evidence of elevated blood pressure among

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HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI)
Published by
HEALTH AND FITNESS ASSOCIATION OF NIGERIA
(BASED IN THE DEPARTMENT OF PHYSICAL AND HEALTH EDUCATION,
UNILORIN)
Vo2. No.1 JUNE, 2001.
Editor — in —Chief— Professor E.A Ogunsakin, Department of Physical and
Health Education, University of Ilorin, Ilorin, Kwara State, Nigeria.
Managing Editor — Dr. A.E Talabi, Department of Physical and Health Education,
University of Ilorin, P.M.B 1515, Ilorin, Kwara State, Nigeria.
Advisory Committee:
Professor L. Emiola
-
University of Ilorin.
Professor O. Oshodin
-
University of Benin.
Professor S. Jimoh
-
University of Ilorin.
Dr. S. Umoh
-
University of Ilorin.
Professor A Adewoye
-
University of Ilorin.
Dr. Danladi Musa
-
Bayero University Kano
EDITORIAL
In this first edition of the year 2001, the Health and Fitness Journal
International wishes to re-emphasize the fact that Health and Fitness are vital
and unseparable in human affairs. Given the increasingly important role that
exercise plays in health and vice versa, all exercise and health professionals need
to produce more scientifically based educational materials that will provide
wholistic exercise and health guidance to the public.
We therefore welcome contributions in all human endevours that will
make this world a healthier and fitter place.
EDITOR-IN- CHIEF
Prof. Ogunsakin
VOLUME 2 NO. 1 2001
ARTICLES
1.
CONTENTS
PAGES
Emotional Problems of Parents and its Implications on The
health and Education of the Girl-Child - Kajang Yakubu Gorak
2.
Evidence of Elevated Blood Pressure Among Secondary School
Students in Ilorin. -Olaitan, O. ‘Lanre
3.
6
14
Effect of Sleep Deprivation on Cardiorespiratory Fitness
Performance of Physical and Health Education Students.
- Musa Muhammed Ogidi
20
4.
Perception of Aging and Death.- Onifade, O. A.
5.
Perceived Factors Associated With Malnutrition and The Implications
on The Health of Children - Audu Andrew Jatau
6.
42
Provision of Recreation and Fitness Programmes in Industries
Okey A. Umeakuka
8.
34
Student’s Perception of Campus Cultism in Higher Institutions.
- Ursula E. Nnabueze
7.
26
51
Effects of Continuous and Circuit Training Programmes On Aerobic
Capacity of Female Undergraduates in Bayero University, Kano.
- Sadiq Ismaila
9.
56
Accidents to Children in the Home: Causes and Prevention:
The Nigerian Experience. - Amunega Stephen Bankole
63
10.
Control and Improvement of the Physical Environment Through Sanitation
Programme: Review of Conditions in Public Schools in Nigeria.
- David W. Bwala & Ibrahim A. Njodi
69
11. The Health Services Appraisal of The Students of Kwara State
School For the Handicapped, Ilorin. - Kola Lafinhan
76
EVIDENCE OF ELEVATED BLOOD PRESSURE AMONG
SECONDARY SCHOOL STUDENTS IN ILORIN
OLAITAN, O ‘LANRE
DEPARTMENT OF PHYSICAL OF HEALTH EDUCATION,
UNIVERSITY OF ILORIN
ABSTRACT
Incidence of elevated blood pressure was assessed in 296 boys and girls aged
11-18 years in form metropolis. Subjects were grouped into male and female of
ages 11-14 years and 15-18 years. Resting blood pressures were assessed using
the protocol of the American Heart Association. The result showed significant age
and sex difference in blood Pressure. Age group 15-18 (female,) had significantly
higher blood pressure than all other groups. The prevalence of hypertension
among these groups of subject was 4. 1%, which confirmed that risk factors of
hypertension could begin very early in life. The study finally made
recommendation to Health authorities, patients and government on how to
prevent /reduce risk factors of hypertension in Nigerian youths.
INTRODUCTION
Blood pressure is the pressure exerted by the blood against the walls of
the vessel. The blood pressure is highest at the time of the contraction of the
ventricles, which is called “systolic pressure”. Pressure during the ventricular
relaxation is called “diastolic pressure” and is principally the result of force
exerted by the elastic rebound of the arterial wall (Butcher et al, 1998). Even
though, blood pressure is subject to fluctuations, in general, the healthy
individual has a systolic pressure of 100 to 120 mm of mercury and diastolic
pressure of 60 to 80mm of mercury. Blood pressure is usually expressed as a
fraction, for example as 120/8OmmHg, the systolic on top and diastolic value,
below.
The World Health Organization (1977) defined hypertension as blood
pressure equal to or greater than 160/95mm1-Ig. Several studies, Harris (1987),
Webber Srinivasan
& Berenson (1993) and Lauer of Beaglehole (1984) have documented that
hypertension
may begin in childhood. It may also be caused by a number of reasons, some of
which include the following:

