CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Hypertension, commonly referred to as high blood pressure, is a major public health concern because of its contribution to cardiovascular diseases, stroke, kidney disease and premature mortality. It occurs when the pressure of blood against the walls of the blood vessels remains persistently elevated, increasing the workload of the heart and potentially damaging vital organs. According to the World Health Organization (WHO, 2025), an estimated 1.4 billion adults aged 30–79 years were living with hypertension worldwide in 2024, representing approximately 33% of the population in that age group. The WHO further reports that a substantial proportion of affected individuals remain unaware of their condition, partly because hypertension may not produce noticeable symptoms in its early stages. This makes awareness, regular blood pressure measurement and appropriate preventive practices important components of hypertension control. Consequently, understanding what people know about hypertension and how they respond to its risk factors is essential for developing effective public health interventions.

Hypertension is particularly important in low- and middle-income countries, where the burden of non-communicable diseases intersects with challenges relating to healthcare access, health education, diagnosis and long-term treatment. The WHO (2025) estimates that approximately two-thirds of adults aged 30–79 years with hypertension live in low- and middle-income countries. In Nigeria, the WHO’s 2025 hypertension profile estimates that 32% of adults aged 30–79 years were living with hypertension in 2024, corresponding to approximately 22 million people. The profile also indicates that only about 13% of adults in this age group with hypertension had their blood pressure controlled. These figures demonstrate the continuing importance of hypertension prevention, early detection and appropriate management in Nigeria. They also highlight the need to investigate knowledge and preventive practices among occupational groups whose working conditions may create practical barriers to maintaining healthy lifestyles and accessing routine health services.

Commercial drivers constitute an occupational group whose daily activities may involve prolonged sitting, extended working hours, irregular meal schedules, traffic-related stress and limited opportunities for planned physical exercise. Depending on their routes and working arrangements, some drivers may frequently purchase meals from roadside vendors and have limited time for routine medical examinations. These circumstances may influence their exposure to lifestyle-related risk factors associated with hypertension, although the experiences of individual drivers can differ considerably. A Nigerian study of intra-city commercial motor vehicle drivers reported a hypertension prevalence of 36.2% among its participants and identified high levels of physical inactivity and alcohol consumption within the study population. The findings demonstrate that cardiovascular risk factors are relevant to the health of commercial drivers and support the need for occupationally focused health research. However, the findings from that study should not automatically be generalised to all commercial drivers in Lagos State because occupational conditions and participant characteristics may vary across locations.

Knowledge of hypertension includes understanding what the condition is, recognising its risk factors, knowing that it may occur without obvious symptoms and appreciating the importance of blood pressure screening and appropriate medical care. Such knowledge can help individuals recognise the need for preventive measures and make informed decisions about their health. The WHO (2025) identifies several modifiable risk factors, including excessive salt consumption, unhealthy diets, physical inactivity, tobacco use, harmful alcohol consumption and overweight or obesity. It also identifies non-modifiable factors such as increasing age and family history. For commercial drivers, knowledge of these factors may be particularly relevant because work-related routines can affect eating patterns, opportunities for exercise and access to health information. Nevertheless, possessing accurate information does not necessarily mean that an individual will consistently practise healthy behaviours, making it important to examine knowledge and preventive practices as related but distinct aspects of hypertension prevention.

Preventive practices regarding hypertension involve behaviours and health actions that can reduce the risk of developing high blood pressure or support its control among individuals who have already been diagnosed. These practices include reducing excessive salt intake, consuming a balanced diet, engaging in regular physical activity, maintaining a healthy body weight, avoiding tobacco, limiting alcohol consumption and attending appropriate health checks. The WHO (2025) recommends lifestyle modifications as important measures for preventing and managing hypertension and emphasises that people with the condition may also require medication prescribed by a qualified health professional. Among commercial drivers, adopting these practices may require adjustments to daily routines, including making healthier food choices while travelling, finding opportunities for physical activity and arranging periodic blood pressure checks. Examining such behaviours can therefore help determine whether drivers’ health knowledge is reflected in their everyday practices and identify areas where targeted health education or workplace-based interventions may be useful.

Evidence from Nigeria also indicates that health education can be relevant to improving hypertension-related knowledge and preventive behaviour. A quasi-experimental study involving pre-hypertensive traders in selected markets in Lagos State examined the effect of a health education intervention on participants’ hypertension knowledge, motivation and preventive practices. The study reported significant improvements in these measures in the intervention group following the programme. Although traders and commercial drivers have different occupational routines, the findings provide a useful local indication that structured health education may help address gaps in knowledge and prevention-related behaviour. They also support the importance of examining whether commercial drivers receive adequate hypertension information and whether they practise behaviours that may reduce their risk. The present study will focus specifically on commercial drivers in selected motor parks rather than assuming that findings from market traders necessarily apply to the transport sector.

