Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria

Background : Rapid transition from rural to urban lifestyle in Africa has been associated with increasing cardiovascular disease burden and thus, the need for continuous reevaluation of cardiovascular risk factors in African slums which have been shown to harbor 40 to 80% of urban residents cannot be over emphasized. Objectives : To evaluate hypertension and obesity in a typical urban slum in South East, Nigeria. Design : Cross-sectional community based study. Setting : A typical urban slum in Enugu State, Eastern Nigeria. Subjects : One hundred and ninety one volunteers from the slum. Results : The mean age of the entire participants in this study was 44.1 ± 16.2 years while their mean BMI was 25.1 ± 5.2 Kg/m2. Their mean systolic BP was 128.8 mmHg ± 22.2 and 79.0mmHg ± 12.9 for mean diastolic BP. Both systolic and diastolic blood pressure (BP) increased as age group increased peaking at the age group 55- 74 years and then dropping after 75 years. Mean BMI peaked at 35- 54 years and then started dropping as age increased. In the entire community, 29.3% of the participants had hypertension (males: 42.1 %, females: 23.9%), 25.1% had isolated systolic HBP (ISH) while 22.0% had isolated diastolic HBP (IDH). In the general population, the general prevalence of HBP and ISH increased as age group increased. IDH increased as age increased peaking at 55- 74 year age group (34.1%) and then dropped thereafter (≥75; ISH=10.0%). Among the females, HBP prevalence increased across board as age increased but among the males, it increased with age and peaked at 55-74 year age group (61.1%) and then dropped (≥75; HBP= 57.1%). The prevalence of obesity in the community was 13.1% (males; 5.3%, females; 16.4%). None of those ≥75 years had obesity. Obesity prevalence was highest in those 35-54 years old (17.6%) and least in those 15- 34 years old (9.1%). Generally and within all age groups, females had higher obesity prevalence than the males. For the males, Obesity was highest in those 55-74 years (11.1%) while for the females, it was highest in those 35-54 years (23.0%). Prevalence of HBP increased with BMI getting to more than double fold in those found to be obese. 26% of the participants (20.8% of males and 31.3% of females) who were found to have hypertension had prior knowledge of it. Conclusion : Hypertension and obesity are on the increase in Nigeria and degree of ignorance about these major cardiovascular risk factors has remained very high.