KNOWLEDGE AND ATTITUDE OF

BUSINESS EXECUTIVE TO
HYPERTENSION

BY

UHUEBOR DAVID ITUA

BEING A DISSERTATION SUBMITTED IN

PARTIAL FULFILMENT OF THE
REQUIREMENT FOR THE AWARD OF
BACHELOR OF MEDICINE, BACHELOR
OF SURGERY DEGREE (MBBS) BY THE
UNIVERSITY OF LAGOS

APRIL 2005

God give us the wisdom to discover the truth,

The will to choose &
The strength to make it endure.

CERTIFICATION

This is to certify that this is an original project work of

Uhuebor David Itua, that has not been submitted for any other purpose before.
Contribution from other sources have been duly acknowledge.

DEDICATION

To JC and his Father, all that I do, I do it for you.

ACKNOWLEDGEMENT
To my family the Ebors my parents Benjamin & Ceceilia,
Toyin for their unwavering love and support, my siblings Anthony, Anthonia, Mary,
Naomi, Bambam, Faith, Funmi & Yemisi for their love, support and encouragements. I
love them so much words fail me.

To this end, I thank my uncle Segun Ebor.

My dawgs-Ikenna, Ifeanyi, Ned, Endy, Lawani, Yemi, Sola, Tobenna, Collins, Tanko,
Ebdido, Tagbo, Skelo, Stompy, Crime, Otuba, Kolaw, Pinnochio, Gido, Bolaz, Fizo,
Scala, Kunle, Ozege, the Banx, Tunde Kolade, chilaka, Timdogg, and all knights of the
lunar table.

Sistas-Damilola Adeyemi, Chioma, Dupe, Chidenma, Ann, Chris, Tinuke, Wanda,

Lola, Odinaka, Yetunde, Chichi.

I wish to acknowledge my cutie-pie who took the time to smile, squeeze my hands,
looking into my eyes and encourage me to follow my dreams.

Finally this work will not possible without the help of my supervisor..Dr Wright
for her guidance and promptness.

TABLE OF CONTENTS
Title

Certification

ii

Dedication

iii

Acknowledgement

iv

Table of contents

List of table and figures

vi

Summary

vii

Chapter 1- Introduction

1-4

Chapter 2- Aims and Objective

Chapter 3- Literature review

6-21

Chapter 4- Material and Method

22-25

Chapter 5- Results

26 34

Chapter 6- Discussion

35 38

Chapter 7- Conclusion

39

Chapter 8- Recommendations

40

References

41 48

Appendix: questionnaire

SUMMARY
A descriptive study was carried out on 150 business executive in Lagos to
determined their knowledge and attitudes to hypertension.
All the respondents have heard about hypertension before and about 86.7%
understood it to be blood pressure above normal.
The incidence of hypertension amongst study population was 18.7% stress was
regarded as the cause by about 43.3% of respondents.
Lack of exercise or physical activity, negative social habits like drinking and
smoking are very common amongst these business executive in which only 28%
participated in sporting activities, 34.7% of them smoke while about 74.7% drink
alcohol.
This study has bought to focus the need to recognize risk factors associated with
hypertension and ways of coping with them.

CHAPTER ONE
INTRODUCTION
Hypertension can be described as the persistent elevation of arterial system blood
pressure of greater than 140mmH g and / or diastolic blood pressure of greater than
90mmHg as measured by a sphygmomanometer.
Morbidity and mortality associated with increased blood pressure rise
continuously across the range of pressures, although more steeply at higher pressures1.
The risk associated with a particular blood pressures are dependent upon the
combination of risk factors in the specific individual2. These risks include risks
associated with age (risks increase with age,), gender (risk in male is greater than
female),ethnic origin (risk greater in blacks, them whites), diet (high salt intake),
smoking and concomitant disease (e.g coronary artery disease)2.
In western socities, the average systolic and diastolic blood pressures gradually
risk with age. The distribution of blood pressures is not Gaussian but skewed towards
hypertension 1.
Hypertension is probably the most common cardiovascular disease in the world
and although high blood pressure in itself is not incapacitating, its complications are
largely responsible for morbidity and mortality in all age groups 3
Historically, the prevalence of hypertension in black African, has been reported
to be the increase 4. Blood pressures levels and the prevalence of hypertension vary with
many factors and their study in black population is still unfolding. It is generally

