Background: A substantial increase in the incidence of chronic non-communicable
diseases (NCDs) and a decline in communicable diseases and poverty-related
diseases are occurring in developing countries (including Nigeria) as a result of an
epidemiological transition. Given the burden and poor outcomes of NCDs related to
hypertension or high blood pressure (BP) in adulthood, there is an urgent need for the
identification of high risk individuals in early life. High BP has already been reported
amongst young people worldwide, including Nigeria. High BP in childhood is predictive
of high BP in adulthood. There is very little information available on the distribution of
blood pressure in children and adolescents, and the factors which determine its
distribution in Nigeria.
Objectives: To determine the association between: socio-economic characteristics and
blood pressure, pubertal maturation status and blood pressure, and anthropometric
measures of adiposity and blood pressure in children and adolescents in Nigeria; and
also to determine the overall prevalence of hypertension in the population of secondary
school aged children and adolescents in Nigeria.
Methods: A school-based stratified randomised cross-sectional survey of students
aged 11 to 18 years was carried out in the urban area of Lagos, Nigeria. Blood
pressure, body weight, height and waist measurements of the participants were
obtained. A self-complete validated questionnaire was used to obtain sociodemographic
information, health-related information, socio-economic characteristics
(including living circumstances and parent/carer education level) and pubertal
maturation status of the participants. Data analysis was carried out using descriptive
statistics and multiple regression analysis.
Results: 1086 students (538 males and 548 females) participated in the study, giving a
total response rate of 90.5%. The overall mean systolic and diastolic blood pressure
was 105.23±12.63mmHg and 57.87±8.09mmHg, respectively. The overall prevalence
of hypertension was 2.5%. Socio-economic characteristics, pubertal maturation status,
body mass index and waist circumference were statistically significantly associated with
systolic and diastolic blood pressure (p<0.05).
Conclusion: This study suggests that the epidemiological transition exists and is
having measurable effects in school children in Nigeria. The findings highlight the
presence of hypertension, and also the need for investigation of factors associated with
blood pressure in children and adolescents so as to guide health policy, public health
preventive interventions and health practice for child and adolescent hypertension. This
study has long term implications for an extra burden of chronic non-communicable
diseases related to hypertension in Nigeria.