INTRODUCTION

Background of the Study

Hypertension (HTN) or High Blood Pressure is one of the common

causes of deadly among rich and poor across all races. HTN or HBP is a

chronic cardiac medical condition in which systemic arterial blood

pressure is elevated causing the heart to work harder than normal to

pump blood around the body (Dickson and Sigmund 2006). Bp is a

measurement of the force against the arteries walls as the heart pumps

blood through the body (Erhun 2005). The normal Bp is 120 over 80

written as 120/80mmHg. One or both of these numbers can be too high.

The top number is called systolic blood pressure (SBP) while the button

number is called the diastolic blood pressure (DBP) normal Bp occurs

when the blood pressure is lower than or equal to 120/80mmHg most of

the time (Ulasi 2011).

Olawale (2011) in a health magazine said high blood pressure (HBP) or

HTN happens when the blood pressure is 140/80mmHg or above most

of the time. People who have been treated for heart or kidney problems

or have undergone treatment for stroke are still at high risk of HTN.

There are various ways different scholars define HTN. The World Health

Organization WHO (1978). Arbitrarily defined HTN in adult as “a

systolic pressure or greater than 95mmHg”. According to World Health

Organization (WHO) / International Society of Hypertension (ISH)

guidelines (WHO/ISH2003) defined HTN as a systolic blood pressure

(SBP) greater than or equal to 140mmHg and or diastolic blood pressure

(DBP) greater than or equal to 90mmHg. It is a major public health

problem and the leading cause of cardiovascular diseases including

HTN. In Nigeria it is also one of the most common non – communicable

diseases with a prevalence of about 20 to 25% in adults (EKOM 2009).

It is generally referred to as silent killer because unlike other diseases at

the initial stages it presents no symptoms. HTN frequently does not give

warning signs it presents no symptoms. It is only after an organ in the

body is irritated or damaged that the consequences of HTN are realized

and this could lead to sudden death (WHO/ISH 2003). In a health

magazine published in 2011 should that 10% of the Nigerians population

has regular HBP. Akinkugbe (2010) in his study confirmed that HTN is

essentially “prevalent in 10% of the population of adults in Nigeria aged

between 18 to 70 years. Prevalence rate was about the same in males

and females”. In a population of 140 million that means about 10 million

people have HTN. Furthermore 10% perhaps between seven and eight

million will fall into the category of mild HTN where there are no

symptoms at all unless a check is conducted (Chobanian 2003).

Hypertension is classified as either primary (essential) hypertension or

secondary hypertension; about 90 to 95% of cases are categorized as

“primary hypertension” which means high blood pressure with no

obvious underlying medical cause. The remaining 5 – 10% cases

(Secondary HTN) are caused by other conditions that affect the kidneys

arteries heart or endocrine system (Carretero and Oparil 2000).

Hypertension is a major risk factor for stroke myocardial infarction (heart

attacks) heart failure aneurysms of the arteries (e.g. aortic aneurysm)

peripheral arterial disease and is a cause of chronic kidney disease. Even

moderate elevation of arterial blood pressure is associated with a

shortened life expectancy. Dietary and lifestyle changes can improve

blood pressure control and decrease the risk of association health

complications although drug treatment is often necessary in people for

whom lifestyle changes prove ineffective or insufficient. (Carretero et al

2000). HTN is rarely accompanied by any symptoms and its

identification is usually through screening or when seeking health care

for an unrelated problem. A proportion of people with HBP reports

headaches (particularly at the back of the head and in the morning) as

well as light headedness vertigo tinnitus (buzzing or hissing in the

ears) altered vision or fainting episodes (Williams and Brown 2004). On

physical examination HTN may be suspected on the basis of presence of

hypertensive retinopathy detected by examination of the optic fundus

found in the back of the eye using ophthalmoscopy. Classically the

severity of the hypertensive retinopathy changes is graded from grade

1-4 although the milder types may be difficult to distinguish from each

other. Opthalmoscopy findings may also indicate how long a person has

been hypertensive (Williams et’ al 2004)

Mancia Backer and Dominiczak (2007) stated that the first line of

treatment for hypertension is identical to the recommended preventative

lifestyle changes and includes: dietary changes physical exercise and

weight loss. These have all been shown to significantly reduce Bp in

people with HTN. Different programmes aimed to reduce psychological

stress such as biofeedback relaxation or medications are advertised to

reduce HTN. However in general claims of efficacy are not supported by

scientific studies which have been in general of low quality (Mancia et’

al 2007).