Parental socioeconomic status (Balogun et al 1990)

Diseases (Shaper, Pocok & Walker 1985)

Environmental stress (Musa & Lawal, 2000)

Inactivity (Armstrong & Welshman, 1997)
These studies have not only confirmed that hypertension may begin very
early in life, it also seems to be on the increase especially in Nigeria. Musa
&Lawal (2000) recorded 8.1% in Kano, Abduirahaman & Ochoga (1978) reported
3.5% for Kaduna and Balogun et al (1990) reported 4% for Ile- Ife.
Hypertension has been identified as one of the major factors involved in
the onset of Coronary Health Diseases (CHD), which is a major cause of death in
many countries (Shapper, Pocok & Walker, 1985 and Wilmore & Costill, 1994).
Framingham, Bagalusa & Muscatine (AHA,1992) identified hypertension as the
most potent antecedent of cardiovascular disease.
Even though clinical manifestations of CHD risk factors appear later in life,
recent epiderniological surveys have indicated that the underlying causes start
early in life (Webber et al 1993); American Heart Association (AHA, 1992).
Webber et al (1993) observed that those who have elevated blood pressure early
in life, stand the risk of becoming hypertensive later in life. Scores of studies
have therefore been done on both the adolescent and childhood population
(Berenson et al, 1980; Lauer and Shekelle; 1980, etc) to determine how early in
life can these underlying risk factors of CHD be identified. Several studies have
observed and documented the distribution of cardiovascular risk factors in
childhood and adolescent population in many countries (Berenson et a!, 1980
and 1984, Harris 1987 and Webberetal, 1993).
In Nigeria, Musa & Lawal (2000), Balogun et al (1990) and Eferakaye et a!
(1 982) have also carried out some studies. There is however paucity of data on
levels of blood pressure in adolescent children in Ilorin, Nigeria. The present
study was therefore designed to assess the levels of blood pressure among
secondary school students in Ilorin. This will help to identify the percentage of
the population that has elevated blood pressure. The information may be able to
aid government effort on its “Health for All” programme.
METHODS AND PROCEDURE
A total of 296 secondary school students (196 boys and 100 girls) ranging
form 11-1 8years from fifteen schools in Ilorin volunteered to participate in this
study. They were stratified into two major groups on the basis of age as follows:
11-14 years and 15-18 years and into two sub-groups on the basis of sex, i.e
male and female. Only 296 pupils completed the measurements.
BLOOD PRESSURE MEASUREMENTS
Resting blood pressure was taken between 8.00-10.OOarn each day in
accordance to the procedure described by Bonne & Zwiren (1993). There
measurements were taken in respect of each subject and the average was
recorded.
Blood pressure levels were considered elevated when they exceeded two
standard deviation (i.e. the 95th percentile) above the mean pressure of the
sample (Abdulrahaman & Ochoga, 1 978). This corresponds with significant
hypertension as defined by the report of the Second Task Force on Blood
Pressure in Children in 1987 (WHO,l987).
STATISTICAL ANALYSIS
Descriptive (mean and standard deviation) statistics were used to analyse
the data. Then t-test was used to identify where significant differences existed.
The probability of 0.05 or less was set to indicate the level of significance.
RESULTS
Subject (boys and girls) physical and blood pressure values are presented
in table I for ages 11-14 years and Table IT for age’s 1 5-18 years.
Table 1: Physical and Blood Pressure Values of Boys and Girls (age 1114 Years)
Male n = 108
Variables
Female n = 16
Mean (x)
S.D
Means (x)
S.D.
Calc. t. value
Weight (kg)
37.28
6.99
36.75
4.11
0.432
Height (M)
1.49
0.07
1.53
0.06
2.433
*
102.56
8.54
112.50
5.00
6.644
*
66.26
7.60
67.55
9.57
0.516
Systolic Blood
Pressure (mmHg)
Diastolic Blood
Pressure (mmHg)
n-124
* significant at< 0.01
Table 2: Physical and Blood Pressure Values of Boys and Girls (age 1518 Years)
Male n = 88
Variables
Female n = 84
Mean (x)
S.D
Means (x)
S.D.
Calc. t. value
Weight (kg)
41.41
6.66
47.10
7.42
5.284
Height (M)
1.55
0.09
1.57
0.06
1.722
*
108.50
9.10
114.80
10.83
4.121
*
68.82
8.87
74.10
11.67
3.33
*
*
Systolic Blood
Pressure (mmHg)
Diastolic Blood
