OBESITY AND BLOOD PRESSURE AMONG ADULT

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REFERENCE

Appendix I

Appendix II

 

Obesity and blood pressure are important challenges facing the public health sector in both developed and developing countries, centre for disease control and prevention (CDC, 2013). Obesity arises from an abnormal accumulation of body fat due to an energy imbalance between calories consumed and calories expended and it is a major risk factor for metabolic and cardiovascular diseases (Halsam et al., 2005). The prevalence of obesity is increasing worldwide and it has been identified as a major risk factor contributing to the overall burden of disease worldwide (CDC, 2013; Ladabaum et al., 2014 and Flemming et al., 2014). Obesity was once reckoned to be a problem restricted to high-income countries, but due to globalization with its accompanying pattern of changing lifestyle, it is now on the increase in low and middle income countries (Popkin et al., 2012; Ellulu et al., 2014 and Abubakari et al., 2008), and Nigeria has not been left out (Akinwale et al., 2013). This trend of emerging obesity in poorer countries is seen more in urban dwellers and rates have reportedly doubled (Finucane et al., 2011 and Prentice, 2005). Recent global figures indicate that the prevalence of obesity is not just a problem of the developed countries but is also on the increase in the developing world and that 65% of the world's populations live in countries where overweight and obesity kill more people than underweight (WHO, 2014). The situation may be worse in African context, where body fatness is associated with beauty, fame and evidence of good living and health particularly in women (WHO, 2014). Furthermore, African men are purported to have a preference for overweight over thin women (Adeboye et al., 2012). In Nigeria, the prevalence of obesity ranged from 4.6% - 22.2%, among adults South-south Nigeria (Aladeniyi et al., 2017). 

High blood pressure (BP) or hypertension is the most common non-communicable disease and a significant risk factor for renal disease and cardiovascular diseases such as heart attacks, stroke, and left ventricular hypertrophy globally (Lim et al., 2012). Sufferers of hypertension are usually unaware that they have the condition, thus many present with the complications or sudden death, and is therefore referred to as a ’silent killer’ (Ataklte et al., 2015 and Adeloye et al., 2015). The prevalence of hypertension among obese patients may range from 60% to 77%, increasing with body–mass index (BMI), in all age groups (Bramlage et al.,2004) and it is significantly higher compared to the 34% found in normal weight subjects (Bramlage et al.,2004). These percentages are relevant even when compared to high blood pressure (BP) prevalence in the general population. In 2015, the global age-standardized prevalence was 24.1% (21.4–27.1) in men and 20.1% (17.8–22.5) in women (Zhou et al., 2017). A review with wider coverage (1968 -2015) found overall crude prevalence of hypertension to range from 2.1 to 47.2% in adults and from 0.1 to 17.5% in children depending on the study site, target population, type of measurement and cut-off value used for defining hypertension (Akinlua, 2015). Hypertension and its complications constitute approximately 25% of emergency medical admissions in urban hospitals in Nigeria (Ekere et al., 2005). Multiple factors have been demonstrated to be associated with the development of hypertension and its complications. These are grouped into modifiable and non-modifiable factors. However, the modifiable factors such as environmental and lifestyle factors rather than non-modifiable factors (genetics and sex) are mainly associated with hypertension (Ekere et al., 2005). Hypertension has a stronger association and causal link with five particular behaviors: Tobacco use, excessive use of alcohol, physical inactivity, unhealthy diet (high salt intake and, insufficient fruit and vegetable consumption) and obesity which are consequences of urbanization in developing countries (van de Vijver et al., 2013).

According to WHO (2014), obesity is 20% accumulation of fat in the blood and body, this accumulation has an impact on high blood pressure by increasing the pressure of blood in the blood vessel as a result of blockage and narrowing cause by excess fat in the blood and body. The pathophysiology of hypertension in obese subjects should be considered as a complex phenomenon. The cardiovascular system is affected by structural, functional and hemodynamic changes (Lavie et al., 2009).Which can directly increase hypertension risk. The study therefore aimed to assess the relationship between obesity and blood pressure among adults in Ikwuano Local Government Area in Abia State.

The consequences of both obesity and blood pressure are enormous. In Nigeria, obesity and hypertension are implicated in various health challenges including diabetes mellitus, dyslipideamia, gyneacological complications, cancer, stroke, sudden deaths, medical stroke, heart failure, psychiatric disorders etc (Maduagwu et al., 2012; Mustapha et al., 2012; Ekpenyong et al., 2011; Ogunniyi et al., 2011 and Ukoli et al., 2007) . Furthermore, excessive body fat is strongly linked with the risk of hypertension (Wilson et al., 2002). In Nigeria, the risk of hypertension is about two times higher among obese individuals than those with normal body weight (Ekanem et al., 2013).  Physical inactivity has been identified as a major cause of excessive body weight and high blood pressure (WHO, 2014; WHO, 2013 and Mahfouz et al., 2011). Most adult men and women spend most hours of the day sitting down and involved in many other sedentary activities and consume diets with mean daily energy intake far higher than recommended levels (Afolabi et al., 2004). Conditions that increase their risk of developing obesity and/or hypertension. Studies on prevalence of obesity and hypertension among various groups in Nigeria are limited to few locations and categories of people, causing paucity of data on prevalence of these conditions in the country. Providing information on the prevalence of obesity and hypertension will contribute to the wealth of knowledge on chronic diseases among Nigerians; help to make informed choices on intervention strategies and as well as evaluate any ongoing attempts to curb these diseases. Hence this study is set to assess the relationship between obesity and blood pressure among adult men and women in Ikwuano, Umuhia North.

The general objective of this study is to determine obesity and blood pressure among adults in Ikwuano local Government area.

The specific objective includes to

I. evaluate social demographic status of adults

III. determine blood pressure level of adults 

IV. examine the relationship between obesity and blood pressure level among adults.

The study will provide information on the number of people affected by obesity, low and high blood pressure (hypertension). To the community nutritionist and dieticians, including other related profession, it will enable them plan and manage obesity, hypotension and hypertension in the community.

The data that shall be provided will also help the Federal Ministry of Health in planning their health program for rural communities. It will also enhance governmental and non-governmental organization on the necessity of developing strategies and concept that center on elevating nutrition education in the society. Doctors and nurses also will use the information generated in the treatment, management and documentation of patient’s history.