Several classes of medications collectively referred to as antihypertensive

drugs are currently available for treating HTN. Prescription should take

into account the persons cardiovascular risk (increasing risk of

myocardial infarction and stroke) as well as pressure readings in order

to gain a more accurate picture of the person’s cardiovascular profile.

The National Heart Lung and Blood Institute’s Seventh Joints National

committee on High Blood Pressure (JNC-7) recommends that the

physician not only monitor for response to treatment but should also

assess for any adverse reactions resulting from medication. Reduction of

the blood pressure by 5mmHg can decrease the risk of stroke by 34% of

ischaemic heart disease by 21% and reduce the likelihood of dementia

heart failure and mortality from cardiovascular disease. The aim of

treatment should be to reduce blood pressure to <140/90mmHg for

most individual and lower for those with diabetes or kidney disease

(Padwal and Hemmelgarn 2008).

Adequate management of HTN can be hampered by inadequacies in the

diagnosis treatment and/ or control of high blood pressure. Health care

providers faces many obstacles to achieving blood pressure control

including resistance to taking multiple medications to reach blood

pressure goals (WHO 2009). People also face the challenges of adhering

to medicines schedules and making lifestyle changes. The achievement

of blood pressure goals is possible and most importantly lowering blood

pressure significantly reduces the risk of death due tom heart disease

and stroke.

Statement of the Problem

HTN has brought much sorrow to many Nigerian families. It either

brings sudden death of a member of the family in most cases the bread

winner or paralysis through partial stroke that could take many years

and much expense in medical bill to cure. In some cases it left it victims

deformed and unable to live a productive life. WHO (2003) in their exert

meeting HTN was ranked first and it is one of the common causes of

death across all races. The world health body said 80% of global deaths

are as a result of cardiovascular diseases including HTN. The study

should that 10% of Nigerian population has population HBP. It has a

prevalent rate of about 20-25% in adults. It is generally referred to as a

silent killer because unlike other diseases at the initial stages it presents

no symptoms. HTN is a medical illness most common due to paucity of

data in different population of Nigeria coupled with low level awareness

treatment is frequent and inadequate lifestyle changes etc (Ekwunife

2010). Untreated HTN is associated with serious end – organ damage

including heart disease kidney disease stroke and paralysis (Ulasi

2011). This present study is therefore timely in order to determine the

new strategies for controlling HTN among civil servant in Minna Niger

State.

Purpose of the Study

The purpose of this study is to proffer strategies for controlling

Hypertension. Specifically the study will:

1. Determine the level of awareness of the lifestyle that can cause

hypertension among civil servant in Minna.

2. Determine ways of controlling hypertension among civil servants in

Minna.

3. Determine the challenges encountered by civil servants in

controlling Hypertension in Minna.

Significant of the Study

This study will be great benefit to the civil servants the Government

the Society and the researchers because the study will reveal the

extend of success failures or weakness on the control of Hypertension

so as to develop new strategies that will call for sensitization and public

awareness campaign on Hypertension prevention and control

programme in the country. When this is achieved civil servant will be

healthy in discharging their duties and become more productive to the

society.

Research Questions

1. What is the level of awareness of the life style that can cause

Hypertension among civil servants?

2. What are the ways of controlling Hypertension?

3. What are the challenges encountered by the civil servant in

controlling Hypertension in Minna?

Scope of the Study

The study was delaminated to the level of awareness on the lifestyle

that can cause Hypertension the ways in which Hypertension could be

controlled and the problems encountered by the civil servants in

controlling Hypertension.