BLOOD PRESSURE STATUS, KNOWLEDGE AND PRACTICE OF RISK BEHAVIORS FOR HYPERTENSION: A COMPARATIVE STUDY OF URBAN AND RURAL COMMUNITIES IN RIVERS STATE

Abstract

Background: Hypertension is one of the commonest chronic non-communicable diseases that have become a challenge to developing countries, due largely to rapid urbanization and accelerating transition to western cultures. It is described as a silent killer often with end organ damage and have been shown to exhibit geographical variation in prevalence.
Objectives: The study was undertaken to investigate rural – urban similarities and differences in blood pressure status, knowledge and practice of risk behavior for hypertension.
Methodology: This community based comparative study was carried out in the city of Port Harcourt and a rural community that is about sixty minutes driving distance from the heart of Port Harcourt. The study sample comprised of two hundred rural participants and two hundred urban participants aged between 15 years and 84 years. They were recruited through a multi-stage sampling technique. A standard questionnaire was used to elicit information from participants on socio-demographic variables, lifestyle, cognitive skills as well as blood pressure and anthropometric measurements.
Results: The urban participants (60.0%) had a better knowledge of what hypertension is compared with the rural participants (56.5%). The difference however was not significant. In the two study areas, the females had better knowledge of hypertension than males.
The correct knowledge of smoking 53.7% rural and 51.6% in the urban, alcoholic indulgence 58.1% rural and 57.8% urban, and physical inactivity 30.5% rural and 39.7% in the urban as risk behaviors for hypertension were more in the rural area except for physical inactivity which was better in the urban area. The difference was also not significant.
In comparing practice of risk behaviors for hypertension, proportionally more rural participants
smoked (8.4%) compared with (2.6%) in the urban area. The difference was not significant. Much more males smoked compared with females. More urban dwellers drank alcohol (25.5%) compared with (23.5 %) in the rural area.
The blood pressure status as classified according to WHO/ISH criteria showed that they were similarly distributed in all levels of blood pressure except for optimal blood pressure category which was seen to be significantly higher in the rural area (chi square 5.84, p=0.0). In the study, there were 27.0% (27.3% for males and 26.7% for females) rural and 29.0% (29.5% males, 28.6% females) urban respondents with hypertension. The males in both sites had the higher prevalence. There was no significant difference in the prevalence of hypertension in the two sites. The prevalence of hypertension was 40.0% among smokers in rural and 25.0% among smokers in the urban area. The prevalence of hypertension among alcohol drinkers was 34.0% in the rural and 39.2% in the urban area. This difference was also not significant. Of the total number that were consumers of excess oil in their diet, 21.3% rural and 22.0% urban had hypertension. While 20.2% rural and 19.1% urban of respondents that consume additional salt at the table had hypertension.
There were 62.5% of rural hypertensives and 37.5% of urban hypertensives who were completely physically inactive. A total of 38.4% of rural hypertensives were aware of their hypertension status while 25.7% of urban hypertensives were aware of their hypertension status. There was a prevalence of 27.0% hypertension in the rural area while in the urban it was 29.0%. There was no significance difference in the prevalencs. The mean SBP and DBP showed similar pattern for rural in comparison with the urban area.
The mean SBP for the rural sample was (128.57 ±21.71mmHg), while urban was marginally higher (129.38±16.81mmHg). The difference was not statistically significant. The mean DBP of the rural sample was (81.38±16.81mmHg) and that of the urban was (81.57± mmHg).
Among the urban dwellers, the mean SBP was observed to increase steadily with increasing BMI from (120.83±14.28mmHg) in those who were under weight (BMI ˃ 18.50 kg/m2) to (133.44±17.21mmHg) in those with BMI = 25-29.99kg/m2 and then decrease to (126.03±19.0mmHg) in obese individuals. The mean DBP also increased steadily with increasing BMI from (80.83±11.14mmHg) in respondents who were under weight (BMI˃18.50kg/m2) to (84.15±14.40mmHg) in those with (BMI 25-29.99kg/m2) then decreased to (78.13±12.43mmHg) in obese individuals.
Conclusions: In this study, there was no variation in blood pressure status, knowledge and practice of risk behavior for hypertension between the rural and urban area. It may well be said that the rural-urban difference in blood pressure status is disappearing as previously determined by Ekpo et al.

BLOOD PRESSURE STATUS, KNOWLEDGE AND PRACTICE OF RISK BEHAVIORS FOR HYPERTENSION: A COMPARATIVE STUDY OF URBAN AND RURAL COMMUNITIES IN RIVERS STATE