believed, for examples, that blood pressures levels are lower in rural than in urban
environments 5.
In more than 95% cases, a specific understanding cause of hypertension is not
found. This is referred to as essential hypertension1. In 70% of those with essential
hypertension, another member of the family is affected and inheritance is though to be
multi factorial1.
Factors influencing the deveploment of essential hypertension include-genetic
and familial, social economic / environmental (related to social deprivation, dietary
factors, - obesity, high salt intake, alcohol and caffeine) hormonal factors high renin,
reduced nitric oxide also atrial nautretic peptide, antidiretic

hormone effects,

neurotransmitters acetylcholine, nor-adrenalin, substance p, neuropeptide Y,

serotonin, dopamine and encephalin 1.
Some difference have been established in essential hypertension between blacks
and whites. Some of the variation in blacks include increased of complications which
occur earlier in blacks, poor response to medication especially, B blockers and
associated lower level of plasma potassium in hypertensive Nigerians and increased
incidence of G-6-P-D deficiency in subjects with hypertension6.
In about 5% of unselected cases, the hypertension can be shown to be
consequence of specific disease or abnormality2.
Nearly all the secondary forms of hypertension are related to an alteration in
hormone secretion and, or renal function2.

Secondary hypertension has been known to result from a number of conditions.

These condition include, renal disease (diabetes, chronic nephropathy, chronic
glomerulonephritis, Adult Polycystic diabetes, chronic tubulo-interstitial nephritis,
Renovascular disease), endocrine factors (Conns syndrome, adrenal hyperplasia,
Phaechromocytoma, Cushings syndrome, acromegaly), cardiovascular disoders (coarc
tation of the aortra), drugs such as oral contraceptive pills steroids and vasopressin and
pregnancy state (pre-clampsia)2.
Therefore, an elevated arterial pressure is probably the most important public
health problem in developed countries. It is common, asymptomatic, readily detectable,
usually, easily treatable, and often leads to lethal complications if left untreated7.
This study is thus set to ascertain the knowledge and attitude of business
executives to hypertension because of its large number of middle aged population
which is particularly exposed to the predisposing factors of hypertension.

CHAPTER TWO

AIMS AND OBJECTIVES

1.

To determine the knowledge of business executive on hypertension.

2.

To determine the attitude of business executives to hypertension.

3.

To identify risk factors associated with hypertension amongst the business

executives

CHAPTER THREE

LITERATURE REVIEW

No one definition of Hypertension is Universally accepted. It has even been

argued that since blood pressure for population is a continuous variable, any cut-off
point becomes necessarily arbitrary3.

Hypertension can be described as the persistent elevation of arterial systolic

blood pressure greater than 90mmHg as measured by a sphygmomanometer1.
Hypertension is defined as a condition in which blood pressure measured with a
sphygmomanometer is higher than normal measured on two or more occasions8.
However, any definition of hypertension must remain flexible as blood pressure
varies with age and sex in most communities and even in the same individual, diurnal
range may be considerable3.
Thus the long-standing controversy as to what constitutes hypertension in adults
was resolved by the universal adaptation defined by the World Health Organization
(WHO) in 1978 which states as follows;
Hypertension in adults is arbitrarily defined as a systolic pressure equal to or
greater than 160mmHg (21.3kp) and / or diastolic equal to or greater than 95mmHg
(12.7kpa).
Borderline hypertension is also defined as the pressure range between 140 /
90mmHg and 160 / 95mmHg.

Hypertension is the commonest non-communicable disease in Nigeria 9. It has

been estimated

that over 4.3 million Nigerians above the age of 15 years are

hypertensive with systolic blood pressure of 16mmHg and above and / or diastolic of
95mmHg and above1.
In Nigeria, awareness about hypertension is poor, as much as 33.8% those with
elevated blood pressure are aware of their condition10.
In a study of patients, medical students, workers and factory hands in Shagamu,
Nigeria, the level of information about hypertension and its various determinants ranges
from 10-51.7%11.
In Nigeria, using the 3 main local dialectal gave the local names for hypertension
as:
(i)

Funpa giga or Eje riru in Yoruba dialect

(ii)

