Hypertension And Obesity In Nigeria: A Cross-Sectional Essay Study." (70 Characters)

1. Despite most research proposals asking you to state the aims and objectives of the proposed project many people are unclear regarding the difference between the two. Briefly:
• Aims are broad; objectives are narrow
• Aims are general; objectives are specific
• Aims are long term; objectives are short term
• Aims cannot be measured; objectives can be measured

2. Once you have written your SMART objectives, it is good to test them, either with other members of the project team or with stakeholders on the project. Test the SMART-ness of your objectives by asking the following questions:
• What exactly is going to be done? (SPECIFIC)
• Is the intended outcome clear? (SPECIFIC)
• How will we know we have achieved the outcome? (MEASURABLE)
• Can it be done in the proposed timeframe? (ACHIEVABLE)
• Can it be done with the available resources? (ACHIEVABLE)
• Is it even possible?! (ACHIEVABLE)
• Will it contribute to current knowledge in that field (RELEVANT)
• Will it address a timely and important question? (RELEVANT)
• When will it be accomplished? (TIMELY)
 

The Prevalence of Hypertension and Obesity in Nigeria

Irrespective of the 40 years of the research, there actually is not clear evaluation & the analysis on the hypertension in Nigeria. This research has studied the information from the findings which were cross sectional on the matter and topic. There are multiple articles which were identified for starting this research and they were methodically evaluated. The information was taken from studies which described hypertension as blood pressure more than the 95^th Percentile of age, height and sex provided the occurrence of the 8.3% for hypertension and 5.2% for prehypertension. For the studies which referred to hypertension as BP more than 2 SD points from the mean of the inhabitants, occurrence of the hypertension was identified as 4%. The burden globally that hypertension is increasing and the burden of another disease as well is related to the increase in the blood pressures. It is presently measured that hypertension impacts total 1 billion people across the world. Hypertension is a source of worry due to the mortality and morbidity conditions as well as because it starts in the childhood or in adult life only. With response to this reality, it is always advised that blood pressures are routinely evaluated in adults. It is very significant in the financially developing countries like Nigeria where the medial conditions are also focused on the transferrable diseases like malaria and tuberculosis etc. From the time the publication of the study of hypertension in adults aged from 18 to 30 years, there were researches which displayed the result of hypertension to be 0.1 to 17.6% in adults. Nevertheless, there have been the present reviews for the patterns of BP in Nigerians. They either are obese and that is how they have BP or they have hypertension. Within adults, the occurrence of obesity rises up in the men more than in women. The occurrence of obesity in African Americans is 1.4 times higher than the White people and Mexican Americans. The socio economic and the demographic conversions that occur in the countries that are developing actually add up to the escalation of the obesity in spite of the continuation of the nutritional deficiencies. This is actually the double burden that puts burden on the health and economic challenges in the populations where there are fewer resources. In the year 1998, the occurrence of obesity in the world which is still developing like Nigeria, it increased from 2.3 to 19.8% within 10 years of time (V 2014). The rate of Obesity has been increasing since 1980s in the areas like Middle East, Pacific Islands and Australia and China. In addition to this, the occurrence of the people and children being overweight has also risen up all across the world wherever the data is obtainable. This disease is not considered as the disease anymore in the developing countries due to people’s high socio economic status groups. The burden of being overweight shifts towards the groups with less socio economic status as the gross products of the country rises.

Risk Factors for Hypertension and Obesity in Nigeria

The major goal of the research is to send the recommendations of the health specialists and the policy makers for apt policies and discussions for the public in order to make them control their weight on the right time (Kotchen 2010). This way they can easily get rid of the risks that are related to the old age and the impacts which display the pessimistic effects of obesity on the health of the adults. The key aim of the research is to experiment and display the relation in between the obesity in adults and hypertension especially in Nigeria. Also, the other aim of the research is to give the structure which is planned and has the explanation of the procedures which are to be commenced for obtaining the aims with the option of having the apt funding resource for the outcomes of the research and also in assisting the study of the research. 

The collection of the data is done with the usage of the very structured questionnaire that gives the knowledge on the socio demographic features of the participants, history of Hypertension and obesity. This was the questionnaire which was presented on a very trivial group of public and the alterations are made as aptly as they can be (Amole 2011). The doctors who are trained on the aims of the screening and the application of the study tools were sued as the assistants in the research. For the measurements of blood pressure, the apt size cuffs were being used for every participant and the blood pressure was evaluated in every 2 minutes with the usage of the standardized mercuric column Sphygmomanometer. 