Lagos State provides a relevant setting for investigating hypertension knowledge and preventive practices among commercial drivers because of its extensive road transport activities and the presence of motor parks serving different routes and passenger needs. Drivers operating from different parks may vary in age, educational background, years of driving experience, working hours, health-service access and exposure to health information. Such differences may influence their understanding of hypertension and their ability to adopt preventive practices. A 2026 study of commercial drivers in Ondo West Local Government Area also examined nutrition knowledge and elevated blood pressure among drivers recruited from four motor parks, demonstrating the relevance of studying occupational health within the motor-transport environment. However, findings from Ondo State cannot be treated as evidence of the knowledge or practices of drivers in Lagos State. It is therefore necessary to conduct a study among drivers in selected Lagos motor parks to establish their level of hypertension knowledge, assess their preventive practices and identify areas requiring health education and other appropriate interventions.

1.2 Statement of the Problem

Hypertension remains an important public health challenge because it can lead to serious complications, including heart disease, stroke and kidney damage, while frequently producing no noticeable symptoms during its early stages. The WHO (2025) reports that many people living with hypertension are unaware of their condition, making routine blood pressure measurement and appropriate health information essential for prevention and early detection. In Nigeria, the WHO’s 2025 hypertension profile estimates that approximately 22 million adults aged 30–79 years were living with hypertension in 2024, while only about 13% of affected adults had their blood pressure controlled. These figures highlight the importance of strengthening hypertension awareness and preventive practices. Among commercial drivers, inadequate knowledge or limited engagement in preventive health behaviours could make it more difficult to recognise risk factors and seek timely screening or care.

Commercial drivers may experience occupational conditions that complicate the adoption of healthy practices. Long periods of sitting, demanding schedules, traffic congestion, irregular meals and limited time away from work may affect opportunities for physical activity, healthy eating and routine medical examinations. Research involving intra-city commercial motor vehicle drivers in Nigeria documented hypertension alongside several cardiovascular risk factors, including physical inactivity and alcohol consumption. These findings indicate that cardiovascular health deserves attention within the commercial transport workforce. However, evidence from one driver population does not establish the level of hypertension knowledge or the preventive practices of commercial drivers working in selected motor parks in Lagos State. This creates a need for research that examines the specific circumstances and health-related behaviours of drivers in the study area.

Another concern is that awareness of hypertension does not necessarily translate into consistent preventive practices. A driver may know that excessive salt intake, physical inactivity, tobacco use or harmful alcohol consumption can contribute to hypertension but still find it difficult to change these behaviours because of work routines, financial limitations, food availability or other circumstances. The WHO (2025) recommends lifestyle modifications and regular blood pressure checks, while Nigerian intervention research among traders in Lagos has reported improvements in hypertension knowledge and preventive practices following health education. Nevertheless, the extent to which commercial drivers in selected motor parks possess relevant knowledge and practise recommended preventive measures remains a separate empirical question. It is therefore important to assess both what drivers know about hypertension and the actions they take to prevent or manage it.

The problem addressed by this study is the need for specific evidence on knowledge and preventive practices regarding hypertension among commercial drivers in selected motor parks in Lagos State. In particular, there is a need to determine drivers’ level of knowledge, assess their adoption of preventive behaviours, examine the relationship between knowledge and preventive practices, and identify barriers that may hinder effective prevention. Without such information, health education and screening initiatives may not adequately address the occupational realities and specific information needs of commercial drivers. The study will therefore investigate these issues to generate findings that may assist relevant health professionals, transport associations and public health stakeholders in planning appropriate hypertension awareness and prevention activities for drivers in the selected motor parks.

1.3 Purpose of the Study

The main purpose of this study is to assess knowledge and preventive practices regarding hypertension among commercial drivers in selected motor parks in Lagos State.

1.4 Objectives of the Study

The specific objectives are to:

1. Assess the level of knowledge regarding hypertension among commercial drivers in selected motor parks in Lagos State.
2. Examine the preventive practices adopted by commercial drivers to reduce the risk of hypertension.
3. Determine the relationship between knowledge of hypertension and preventive practices among commercial drivers in the selected motor parks.
4. Identify the factors that hinder commercial drivers from adopting appropriate hypertension preventive practices.