Hauwa jinni in Hausa dialect

(iii)

Obala mgbanienu in Igbo dialect

CLASSIFICATION
Hypertension can be classified into primary and secondary12. It is designated as
primary or essential hypertension if even after thorough investigation, no specific cause
is found12. This form of hypertension is seen in more than 95% of case1.
In 70% of those with essential hypertension, another member of the family is
affected and inheritance is thought to be mutifactorial1.
Factors influencing the development of essential hypertension include:

Genetic factors blood pressure tends to run in families and children of hypertensive
parents tend to have higher blood pressure. Clearly this family concordance of blood
pressure may be explained, at least in part by shared environmental influences however,
there still remains a large, still unidentified genetic component12.
Fetal factors studies have constantly shown a relationship between lower birth weight
and subsequent higher blood pressure12.
Environment factors- most significant amongst the lots are obesity where fat people
have higher blood pressure than thin people12.
Alcohol intake where most studies have shown a close relationship between the
consumption of alcohol and blood pressure level.
However, subjects who consume small amount of alcohol seem to have lower blood
pressure level than those who consume no alcohol12.
Sodium intake in high amounts has been suggested to be an important determinant of
blood pressure differences between and within population in the world. Populations
with a higher sodium intake have average higher blood pressure than those with lower
sodium intake.
Hormonal mechanisms- the autonomic nervous system as well as renin-angiotension,
natriuretic peptide and Kallikrein kinin system, plays a role in the physiological
regulation of short term changes in blood pressure and has been implicated in the
pathogenesis of essential hypertension.
Insulin resistance in diabetes and hypertension has long been recognized.

Some differences have been established in essential hypertension between blacks and
whites. Some of the variation in blacks includes; increased incidence complication
which tends to occur earlier in blacks with poor response to medication especially B
blockers.
In secondary hypertension, there is a specific and a potentially treatable cause. This
form is found in about 5% of the population.
Nearly all the secondary forms of hypertension are related to an alteration in hormone
secretion and /or renal function.
Secondary hypertension has been known to result from a number of conditions. These
conditions include,
i.

Renal disease - This accounts for 80% of the cases of secondary hypertension.
The common causes are:

a. Parenchymatous e.g acute and chronic glomerulonephritis, pyelonephritis,

analgesic induced nephropathy, system lupus erythematous and polyarteritis
nodosa.
b.

Polycystic kidneys

c.

Renal artery stenosis

ii.

Coarctation of aorta

iii.

Endocrine disorders and hormone therapy

a. Phaechromocytoma
b. Cushings syndrome, spontaneous and drug induced
c. Primary aldosterinism (Conn s syndrome)

d. Pregnacy state (pre-eclampsia).

EPIDEMIOLOGY
Hypertension is a world wide health problem. Conflating reports regarding the
incidence and prevalence of elevated blood pressure in various racial groups spanning
several deeds have been published.

Industrialization seems to be associated with high incidence of hypertension and

hypertensive vascular disease.

RACIAL GROUPS
Historically, the prevalence of hypertension in black Africans has been reported to be
on the increase. In Africans, there have been numerous studies originating that have
stressed the marked difference between blood pressure in African Negro and the Negros
in the United Stated and Western Hemisphere.
Early repoters of study of natives of East Africa reported that blood pressures were
lower in all age groups and both sexes than in comparable group of white and negroes
elsewhere.
In more recent studies, it was observed that high blood pressure occurs frequently in
adult Africans and in blacks. Its complication on target organs seem more severe in this
group of patients than in Caucasians.

Furthermore, it was stated in all age group, hypertension and the incidence rate of
stroke were found to be twice as high in black as in white, even when they had been
marked for socio-economic status.

Studies carried out in North America support this view, that this condition is at least
twice as common in Negros as in his white counterpart.
In West Africa, the first report on the study of high blood pressure came from Liberia,
where it was noted to be less common among the Negros there than whites.
In Nigeria, a study involving 641 Nigerians all aged over 20 years in a rural
environment in Ibadan but they could not detect any important difference when
comparing rates of risk of arterial pressure with age with that of the white race17.
In South African, studies on the Business of the Kalahari Desert, did not detect
any significant rise in pressure with age, nor was the incidence of hypertension
remarkable18.