The research was actually done on the patients of the clinic of the Baptist Medical Center in Ogbomosho in the year 2008 in July. That particular hospital was a 200 bed mission hospital which provides the initial and the secondary care in health. It was in reality the referral center for every hospital in Ogbomosho (Olorun 2011). The key goal of the analysis was to identify occurrence of Hypertension & the obesity rendering to WC & also if there is any connection between the both.

A survey which was cross sectional and descriptive was used for this method. The participants who actually gave the consent were aged 18 years and older because the study which was to be done was in adults. The pregnant females and females in puerperium and the patients who had ascites or intrabdominal masses were not involved in this study. A very systematic way was actually being used for the selection of the applicants. The list of the patients who had engagements at the hospital were taken to frame the example & then from the records, review was taken as the average of 100 patients which was estimated to attend the clinic every day while in the period of study. A fraction of 10 for the sampling was taken and as per the sampling method which was simple and random, the very first subject from each 10 patients on the register was actually selected by the researchers so that they could participate.   The sticker of the identification was placed on the record cards of the participants who were selected at the office where records were kept and then they were sent to the consulting office which was elected for the further research.  The subjects who were selected were then screened and those people who met the criteria of inclusion were actually recruited for the further research on the acquisition of the informed consent.

Relationship between Hypertension and Obesity in Nigeria

The sticker which was used for the identification on each card of the participant till the study got completed for ignoring the repeat selection. This method of sampling produced 400 participants on the whole whose age were 18 years and above. The demographic knowledge such as age, ethnic groups, occupation, physical activity, gender, religion, education and family history of hypertension and also the eating habits of the family were achieved via pre tested questionnaire.

WC in centimeters was calculated with the help of flexible and non stretchable tape calculations, and at the middle point in between the lower rib border and the iliac crest in the end of expiration instead participants were standing up righty. The weight of the abdomen was referred as a WC in between 94 cm and 101 cm for males and in between 80 cm and 87 cm for females whereas abdominal obesity was defined as WC ≥ 102 cm and ≥ 88 cm for males’ and females respectively.

The blood pressure was calculated with the usage of the Accoson Dekamet Mercury sphygmomanometer with the apt cuff size and a Littmann stethoscope. Blood pressure was calculated in the right side arm just after 15 minutes of the test and whereas the participants were sitting down. The cuff which was approx 12.4 cm wide was applied consistently and cozily around the arm with the lower edge 2.5 cm and above the antecubital fossa. The thigh Cuff which was about 15 cm wide was being used for the subjects who were obese. The cuff was exaggerated suddenly to about 30mmHg above the level at which the radial pulse was absolutely no longer palpable pursued by the slow devaluation. The researcher paid attention with the stethoscope over the brachial artery in the antecubital fossa whereas devaluating the cuff. In total 3 readings minimum 2 minutes apart were obtained for every subject and the mean of the 2^nd and 3^rd readings were used for the further study (Adamu, Makusidi and Chijioke 2014). The systolic force was in used as first-stage sound of Korotkoff and diastolic force was considered as fifth-stage sound of Korotkoff. The experiential rate was evaluated to being near about 2 mmHg. Hypertension was prominent if systolic blood pressure went beyond 140 mmHg or diastolic blood pressure went beyond 90 mmHg. Also upon self-report of a medical analysis of hypertension or present action for hypertension with instruction medicine.

The participants who were involved in the 30 min. leisure physical activity  like walking, training of fitness or any other sports had at least three times every week were considered as the physically active people. These people just cannot have the sedentary lifestyle. This meant that their body had a movement in every day and such people are not usually obese as much as people with sedentary lifestyle are.

Socio-Economic and Demographic Factors Contributing to Hypertension and Obesity in Nigeria

Then the participants were divided with respect to the social classes. These social classes were based upon their field of work and it was as per the Registrar General Scale of social classes. Some of the classifications are as follows:

Class 1: This class had the professionals like Lawyers, charted accountants or the doctors.

Class 2: This class had intermediates like the teachers, all types of managers or leaders and nurses etc. (Akinlua, et al. 2015).

Class 3N: This class had talented non Manual work people like the clerks, assistant of the shop, typists or the operators (telephonic or otherwise) etc.

