Project – Awareness and Management of Hypertension among Adults Attending Primary Health Centres in Uyo

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Hypertension, commonly referred to as high blood pressure, is a major public health concern worldwide. It is a chronic medical condition characterized by persistently elevated arterial blood pressure, which increases the risk of cardiovascular diseases, stroke, kidney failure, and premature death (WHO, 2023). Globally, an estimated 1.28 billion adults aged 30–79 years suffer from hypertension, with two-thirds living in low- and middle-income countries. Despite its high prevalence, hypertension often remains undiagnosed or inadequately managed due to its asymptomatic nature, earning it the nickname “the silent killer” (World Hypertension League, 2022).

In Nigeria, hypertension has emerged as one of the leading causes of morbidity and mortality. According to the Nigerian National Non-Communicable Disease (NCD) survey, about 33% of Nigerian adults have elevated blood pressure, yet only a small fraction are aware of their condition or have it under control (Oguoma et al., 2018). Urbanization, sedentary lifestyles, poor dietary habits, obesity, and genetic predisposition contribute significantly to the rising prevalence of hypertension in Nigeria (Akinlua et al., 2015).

Awareness and effective management of hypertension are critical in preventing its complications. Awareness refers to individuals’ knowledge of their hypertensive status, risk factors, and the consequences of uncontrolled blood pressure. Management encompasses lifestyle modifications (such as reduced salt intake, regular physical activity, weight management, and avoidance of alcohol and tobacco) as well as adherence to prescribed antihypertensive medications. Studies have shown that lack of awareness, poor knowledge, and non-adherence to treatment significantly contribute to uncontrolled hypertension, increasing the risk of cardiovascular complications and mortality (Ibrahim & Damasceno, 2012).

Primary Health Centres (PHCs) play a pivotal role in hypertension control in Nigeria by providing accessible healthcare services for early detection, continuous monitoring, patient education, and treatment. PHCs are particularly important in urban and semi-urban areas, where the burden of hypertension is high and healthcare-seeking behaviors vary (Akinlua et al., 2015). In Uyo, the capital of Akwa Ibom State, adults routinely visit PHCs for preventive care, chronic disease management, and health education programs. However, the level of awareness and management of hypertension among adults attending these facilities remains unclear, and data on patient knowledge, lifestyle practices, and adherence to treatment are limited.

A growing body of research emphasizes that hypertension control is closely linked to patient education and awareness. Adults who are informed about the risk factors, complications, and importance of adherence to treatment are more likely to adopt healthy behaviors and maintain blood pressure control (Adeyemo et al., 2020). Conversely, inadequate awareness and poor management practices contribute to poor health outcomes, increased hospitalization, and healthcare costs.

Therefore, it is crucial to assess both the awareness and management practices of hypertension among adults attending PHCs in Uyo. Such an assessment will provide evidence for strengthening health education programs, improving adherence to treatment, and designing community-based interventions to reduce the burden of hypertension in the area.

1.2 Statement of the Problem

Hypertension is a major contributor to cardiovascular morbidity and mortality in Nigeria. Despite ongoing public health interventions and the availability of healthcare services at PHCs, many adults remain unaware of their hypertensive status or fail to manage the condition effectively. The consequences of uncontrolled hypertension include stroke, heart failure, renal failure, and premature death.

In Uyo, anecdotal evidence and hospital records suggest that hypertension is prevalent among adults attending PHCs. However, there is limited empirical data on the level of awareness, knowledge, and management practices of hypertension within this population. Many adults may not routinely monitor their blood pressure, may fail to adhere to prescribed medication regimens, or may be unaware of lifestyle modifications that help control hypertension.

Factors contributing to poor awareness and management may include low health literacy, socioeconomic constraints, cultural beliefs, limited health education, and inadequate patient follow-up. Additionally, PHCs may face challenges in providing consistent hypertension education, counseling, and monitoring due to staffing, infrastructure, or resource limitations.

Without a clear understanding of awareness and management practices, policymakers and healthcare providers cannot design effective interventions to reduce hypertension-related complications. There is a need to investigate the level of awareness, management strategies, and associated factors among adults attending PHCs in Uyo to guide public health strategies and improve cardiovascular health outcomes.

1.3 Objectives of the Study

The general objective of this study is to assess the awareness and management of hypertension among adults attending Primary Health Centres in Uyo.

The specific objectives are to:

1. Determine the level of awareness of hypertension among adults attending PHCs in Uyo.
2. Assess the knowledge of risk factors, complications, and preventive measures of hypertension among adults.
3. Evaluate the management practices of hypertension, including medication adherence and lifestyle modifications.
4. Identify socio-demographic and behavioral factors influencing awareness and management of hypertension.
5. Provide recommendations for improving awareness, management practices, and health education programs in PHCs.

1.4 Research Questions

1. What is the level of awareness of hypertension among adults attending PHCs in Uyo?
2. What is the level of knowledge about the risk factors and complications of hypertension?
3. How do adults manage hypertension in terms of medication adherence and lifestyle modification?
4. What socio-demographic and behavioral factors influence awareness and management practices?
5. What strategies can improve awareness and management of hypertension in PHCs?

1.5 Research Hypothesis

H₀ (Null Hypothesis):
There is no significant relationship between awareness of hypertension and management practices among adults attending Primary Health Centres in Uyo.

1.6 Significance of the Study

This study is significant for several reasons:

• Healthcare Providers: It will provide data to improve patient counseling, monitoring, and follow-up at PHCs.
• Public Health Authorities: Findings will inform policies and health education programs aimed at reducing hypertension-related complications.
• Community Members: It will enhance awareness about hypertension, promote healthy lifestyle choices, and encourage adherence to treatment.
• Researchers: It will contribute to literature on hypertension awareness and management in urban Nigerian populations.

1.7 Scope of the Study

This study focuses on adults aged 18 years and above attending selected Primary Health Centres in Uyo. It examines their awareness, knowledge, and management practices regarding hypertension, including lifestyle behaviors and medication adherence.

1.8 Operational Definition of Terms

• Hypertension: A condition characterized by consistently elevated blood pressure above 140/90 mmHg.
• Awareness: Knowledge of one’s hypertensive status, risk factors, complications, and the importance of treatment.
• Management: Actions taken to control blood pressure, including adherence to medication and lifestyle modifications.
• Primary Health Centres (PHCs): Local government-operated health facilities providing preventive and curative services.
• Adults: Individuals aged 18 years and above.

Project – Awareness and Management of Hypertension among Adults Attending Primary Health Centres in Uyo