RURAL AND UBARN COMMUNITIES

Differences have been found between the rural and urban population blood pressure.
In West African, Urban (industrial) arterial pressure in those over 40 years was
generally higher than rural values obtained in comparable age group19.
It also found out that mean value of systolic and diastolic pressure were found to be
higher in women industrial workers than in women civil servants.
This was also true for diastolic, though not of systolic pressure in the male19.

Urban subjects from Hausa people of Northern Nigeria had mean systolic blood
pressure and diastolic blood pressure that were generally higher than those of rural
subjects20.
In Cameroon, it was found that the average prevalence of hypertension in
Yaounde (an urban settlement) was 11.7%. Men were more frequently affected, and it
usually affects patients in their 4th and 5th decades in life. However, mean systolic and
diastolic blood pressure levels were higher, mean systolic and diastolic blood levels
were higher in women21.
Blood pressure may change if the immediate environment changes. A study
showed that the mean systolic pressure laborers who were in prison were higher than
the pressures of their still nomadic brothers22.
A study on men who had joined the army showed a significant increase in blood
pressure. Blood pressure were significantly higher 26months and 70months after
recruitment than they were at recruitment22.
In Epe, result from a survey conducted that hypertension is a common condition
although most of them affected were symptom less23.

It is only recently that there has been any real interest in the epidemiology of
hypertension and its precursors in infants and children.
It has been difficult to investigate the blood pressure of any large number of
infant and small children24.

A study involving 157 predominantly black infant and children aged 1 to 14

years together with their mother, fathers and siblings. Blood pressures of those under 2
years were recorded using the Doppler techniques. The means systolic pressures for 1 to
3 years old males were 102mmHg and for female 104.2mmHg means diastolic pressure
in there same age groups ranged from 62.2mmHg to 65.4mmHg in males, from
65.5mmHg to 67.8mmHg in female. However, it was observed that both mean systolic
and diastolic pressures of 4 to 7 year old boys exceeded the pressures of girls25.
The incidence of hypertension in children has been reported to be less than 3%26.
Other statistics have been given an incidence of 1-20% in children as against 1020% in adults.

CLINICAL FEATURES

In the majority of patients, there are no specific symptoms attributable to

hypertension which is detected on routine examination or because of one of its
complications27.
Most of the symptoms are due to target organs damage prompt and adequate
treatment of hypertension will delay outset of complications and end organ damages28.
Waiting for onset of symptoms, as most of the local populace are likely to do,
could delay diagnosis and medical intervention. It has been observed that over 75% of
hypertensive patients in this environment already have cardiac hypertrophy at the time
diagnosis29.

Acute hypertension occasionally cause headaches and polyuria but these may be
transient. In few individuals, it may present with occasional throbbing headaches,
unclear or hazy vision or palpitation. One or a combination of these symptoms may
occur in a person. It should be noted that those symptoms are not specific for
hypertension and may occur in persons with normal blood pressure. It must however, be
emphasized

that

hypertension

is

measuring

the

blood

pressure

with

sphygmomanometer.

The three main objectives of any clinical examination in a hypertensive patient are to
identify any cause, to recognize risk factors for the development of complication and to
detect any complications.

COMPLICATIONS

Hypertension is recognized as a silent killer30.

It damages the target organs on a continuous and progressive basis until symptoms are
manifested31.

Several major epidemiology studies have confirmed the increase with cardiovascular
and cerebrovascular risk associated with hypertension. It contributes to cardiovascular
morbidity and morality and its control reduces significantly the end organ effects of the
disease. Population based studies have shown that hypertension accounts for up to 35%

of all atherosclerotic events including 49% of all cases of heart failures. It increases 2 to
3 times an individuals risk of various cardiovascular consequences32.

The occurrence of any of these outcome adversely effect the quality and often the
length of a patients life into 2 categories- direct and indirect. In the vast majority of
cases, the direct consequence of congestive heart failure and cerebral hemorrhage
(stroke) can be prevented if the blood pressure is brought down to and maintained at
normal levels34.

Complications that are of an indirect-nature, that is, they are not the immediate result of
the increased pressure, but of premature and severe atherosclerosis evoked by chronic
hypertension34.