1.5 Research Questions

The following research questions will guide the study:

1. What is the level of knowledge regarding hypertension among commercial drivers in selected motor parks in Lagos State?
2. What preventive practices do commercial drivers adopt to reduce the risk of hypertension?
3. What relationship exists between knowledge of hypertension and preventive practices among commercial drivers in the selected motor parks?
4. What factors hinder commercial drivers from adopting appropriate hypertension preventive practices?

1.6 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no statistically significant relationship between knowledge of hypertension and preventive practices among commercial drivers in selected motor parks in Lagos State.

1.7 Significance of the Study

The findings of this study are expected to be beneficial to commercial drivers, healthcare professionals, transport associations, government agencies, public health educators and researchers.

Commercial Drivers: The study may help commercial drivers understand the importance of hypertension awareness, early detection and preventive health practices. By identifying knowledge gaps and barriers to prevention, the findings may encourage drivers to pay greater attention to blood pressure screening, healthy eating, physical activity and other appropriate preventive measures.

Healthcare Professionals: The findings may provide useful information for healthcare professionals involved in hypertension prevention, health education and screening. Understanding the knowledge and practices of commercial drivers may help them develop health education messages and screening activities that are appropriate to drivers’ occupational routines and health needs.

Transport Associations and Motor Park Authorities: The study may help transport associations and motor park authorities understand the health-related challenges experienced by their members. The findings may encourage the organisation of health awareness campaigns, periodic blood pressure screening and other appropriate health promotion activities within motor parks.

Government and Public Health Agencies: The findings may assist relevant government agencies and public health authorities in planning hypertension prevention initiatives for occupational groups. The study may provide information that can contribute to the development of health promotion strategies targeting commercial drivers and other transport workers.

Public Health Educators: The study may help health educators identify areas where commercial drivers require additional information concerning hypertension, its risk factors, possible complications and preventive practices. Such information may support the development of educational materials and interventions that address drivers’ specific needs.

Researchers and Students: The study may contribute to the existing body of knowledge on hypertension awareness and preventive practices among occupational groups in Nigeria. It may also serve as a reference for students and researchers undertaking further studies on hypertension, occupational health and health-promoting behaviours.

1.8 Scope of the Study

The study focuses on knowledge and preventive practices regarding hypertension among commercial drivers in selected motor parks in Lagos State, Nigeria.

Geographical Scope: The study will be conducted in selected motor parks in Lagos State. The specific motor parks will be identified based on their relevance to the research objectives, accessibility and the presence of eligible commercial drivers.

Content Scope: The study will examine the following areas:

• Knowledge of hypertension, including its meaning, risk factors, symptoms, complications and prevention.
• Preventive practices adopted by commercial drivers, including dietary habits, physical activity, blood pressure screening and other relevant health behaviours.
• The relationship between hypertension knowledge and preventive practices.
• Factors that may hinder commercial drivers from adopting appropriate preventive practices.

Population Scope: The study will focus on commercial drivers operating from the selected motor parks. Eligible participants will be determined according to the inclusion criteria established for the research.

1.9 Operational Definition of Terms

Knowledge of Hypertension: This refers to the level of understanding commercial drivers have regarding hypertension, including its meaning, risk factors, possible complications, detection and prevention, as measured by the study instrument.

Preventive Practices: These refer to the health-related behaviours adopted by commercial drivers to reduce their risk of developing hypertension or to support blood pressure control. Such behaviours may include healthy dietary choices, physical activity, blood pressure screening and avoidance of tobacco.

Hypertension: This refers to persistently elevated blood pressure. For this study, the WHO clinical definition of hypertension in adults—systolic blood pressure of 140 mmHg or higher and/or diastolic blood pressure of 90 mmHg or higher, confirmed through appropriate measurements—will provide the clinical reference point.

Commercial Drivers: These are individuals who operate motor vehicles to transport passengers or goods for financial reward as part of their occupation.

Motor Parks: These are designated locations where commercial vehicles assemble to pick up and drop off passengers, load goods or organise transport services.

Risk Factors: These refer to characteristics, conditions or behaviours that increase the likelihood of developing hypertension, including excessive salt consumption, physical inactivity, overweight or obesity, tobacco use and harmful alcohol consumption.

Blood Pressure Screening: This refers to the measurement of blood pressure to identify individuals who may have elevated readings and require further assessment by a qualified healthcare professional.

Health Education: This refers to organised communication and learning activities designed to improve individuals’ understanding of health conditions and encourage informed health-related decisions and behaviours.