Pressure (mmHg)
n-124
* significant at< 0.01
In all the variables measured the older students (age’s 15-18 years) (male
& female) showed higher mean values than the younger ones (age’s 11-14
years). The 15- 18 years ages group had significantly higher means values in
systolic and diastolic blood pressure for male and only diastolic for female group
than 11 -14years old age group.
Table 3: Comparison between the two age groups for both male and
female categories
Sex
Variables
Male
Systolic Blood
n = 196
Pressure (mmHg)
Diastolic Blood
11-14 yrs
15-18uyrs
Calc. t. value
102.56
108.50
4.672
66.26
68.82
2.142
*
112.50
114.80
1.337
*
67.55
74.10
2.417
*
Pressure (mmHg)
Female
Systolic Blood
n = 100
Pressure (mmHg)
Diastolic Blood
Pressure (mmHg)
n = 296
* significant at< 0.05
However in the 11-14 years group, the female group had significantly
higher weight and systolic pressure and lower diastolic pressure than their male
counterpart. In the 15-18 years age group, the female had significantly higher
values in weight, systolic and diastolic pressure than their counterparts. All these
values were significant at above 0.01 value. (Tables 1 and 2.)
ELEVATED BLOOD PRESSURE
The total number of students with elevated blood pressure for both male
and female, ages 1 1-l4years and 15 — l8years are presented in Table 4. Using
the criterion of 2 standard deviations above the mean as elevated blood
pressure, a total of 12 students out of 296 had elevated blood pressure. 4 had
elevated systolic pressure while 8 had elevated diastolic pressure.
TABLE 4: Prevalence of Elevated Blood Pressure
11-14 years
Total N
15-18 years
Total
Male
Female
Male
Female
108
16
88
84
296
0(0%)
0(0%)
0(0%)
12(14.2%)
4.05%
0(0%)
0(0%)
0(0%)
4(4.8%)
1.35%
0(0%)
0(0%)
0(0%)
8(9.5%)
2.7%
No. & % with
Elevated BP
No. & % with
Elevated SBP
No. & % with
Elevated DBP
DISCUSSION
The age gradient in weight, height, systolic and diastolic pressure found in
this study is similar with the findings of Reeds (1981), Eferakeya and Ekeocha
(1982) and Musa and Lawal (2000).
The incidence of elevated blood pressure of 4.05% found in this study
clearly confirms that underlying risk factors of hypertension can begin in very
early life, The prevalence figures of 4.05% obtained in this study is similar to the
3.5 % reported by Abduirahaman and Ochoga (1978) for Kaduna children and
4% reported by Balogun et al (1990) for Ile- Ife children. It is however different
from the prevalence figure of 8.1% reported by Musa and Lawal (2000) for Kano
girls. This could be the result of climatic/social — cultural conditions.
The result from this study revealed that incidence of elevated blood
pressure is more in the girls than the boys. The incidence of elevated BP was
found in the 15 I 8years old, male and female and not in the 11-years old male
and female. This and other findings in Nigeria clearly is enough evidence that
risk factors of hypertension can already be identified very early. It means that
health authorities, parents and government should begin early to tackle the
problems before it becomes significant.
CONCLUSIONS
Elevated blood pressure (BP) may not necessarily mean hypertension, but
could be a predisposing factor that can lead to hypertension. From this study
female students generally had elevated BP than their male counterpart. Even
females of lower age group have relatively elevated BP than males in both lower
& higher age groups. This could mean that girls arc more subjected to more
stresses than their male counterparts.
Ad1escent hood in girls, is the time of different physical development,
which can disturb the minds of the girls. Such development as breasts
enlargement, protrusion of hips and monthly period (menstruation) may be
strange to the body, thereby subjecting the minds of these girls to serious
tension which can lead to elevated Blood Pressure (BP).
RECOMMENDATION
This study however suggest that physical activity be encouraged among
the school aged children, Constant health education to propagate physiological
examination of the children will help to prevent this elevated BP and to detect
this problem earlier (if already elevated) and thereby prompt solution to it so as
not to subject the child to hypertension later in life.
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