Hypertensive retinopathy is also seen in long standing hypertension of moderate

severity. The major change is a thickening of the walls of the retinal arterioles, causing
diffuse or segmental narrowing of the blood columns, varying width of the light reflex
from the vessel wall and often some arteriovenous nipping. With more severe
hypertension, retinal hemorrhage is seen. In early retinopathy, there is little effect on
visual acuity, but extensive exudates or homologue can caused visual field defeats or
blindness if the macula is affected27.

MANAGEMENT

Decision about management should take into account the predisposing factor associated
with hypertension.
A combination of non-pharmacology and / or pharmacology therapies is characteristic
to attain the long-term benefit of blood pressure control35.
Non-pharmacology therapies for hypertension have received increased attention mainly
because of the problems associated with pharmacotherapy36.

These non-pharmacological modalities, that is, behavioural changes or appropriate life

style measures many obviate the need for doing therapy in patient with borderline
hypertension, reduce the dose and / or the number of drugs required in patients with
established hypertension and directly reduce cardiovascular risks36.

Correcting obesity, reducing alcohol intake, restricting salt intake, taking regular
physical exercise and increasing consumption of fruits and vegetables can all lower
blood pressure. Moreover, quitting smoking, eating oily fish and adopting a diet that is
low in saturated fat may produce further reduction in cardiovascular risk36.
The sole objective of antihypertensive therapy is to reduce the incidence of adverse
cardiovascular events, particularly concerning heart disease, stoke and heart failure. The
relative benefit of antihypertensive therapy- 30% reduction in risk of stoke and 20%
reduction in risk of coronary heart disease is similar in all patient groups, so the
absolute benefit of treatment is greatest in those at highest risk37.

The choice of antihypertensive therapy is usually dictated cost, convenience, the

response to treatment and freedom from side-effects or quality of life38.

Although some patient can be satisfactorily treated with a single antihypertensive drug,
a combination of drugs is often required to achieve optimal blood pressure control38.

Various antihypertensive drugs are available and they include: Thiazides, - blockers,
calcium antagonists, ACE inhibitors and blockers38.

For a cohort hypertensive patient about half of which have been attending the clinic
for more than 5 years- it is worrisome that only about a third were aware that treatment
for hypertension should be life long.

The majority believed that drugs should be taken only when they have symptoms or a
period of time. This practice has sometimes resulted in disastrous consequences39.
Hypertension treatment should ideally be for life. Though it has been suggested that it is
sometimes possible to withdraw drugs therapy and continue life-style modification after
several years39.

The consensus is that almost all who are hypertensive before treatment will become
hypertensive again if treatment is stopped40, 41.

It was also observed that male gender and residence in a developing country were
factors associated with poor blood pressure control42.
The joint National committees 6th report believed that only about half of the patient who
are diagnosed as hypertensive are adequately controlled42.
Drug therapy remain the mainstay of hypertension management, however,
antihypertensive dry therapy is not without its attending problems such as troublesome
side effects, and long term completions44.

CHAPTER FOUR

METHODOLOGY

A descriptive study was carried out to determine the knowledge and attitude of business
executive to hypertension.

STUDY BACKGROUND
Lagos, the former capital city of Nigeria is situated in the South Weatern part of the
country. Ti is the most populous city in Nigeria.

Lagos is the Chief commercial and financial never center of Nigeria with a DNP
crippling that of any other West African Country1.

Lagos inhabits more than 13million people with an estimated are of 300 square
kilometers.

The population is essentially a dynamic one consisting of both workers and residents. It
has a high concentration of blanks, insurance firm and telecommunication companies.

Final financial firm within this area make up most of the establishment in the
metropolis of which almost all have their corporate head offices within the metropolis.

The senior executive make up a small member of the workforce, they include managing
directors, executive director, group heads, general managers, deputy general mangers,
senior managers, deputy managers and assistant managers.

STUDY POPULATION
The study population include mainly executives working in the Lagos metropolis. For
the purpose of this study, an executive is any persons charged with the authority to
carryout decisions, and laws and in the hieracy of power in their various departments.

STUDY DESIGN

Eight institutions will be used form my study. These institution are standard trust bank,
Hallmark bank, Standard Chartered bank, Guaranty trust bank, United bank for Africa,
Zennith bank, Nigeria Telecommunication Plc, Gold link Assurance Plc.