Class 3M: This class had talented manual people like people who worked in mines, drivers of the bus, chefs or any type of artists etc.  

Class 4: This class had talented manual people who were only talented partly. Like workers of the farm or the conductors in the bus etc.

Class 5: This class consisted of the people who were not skilled at all like the cleaners and the laborers.

The data was evaluated with the package which was statistical for the social sciences.

All participants who were present were given the information about the screening exercise, the benefits of it and the probable harms too. They were also given the information about the use of information and the data which was obtained for the research purpose and the consent of the participants were obtained (Ejike 2017). After then every participant was given the copy the copy to sign which displayed that the participants were ready to get involved in the research trails. Every one of them were given the chance to request for the outcome from the researchers and people who were evaluated with high blood pressures, albuminuria and high blood sugar were also immediately referred to the medical department of the Usmanu Danfodiyo University Hospital in Sokoto so that they could be studies further. The participants were also given the knowledge about their rights of withdrawing their consent at any time to be the part of the research and that will not even have any negative effect on them. This study was totally taken further with all the ethical considerations keeping in mind and the same was given a green sigh by ethical review board. 

The research was of long time study and that was what could be considered as the limitation of this research. 40 Years is actually a very long duration and it becomes really tough for the researchers to follow the people who were taking part in the study. Then there was one another limitation which was that the people who were fat at the starting of the research might lose weight after some years and might not fall under the group of being fat at all.  Similarly, just the opposite may have happened with the people who were not obese. People definitely were very tough to track for 20 years straight and the study was costly as well.

Methodology of the Study

The major effects of the research were predicted to be helpful for controlling the issue of obesity and hypertension within the adults so that they could have their normal life back and can live healthily. If obesity will be found linked with hypertension in adults, it could help the Nigerian government to renew the policies after discussing them with the health experts and reduce the issue if obesity and hypertension. The new policies could involve motivating the adults to move their bodies and lead an active lifestyle and do some more physical activities. The control of obesity in adult stage may help to reduce other related diseases like diabetes and cardiovascular diseases (Ajayi, et al. 2016). 

For this research, the Nigerian Government gave the permission to the researchers to be a part of this research and also allow to involve people from the hospital after having their informed consent. The ethical review board was also involved just to make sure that the research was being done keeping all the ethical considerations in mind.

References 

Adamu, Habibullah, Muhammadu A. Makusidi, and Adindu Chijioke. 2014. "Prevalence of Obesity, Diabetes Type 2 and Hypertension among a Sampled Population from Sokoto Metropolis-Nigeria." British Journal of Medicine & Medical Research 4 (10).

Ajayi, Ikeoluwapo O, Ibukun Opeyemi Sowemimo, Onoja Matthew Akpa, and Ndudi Edmund Ossai. 2016. "Prevalence of hypertension and associated factors among residents of Ibadan-North Local Government Area of Nigeria." Nigerian Journal of Cardiology 13 (1): 67-75.

Akinlua, James Tosin, Richard Meakin, Aminu Mahmoud Umar, and Nick Freemantle . 2015. "Current Prevalence Pattern of Hypertension in Nigeria: A Systematic Review." PlosOne 10 (10).

Amole, Isaac O. 2011. "The prevalence of abdominal obesity and hypertension amongst adults in Ogbomoso, Nigeria." African Journal of Primary Health Care & Family Medicine 3 (1).

Chukwuonye, Innocent Ijezie. 2013. "Prevalence of overweight and obesity in adult Nigerians – a systematic review." Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 6: 43-47.

Ejike, Chukwunonso E.C.C. 2017. "Prevalence of Hypertension in Nigerian Children and Adolescents: A Systematic Review and Trend Analysis of Data from the Past Four Decades." Journal of Tropical Pediatrics 63 (3): 229–241.

Kotchen, Theodore A. 2010. "Obesity-Related Hypertension: Epidemiology, Pathophysiology, and Clinical Management." American Journal of Hypertension 23 (11): 1170-1178.

Olorun, AD. 2011. "Prevalence of obesity and hypertension among adults in Ogbomoso, Nigeria." Internet Journal of Medical Update 6 (2): 9-14.

V, Iruegbukpe. 2014. "The Effects of Obesity on Hypertension: Does Increase in Body Mass Index Equates Persistent and Poor Control of Hypertension in Nigeria?" International Invention Journal of Medicine and Medical Sciences 1 (5): 60-64.