Description
ABSTRACT
This study was designed to establish the relationship between body mass index (BMI) and blood pressure (BP) in an increasingly industrialised town in Nigeria due to the rising prevalence of hypertension in non-industrialised countries. Factors associated with BMI and BP levels were determined in three hundred adult male and female subjects in DASIT Specialist Hospital in Lafia, Nigeria. The levels of the overweight among the male and female subjects were 53.03% and 47.37% respectively. The levels of hypertensive male and female subjects were 40.91% and 35.34% respectively. The overweight and underweight among the hypertensive male were 54.29% and 0% respectively; while the overweight and underweight among the hypertensive female were 42.86% and 28.57% respectively. Hypertension among the overweight, and hypotension among the underweight, are major health concern in Lafia that requires intensive medical care.
ABBREVIATIONS
BP: Blood pressure
BMI: Body mass index
PA: Physical activity
HBP: High blood pressure
CVD: Cardiovascular disease
WHR: Waist to hip ratio
NCD: Non-communicable disease
LMIC: Low and middle-income countries
SSA: Sub-Saharan Africa
EA: Enumeration area
CHAPTER ONE
1.1 INTRODUCTION
High blood pressure (BP) is a leading cause of cardiovascular diseases. The increasing prevalence of cardiovascular diseases is putting a tremendous pressure on already overburdened resources in non-industrialized countries and reflects on the high prevalence of cardiovascular diseases .There are many uncontrollable risk factors that contribute to high BP – such as increase in age, race, heredity, and gender. However, there are some controllable factors, like the weight gain and obesity, stress levels, sodium intake, physical inactivity and certain drugs intake. Understanding the function and proper management of the heart is essential to developing efficient strategies for controlling hypertension. The heart is composed of two independent pumping systems, one on the right side, and the other on the left. Each has two chambers, an atrium and a ventricle. The ventricles are the major pumps in the heart. The left ventricle is the strongest of the heart pumps. Its thicker muscles need to perform contractions powerful enough to force the blood to all parts of the body. This strong contraction produces systolic BP. On the other hand, the diastolic BP is measured when the left ventricle relaxes to refill the heart with blood between the beats.
High body mass index (BMI) could influence positively and to be independently associated with morbidity and mortality from hypertension and other chronic diseases. Despite a growing burden of obesity and hypertension in developing countries, there is limited information on the contribution of BMI to BP in these populations. Positive associations between body mass and BP have been documented. This relationship, however, is not sufficiently explored among lean populations in Africa. The relationship between BMI and hypertension is of particular interest to developing countries because it has being observed rise cardiovascular mortality among lean hypertensive subjects. The volume of researches on cardiovascular diseases, as well as, risk factors associated with them is extremely low in Africa. Therefore, this work was designed to further establish the relationship between BMI and BP in an increasingly in DASIT Specialist Hospital in Lafia, Nigeria.
1.2 BACKGROUND OF THE STUDY
Globally, there is an increasing prevalence of high blood pressure (HBP) among adults and youth. However, the mechanisms of how the risk factors (physical inactivity and obesity) relate with blood pressure (BP) are not well known especially among the urban poor youth in low and middle income countries. Meanwhile childhood and adolescent physical inactivity and obesity, particularly in conditions of poverty, predispose individuals to cardiovascular diseases (CVDs) in later life.
1.3 OBJECTIVE OF THE STUDY
The aim of this study was to assess the BP levels and to examine its associations with physical activity (PA) and body mass index (BMI) amongst patients in DASIT Specialist Hospital in Lafia, Nigeria. To investigate the association between changes in body mass index (BMI) and change in diastolic blood pressure (DBP), systolic blood pressure (SBP), and hypertension status.
1.4 LIMITATIONS OF THE STUDY
The study has some limitations. There is a potential bias in the self-reported participation of leisure PA. For instance, subjects’ recall bias effect may introduce some inconsistencies into the analysis. Also, there is a limitation with choosing only the frequency of leisure physical activity and not considering other forms of physical activity as well as their levels of intensity and duration, which could have better predicted the physical activity level of the respondents. We chose leisure activity as our operational concept because it involves a conscious decision and plan to engage in physical activity to increase physical fitness. However, it is important to consider that occupational activities in the communities involve manual work such as fishing, petty trading and artisan work, which some of the older respondents were engaged in. Such working activities involve energy expenditure which should be incorporated into a holistic measurement of physical activity. Finally the difficulty of establishing the cause and effect between physical activity and BMI does not allow for conclusive statements on the known benefits of physical activity. This may be attributed to the small sample size which could not allow for establishing the known associations between the variables. Despite these limitations, the findings in this study are consistent with findings from other studies and they provide insights that can inform interventions to lower HBP and cardiovascular disease (CVD) risk among youth in the research communities.
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