These institutions were chosen by multistage sampling using balloting method. In

Lagos island, we have 35banks, 15 insurance companies, 6 telecommunication
companies each of the institutions branches was placed of paper, which folded and
then a random selection was done by balloting. This lead to picking the particular
branch or particular institutions.

The number of executive in the institution totaled 150

METHOD OF DATA COLLECTION

Self administered questionnaire has used to carry out study.

Each participant will be given a questionnaire. The self administer questionnaire will
contain both closed and open ended questions covering the personal profile, work place
condition, social history, medical historical, knowledge and attitude toward
hypertension.

ETHICAL CONSIDERATION.
An informed consent will be obtained from each participant and confidentiality assured.

DATA ANALYSIS
The information supply by the subjects on the questionnaire were extracted.
The collected data were subjected to manual statistical analysis.

LIMITATION OF STUDY

Time and large sample size, would have been suitable for the study, but due to
comparing academic responsibilities this may not be possible.

CHAPTER FIVE

RESULTS
Table 1- Age and Sex distribution of Respondents.

Age (years)
21 30
31 -40
41 -50
51 60
61 70
Total

Male No
7
14
48
42
9
120

%
5.8
11.7
40
38
7.5
100

Female No
3
9
9
6
3
30

%
10
30
30
20
10
100

Of the 150 respondents, 40% of the male respondents were within the age group of 41
50 years and 30% of the female respondent were within the same age group.
Figure1: Bar chart showing age and sex distribution of respondents.

60
50
40
Male

30

Female

20
10
0
21-30
31-40
41-50
51-60
61-70
Table 2- length
of working
Hours
of Respondents

Working Hours
4-6

No
11

%
7.3

7-9
10-12
> 12
Total

7
107
25
150

4.7
71.3
16.7
100

A large number (71.3%) of the respondents spaced between 10 and 12 hours at work

Tables 3. Assessment of knowledge of knowledge of respondent on term Hypertension

What do you understand as Hypertension
Blood pressure above Normal
Normal blood pressure
Blood pressure below normal
Other (not sure)
Total

No
130
8
12

%
86.7
5.3
8

150

1000

Majority (86.7%) of the respondents understood hypertension to be blood pressure

above normal

Table 4; Respondent that have heard about hypertension

Have

you

hypertension
Yes
No

heard

of No
150
-

All the respondents have heard about hypertension

%
100%
-

Table 5 Respondent with hypertension

Are you Hypertensive
No
%
Yes
28
18.7
No
107
71.3
Dont know
15
10
Total
150
100
Of the 150 respondents, about 18.7% were known hypertensive.

Table 6.

Assessment of knowledge of respondent on the causes of hypertension.

Cause of Hypertension
No
%
Genetics
40
26.7
Stress
65
43.3
High ssalt intake
25
16.7
Dont know
20
13.3
Total
150
100
A sizable proportion (43.3%) of respondents attributed their hypertension to stress.

Table 7- Respondents currently managed for hypertension

Currently managed
No
%
Yes
21
75%
No
7
25%
Total
26
100
A large number (75%) of the respondent are currently being managed for hypertension

Table 8.

Forms of management

No
%
Drug
20
71.4
Diet restricts
25
89.3
Increase physical exercise
25
53.6
Others
20
13.3
Most (89.3%) of the respondents had diet restriction as a form of management

Table 9- Distribution of Respondents on salt intake

Salt shaker
No
%
Always
13
8.7
Sometimes
99
66
Never
38
25.3
Total
150
25.3
A large number of the respondents are habitual salt shakers

Table 10-Distribution of Respondent in exercise/sporting activities

Do you exercise
Yes
No
Total

No
42
108
150

%
28
72
100

Of the 105 respondents, 28% use involved in exercise /physical activities

Table 11- Distribution of Respondent in smoking

Do you smoke
No
Yes
52
No
98
Total
150
A sizeable proportion 165.3% of the respondents smoked

Yes
34.7
56.3
100

Table 12-Distribution pf Respondent, on period of smoking

Period
No
Yes
< 1 years
1-5 year
3
5.8
6-10 years
13
25.0
> 10 years
36
69.3
Total
52
100
A large percentage 69.2 respondents that smoked have been smoking for more than 10
years

Table 13- Distribution of Respondents on alcohol

Do you drink alcohol
No of subject
Yes
112
No
38
Total
150
Majority (74.7%) of the respondents drink alcohol

%
74.7
25.3
100

Table 14- Distribution of respondent on period of drinking

How long have you been No

drinking
< 1 year
1-5 years
9
8.0
5-10 years
30
26.8
> 10 years
73
65.2
Total
112
100
A sizeable proportion (65.2%) of respondents that drink alcohol have been drinking for
more than 10 years.

