 2013).
1.3 Objectives of the Study
The main objective of this study is to investigate risk assessment and prevention of hypertension among unmarried adults above 30 years in Agogo Presbyterian Hospital, Ghana. However, the specific objectives are:
i) To examine the reasons for the prevalent of hypertension among unmarried adults above 30 years in Ghana
ii) To determine the causes of hypertension among unmarried adults above 30 years in Ghana
iii) To understand the symptoms of hypertension among adults
iv) To understand the risk factors associated with hypertension and how it can be prevented among adults
1.4 Research Questions
The following questions were spelt out to be the research questions for this study:
i) What are the reasons for the prevalent of hypertension among unmarried adults above 30 years in Ghana?
ii) What are the causes of hypertension among unmarried adults above 30 years in Ghana?
iii) What are the symptoms of hypertension among adults?
iv) What are the risk factors associated with hypertension and how it can be prevented among adults?
1.5 Significance of the Study
The result of this study will serve as good base or guide for future reference and it will also encourage further research on the importance of staying healthy and being free from health related issues that may lead to untimely death. Furthermore, this study will provide relevant information on the reasons for the factors associated with hypertension and how it can be prevented among adults. Also, this study would be of immense importance towards containing this deadly disease and its management in Ghana and in the whole of Africa.
1.6 Scope of the Study
This study is on the risk assessment and prevention of hypertension among unmarried adults above 30 years in Agogo Presbyterian Hospital, Ghana. Therefore, one hundred respondents shall be selected within the space of three weeks as it is sometime not possible to get the required samples of one hundred within a day or a week.
1.7 Limitations of the Study
This study was a one-spot screening study. Participants did not have opportunity for blood pressure recheck. There may also be the risk of selection bias as individuals in the study area who already knew their hypertensive or diabetic state may not have participated in the screening.
