The Effect of Weight on Blood Pressure of Hypertensive Patients
CHAPTER ONE
Aims and objective
This project work is aimed at investigating whether there is a relationship between weight and blood pressure of patients with high blood pressure.
- To estimate the regression model between the variables based on the sample collected.
- To test the significance of the coefficient of regression.
- To determine the extent and direction of the relationship between the variables; weight and blood pressure.
CHAPTER TWO
LITERATURE REVIEW
Obesity and hypertension Mechanisms
The increased metabolic demand of obese individuals is known to raise the cardiac output (expressed in absolute terms) although the cardiac index, which is a relative measure, may be normal or even decreased. The increased cardiac output is usually due to an increase in stroke volume; the plasma and total blood volumes are also usually raised. When vascular resistance increases (as it does in the pathogenesis of essential (primary) hypertension), a high cardiac output related to obesity may act as an important factor contributing to the development of hypertension. Other mechanisms that may be involved are: genetic and environmental determinants of body weight and blood pressure; cell membrane abnormalities; and some endocrine and metabolic abnormalities related to the adrenocortical steroids or to impaired carbohydrate metabolism.
Although how obesity contributes to the pathogenesis of arterial hypertension is not entirely clear, from a practical aspect the important point is that the control of obesity helps the control of hypertension.
Epldemlologlcal findings
Epidemiological studies up to 1967 and the more recent ones have been reviewed, respectively, by Chiang et al. (2012) and Staessen et al. (2013). They provide strong evidence that in populations with “western” life-styles the body weight and blood pressure are positively correlated. This applies also to some African and Asian, and certain traditional (“primitive”) societies. The higher prevalence of hypertension in the lower socioeconomic strata of European and North American populations may be explained in part by a three times higher prevalence of obesity in the lower income groups.
Blood pressure and body weight are also correlated in children and adolescents; both variables tend to track, i.e., children who are found to have higher relative body weights and blood pressures than their average peers will continue on the high side even years after the first measurement. Age-related increase in blood pressure in the young, like that in middle age, is usually proportional to the gain in body weight. Childhood obesity predisposes to hypertension in adulthood. Therefore, hypertensive children and adolescents may be the ideal target population for the introduction of weight control programmes.
These epidemiological associations imply that obesity control has a definite potential for the prevention of hypertension. Thus, in a U.S. community study it has been calculated that, in theory, weight control has a potential of preventing 28% of future cases of essential hypertension in Blacks and 48% in Whites. Of even greater importance is the calculation that by weight control in those who were clearly overweight (12—14% of the population), up to 28% of eventual cases of hypertension could be prevented (6). Obesity control thus seems to be a viable approach for the primary prevention of many cases of arterial hypertension.
Obviously, not all hypertensives are obese, and not all obese persons have hypertension. Nevertheless, over a period of 10-15 years at least 60% of overweight individuals will become hypertensive.
CHAPTER THREE
METHODS
Research design
The study was a descriptive, cross-sectional and took place from January 2019 to May 2020. Male and female aged 18 – 80 years Participated.
Population
Population of the study were from University of Nigeria Teaching Hospital Ituku/Ozalla Enugu State. Participants attended the Laboratory of Nutrition and Nutritional Biochemistry during health campaign programs. A total of 6 483 individuals took part in the study with an eligible population of 6 399- 2 649 males and 3 750 females. All 6 399 eligible individuals participated in the study and 5 757 (89.9%) consented. Participants with inadequate personal data were eliminated from the study.
Participants were made of mostly middle grade civil servants, students and middle income earners from the private and public sector. The principal eligibility criteria for study participation included age between 18 – 80 years and no evidence of pregnancy.
CHAPTER FOUR
RESULTS AND DISCUSSION
Results
Of the 5,757 participants included in this study, aged 18 –
80 years, and BMI 18 -62.50 Kg/m2; 3,347 individuals (61.6%) were females and 2,210 males (38.4%); with SBP range between 97 – 271 mmHg and DBP 78 – 228 mmHg. When comparing anthropometric measurements; there was no significant difference (p > 0.05) between males and females mean age (33.78 ± 10.39) years and (33.05 ± 11.53) years respectively. Also SBP (125.45 ± 18.51) mm Hg and (123.90 ± 19.19) mm Hg; DBP (83.69 ± 15.16) mm Hg and (83.77 ± 15.69) mm Hg. Heart rate (HR) (74.12 ± 14.38) beats/min and (74.19 ± 12.67) beats/min; WHR (0.83 ± 0.09) and (0.84 ± 0.35) showed no significant differences in males compared to females respectively. However, males and females were significantly different (p < 0.05) for parameters like BMI (28.38 ± 6.07) and (27.48 ± 6.44) Kg/m2 and body fat 31% and 34.44% respectively.
CHAPTER FIVE
CONCLUSION
This study showed that diastolic hypertension was common among the population and, revealed the strong association of BMI with hypertension. It also showed high proportion of obese in the population among who many had hypertension. High blood pressure was also common among younger individuals of both sexes of 25 – 39 years old. Given that hypertension is the most important of the known risk factors of cardiovascular diseases and contributes very substantially to the high cardiovascular mortality and morbidity associated with obesity; and understanding therefore of the mechanisms of obesity-induced hypertension is important both for prevention and therapy in Enugu state, Nigeria with a special care to be deserved to younger adults.
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