Table 15-Family History of Hypertension among Respondents

Family

History

Hypertension
Yes

of No
38

%
25.3

No
90
60.0
Dont know
22
14.7
Total
150
100
Of the 150 respondents, 25.3% have a family history of hypertension

Table 2: Family history of hypertension among respondents

14.7
25.3

No
Yes

60.0

Dont Know

CHAPTER SIX

DISCUSSION

Results from this study shows that 86.7% of the respondents understood what the term
hypertension stands for.

This results is much higher than one obtained from a similar study carried out on
patients, medical students, workers and factory hands in Shagamu, Nigeria. There, the
level of information about hypertension ranged from between 10-51.7%11.

This difference may result from the level of education and exposure amongst the
respective respondents

Of the 150 respondents studied, 18.7% knew they were hypertensive. In other studies
on some Urban Nigerian populations carried out in Calabar studying a population of
middle class group revealed the incidence of hypertension to be 17.4% in this class 22.
Another study carried out on a similar class in Benin, Nigeria revealed an incidence of
3.3%.

It is however, seen that the incident of hypertension is higher in males than in females
of the same age group, but this result in female subjects should be considered with
caution because of the female sample size.

Amongst the respondents, 13.3% did not know the cause of their hypertension. A large
majority about 43.3% attributed it to stress. In a previous study, it was concluded that
there appears to be no convincing evidence that stress plays a significant role in the
etiology of hypertension. They argued that the reaction of the individual to his

environment has a greater effect upon his vascular system than the individual job and its
demands22.

However, 26.7% of the respondents related it to genetics and another 16.7% said it was
due to high salt intake.
Salt intake, a predisposing factor to hypertension has been shown to have a positive
effect on blood pressure A study regarded hypertensive patients as salt sensitive and
that there was a direct relationship between sodium intake and hypertension 32. Sodium
intake in large amount has been suggested to be an important determination of blood
pressure difference between and within populations around the world. Populations with
a higher sodium intake have higher average blood pressures than those with lower
sodium intake. Of the 28 respondents known to be hypertensive, 75% are currently on
one or more from of management. A lot of the respondents were on more than one one
form of management.

These forms of management are a combination of non-pharmacologic and or

pharmacologic therapies which is characteristically important to attain the long-term
benefits of blood pressure control.

Of the 150 respondents, only 28% were involved in any form of exercise or physical
activities. This re-instates the sedentary life style associated with members of this social

class. Amongst the respondents, 34.7% smoked and a large majority about 69.2 has
been smoking for more than 10years.

Previous studies have reported no established association between cigarette smoking

and arterial blood pressure.

A high percentage of the respondents 74.7% drink alcohol and over 65% of those that
drank alcohol have done so for more than 10 years.

Alcohol consumption was shown in previous studies to be positively associated with

hypertension.

A family history of hypertension was found in 25.3% of the respondents. Of the 28

respondents that were known hypertensive,12 (42.9%) had a family history of
hypertension.

This result may suggest a strong genetic influence.

CHAPTER SEVEN
CONCLUSION

This study shows that the respondents have heard about hypertension. The respondents
demonstrated a high level of awareness. A large majority of them know what it stands
for.
The incidence of hypertension was quite high amongst the respondents. A vast number
of them could attribute it to a particular cause, stress was highlighted as the major cause
though the most outstanding risks were alcohol ingestion and lack of exercise.
Negative said habits like drinking and smoking are very common amongst these
respondents.
This could be as a result of the stress they experience and thus find there little habits
relieving
Various personal characteristics and social habits were known to affect blood pressure
positively as well as increase the incidence of hypertension in community. These
include: age, sex, alcohol consumption and salt intake. It is therefore, worthwhile to
detect all causes of hypertension for proper follow-up and management1.

