RURAL – URBAN’ COMPARISON OF THE KNOWLEDGE, PREVALENCE AND ASSOCIATED RISK FACTORS OF HYPERTENSION AMONG SECONDARY SCHOOL STUDENTS IN LAGOS STATE
Hypertension is a significant contributor to morbidity and mortality. It is the most prevalent cardiovascular risk factor worldwide. Though generally believed to be a disease of adulthood, hypertension has been shown to start early in life. Adolescent hypertension can progress to adulthood. Early detection of hypertension may prevent complications.In Nigeria, the prevalence rate of adult hypertension ranges from 8% to 46% depending on the study target population, type of measurement and cut off value used for defining hypertension while the prevalence of adolescent hypertension ranges from 0.1% to 17.5%. Differences in prevalence rates in rural and urban areas exist for adults however data is sparse among adolescents.
Objective: The objective of this study was to determine and compare the knowledge, prevalence and associated risk factors for hypertension among students in secondary schools in rural and urban areas of Lagos state
Methodology: The study was a cross sectional analytic study involving six hundred and seventy two students selected using the multistage sampling technique from sixteen secondary schools in two rural and two urban LGAs in Lagos state. Three hundred and thirty six students from rural and Three hundred and thirty six students from urban LGAs participated in the study. Interviewer administered questionnaires were used to collect data on the students’ knowledge of hypertension and the presence of its associated risk. Blood pressures and anthropometric measurements such as the height, weight, BMI, waist circumference and hip circumference of the participants were taken. A urine test was carried out on a subset of the participants to determine microalbuminuria.Data was analysed using SPSS version 20.0 Level of significance was set at p < 0.05
Results: Majority of the students were 15 years and less. The mean age of the students was 14.4±2.2 years in the rural and 13.8±2.0 years in the urban areas, the difference in the ages
was found to be statistically significant with rural students being older. (p = 0.02) A higher proportion of the mothers of students in the urban schools had secondary and tertiary education 118 (35.1%), 145 (43.2%) in comparison to the mothers of the students in rural schools 111 (33.0%), 101 (30.1%) (p< 0.001) The awareness of hypertension among the rural 305 (90.8%) and urban 293 (87.2%) respondents was high (p = 0.139) The overall level of good knowledge among rural 160 (47.6%) and urban 157 (46.7%) respondents was low and no statistically significant difference was found between overall knowledge and the location of the schools (p = 0.435) The prevalence of hypertension was high among the respondents though significantly higher for the rural respondents 44 (13.1%) than the urban 26 (7.7%) (p = 0.023) Ever smoking, 29 (8.6%) urban and 16 (4.8%) rural (p = 0.045), Ever use of alcohol 53 (15.8%) urban and 31 (19.2%) rural (p = 0.010) Frequent consumption of sugary drinks 53 (17.4%) urban, 35 (10.5%) rural (p = 0.024) were significantly higher among students in urban areas than in rural areas. A family history of hypertension was significantly higher among students in rural 57 (17.0%) than in urban areas 32 (9.5%) (p = 0.017). A family history of hypertension was found to be significantly associated with being hypertensive in both rural and urban schools. The prevalence of microalbuminuria was high among rural 20 (13.8%) and urban 10 (6.9%) respondents. There was no statistically significant association between being positive for microalbuminuria and the location of the schools.
Conclusion: The prevalence of hypertension was high among rural and urban adolescents. Knowledge about hypertension among rural and urban adolescents is low and a family history of hypertension was found to be the principal risk factor for adolescent hypertension in this study. Health education, early lifestyle modification, screening for students with a positive family history for hypertension are recommended.