Risk factors associated with development of hypertension Among armed forces personnel attending medical outpatient Clinic at armed forces memorial hospital Nairobi, Kenya

Abstract

Hypertension remains a major risk factor for the development of cardiovascular diseases CVDs)worldwide. Statistics show a rising morbidity and mortality in developing countries especiallyin the Sub Saharan Africa (SSA) as a result of hypertension, (WHO,2003). Military personnelengage in physical activities and regular exercise which improve their physical fitnesshence reducing chances of developing CVDs, (Haskell et al 2007). However, hypertensionhas been observed to be on the rise in this population. This study therefore, soughtto identify risk factors that could be associated with development of hypertension amongthis population. Study objective The objective of this study was to determine the risk factors associated with development of hypertension among military personnel attending medical outpatient clinic at Armed Forces Memorial Hospital (AFMH) in Nairobi Kenya. Methodology This was an exploratory cross-sectional survey that was carried out at Armed Forces Memorial Hospital situated along Mbagathi road for a period of 12 weeks from May to July 2010. Simple random sampling was utilized in selecting subjects. A total of 170 hypertensive and 170 normotensive subjects were recruited to this study. A structured questionnaire based on WHO STEPS approach for surveillance of chronic disease was used as a tool for data collection for both groups with physiological and anthropometric measurements being obtained from each subject. STAT A version 11 was used to analyze collected data and measures of central tendency, chi square, t-test, bivariate, multivariate and logistic regression employed as statistical methods for data analysis. XIV Results A total of 170 hypertensive subjects from the MOPC and 170 normotensive subjects from AFMH staff nominal roll were enrolled into the study. The mean age (SD) of hypertensive and normotensives subjects were 45.1(7.7) and 40.8(7.3) years, respectively. On average the hypertensive patients were 4.82 older than the nonnotensives (p<O.OOO1). Ninety-five percent of the cases were male compared to 5% of females. There was a strong statistical association between the frequency of alcohol consumption and hypertension in the bivariate analysis (l= 34.33, d.f. =3; P<O.OOOI). Approximately 11% of cases were current smokers compared to only 4.2% of controls who also reported smoking. There was a statistically significant association between current smoking and hypertension with an OR =0.17; 95%CI (0.14-0.89) indicating that hypertension was more prevalent among smokers compared to individuals who did not smoke. From this analysis the cases of hypertension were noted to have poorer nutritional indicators compared to the controls. Cases were more likely to be overweight (59.76% versus 28.24%) or obese (19.53% versus 3.53%) compared to the controls. Conclusion and recommendation In this study, higher anthropometric measurements, cigarette smoking and certain dietary habits remained significantly associated with hypertension in this population. In addition, the level of physical fitness in this population was excellent as per the fitness index results. The study findings thus, provide an impetus for urgent need to encourage healthy lifestyles as a primary prevention strategy. There is also need to explore other possible risk factors for CVDs and hypertension in this population.