CHAPTER EIGHT
RECOMMENDATION
a.

Further studies should be carried out amongst similar social economic groups and
under geographical area.

b.

Government should enact policies prohibiting the manufacture of

cigarettes and alcohol

c.

Government should make certain that products containing high levels of

fats and cholesterol should be high lighted and a warning should accompany such
products about the adverse effects of excess cholesterol in gestion.

d.

Diet and proper eating habits should be encourage and promoted

e.

To prevents hypertension and ultimately the risk it complications,

authorities should consider the following;
i.

Authorities should make available recreational facilities for the executives.

ii.

Annual comprehensive medical checkup should be mandatory for all

executives

iii.

Health care givers should undergo regular update on newer ways of

managing/treating hypertension

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QUESTIONNAIRE
Introduction
I am final year student of the College of medicine University of Lagos carrying out a
study on the topic KNOWLEDGE & ATTITUDES OF BUSINESS EXECUTIVE ON
HYPERTENSION it is in partial fulfillment of the requirement for the award of the
MBBS degrees of the College of medicine, University of Lagos. You are kindly
requested to please complete this questionnaire by filling in as appropriate. The success
of the project depends on the completion of the questionnaire truthfully.
Nothing that all personal information given will be kept confidential.
Thank you,
UHUEBOR DAVID I.
SECTION A: BIODATA/SOCIO-DEMOGRAPHIC
1.
Sex:
a.
Male
b. Female
2.
Marital Status
a.
Single
b.
Married
c.
Widowed d.
Divorced
e.
others (please specify)
3.
Age
a.
21 30 years
b.
31 40 years
c.
41 50 year d.
51 60 years
e. 61 70 years
4.
How long have you occupied this position?
a. <1 year b.1 5 yearsc. 6 10 years
d. 11 15 years e. >15 years.
5.
How many hours do you spend at work?
a. 4 6 hours
b. 7- 9 hours
c. 10 12 years d. >12 hours
6.
Do you always feel exhausted after working each day?
a. Yes
b.
No c. I dont know
SECTION B: KNOWLEDGE ON HYPERTENSION
7.
Have you heard of hypertension?
a. Yes
b. No. c. I dont know
8.
What do you understand by the term hypertension?
a.
blood pressure above normal
b. normal blood pressure
c.
blood pressure below normal
d. other (place specify).
9.
Are you hypertensive?
a.Yes b. No.
c.I dont know
10. If yes, what year was it diagnosed..
11. What was diagnosed as the cause of your hypertension?
a. Genetics b. Stress c. High salt intake d. I dont know
SECTION D: ATTITUDE
12. Are you currently managed fro hypertension?
a. Yes b. No
13. If yes, tick the relevant form of management (you can tick >1)

a. Drugs b. Diet restriction c. Increased physical exercise

d. Others (please specify) .
Do you have a personal history of other cardiovascular disease as (please tick as
appropriately)

14.

Yes
a.
b.
c.
d.
e.
f.
g.
h.
15.
16.
17.
18.
19.
20.
21
22
23
24.
25.
26.

No

I dont know

Congential heart disease

Ischaemic heart disease
Rheumatic heart disease
Anaemia
Cor pulmonale
Pericarditis
Cardiomyopathy
Infective endocarditis

Are you a habitual salt shaker i.e do you add salt to each meal you take?
a. Always b. sometimes c. Never
Do you know your weight?
a. Yes b. No
If yes, what is it in kilograms?
would you consider yourself underweight?
a. Yes b. No
Do you involve yourself in any form of exercise/sporting activities?
a. Yes b. No
If yes. What type?
a. water sports b. ball sports c. Aerobic exercise d. Others (please specify)
..
Do you smoke?
a. Yes b. No
If yes, how long have you been smoking?
a. < 1 year b. 1-5years c. 5-10years d.>10years
Do you drink alchol?
a. Yes b. No
If yes, How long have you been drinking?
a. <1 year b. 1-5 years c. 5-10 years d. >10years
Has anyone in your family ever been diagnosed having hypertension?
a. Yes b. No c. I dont know
Has any member of your family been diagnosed having stroke?
a. Yes b. No c. I dont know.