Assessing The Incidence of Hypertension Among Patients with Above Normal BMI at Mitooma Health Centre IV in Western Uganda

ABSTRACT

The association of obesity and hypertension has been recognized since the beginning of the 20th century, when BP was first measured in populations. This relationship between body weight and BP was demonstrated prospectively in the Framingham Heart Study in the 1960s (Kannel et al,1967) The nature of the linkage between BP and body weight remained obscure until the mid1980s when basic clinical and population-based research significantly clarified many aspects of the relationship between these two common and complex regulatory disturbances. The general objective of the study was to determine the incidence of hypertension among patients 18-60 years with above normal BMI that’s; more than 24.9 Kg/M2 seeking health care services at Mitooma HC IV, South Western Uganda. The study was carried out from the 3rd week of October to the 3rd week of December 2014 and a cross-sectional descriptive study was used. The sample size of the study was obtained using Yamane formula (Yamane, 1967) and since the health center receives approximately 1500 patients aged between 18-60 years in a month, a total of 316 participants were selected using a simple random method though five declined and 311 participated. Data was collected using a data collection sheet, and later exported to SPSS where coding and ranging was made. The data was presented in form of pie charts, graphs, frequency table for easy description and from the study it was found that majority of the respondents were above the age of 41 years (54.4%) and also that, women 59.9% were the majority and this could be because of their sedentary life style which predisposes them to acquisition of excessive weight (Kushner 2007). A big number of respondents 73.7% were overweight and it also was found that female had the highest incidence of hypertension with 59.8%. Therefore, one hundred and eighty one (181) participants had elevated blood pressure and thus the incidence is 58.2% of the sample population. This is not far from (Bethesda 2004) whose study found out that generally, risk estimates suggest that approximately 75 and 65 percent of the cases of hypertension in men and women, respectively, are directly attributable to an overweight condition and obesity. While the numbers alone are formidable, they leave unaddressed the medical costs associated with obesity and obesity-related comorbidities. It is essential therefore, to routinely take patients’ BMI and develop treatment strategies for the management of obesity in order to reduce the development of obesity-related hypertension as well as to effectively manage high blood pressure (BP) in the overweightando

 TABLE OF CONTENTS

Declaration……………………………………………………..……………….I 

Approval…………………………………………………………..……………II

Dedication …………………………………………………………..………….III

Acknowledgement…………………………………………………..………….IV

List of tables…………………………………………………………..…...........V

List of figures………………………………………………………….……….VI

Table of contents………………………………………………………..……...VII

Acronyms………………………………………………………………..……...X

Operational definitions…………………………………………………..……..XI

Abstract…………………………………………………………………….…...XII 

CHAPTER ONE 

1.0 Background of the Study…………………………………………….………1 

1.1Obesity and overweight…………………………………………………........1

 1.1.1 Global perspective………………………………………………………1

 1.1.2 African perspective……………………………………………………...2

 1.1.3 Ugandan perspective…………………………………………………….2

1.2 Problem Statement..…….………………...………………………….………3 

1.3 Objectives of the Study………………………….…………………………..3

 1.3.1 General objective……………………………………………………….3

 1.3.2 Specific objectives……………………………………………………...3

1.4 Research Questions………………………………………………..................3

1.5 Justification of the study……………………………………………….….…4

1.6 Scope of the study………………………………………………………..…..4 

 1.6.1 Geographical scope……………………………………………………..4 

 1.6.2 Content scope……………………………………………………...........4

 1.6.3 Time scope….………………………………………………………......5

1.7 Conceptual Framework ………………..………….…………………………5 

CHAPTER TWO 

2.0 Literature Review …………………………………………………………....6 

2.1 Obesity………………………………………………………………………..6

2.2 Hypertension……………………………………………………………….....9

CHAPTER THREE 

3.0 Research Methodology ……………………………………………………....12

3.1 Research Design …..…………………………………………………………12

3.2 Study Area……………………………………………………………………12 

3.3 Study variables……..……………………………………………………...…13 

3.4 Study population selection…………………………………………………...13

3.5 Sample size determination ………………….……………………………......13

3.6 Sampling technique…………………………………………………………...13

3.7 Inclusion and exclusion criteria…………………………………………........13

3.7.1 Inclusions……………………………………………………………...…....13

3.7.2 Exclusions……………………………………………………………...…...13

3.8 Data collection methods…………………………………………………........13

3.9. Ethical consideration……………..………………………………..................14

3.10 Data collection………………………………………………………….........14

3.11 Data management and analysis……………………………………………...14

3.12 Study limitations………………………………………………………….....14

CHAPTER FOUR 

4.0 Data Presentation, Analysis and Discussion………………………………….15

4.1 Demographic characteristics of the respondents……………………………...15

4.2 BMI categories of respondents………………………………………………..16

4.3 The relationship between BMI and age of the respondents…………………..17

4.4 The relationship between BMI and sex…………………………………….....18

4.5 The distribution of diastolic and systolic blood pressure……………………...19

4.6 The distribution of blood pressure with age……………………………………20

4.7 The distribution of blood pressure against sex…………………………………21

4.8 The distribution of blood pressure with BMI…………………………………..22

4.9 Discussion of results…………………………………………………………….23

 4.9.1 The demographic characteristics of the respondents……………………...23

 4.9.2 BMI category of respondents………………………………………………23

 4.9.3 The relationship between BMI and age…………………………………….23

 4.9.4 The relationship between BMI and sex…………………………………….23

 4.9.5 Distribution of diastolic and systolic blood pressure………………………24

CHAPTER FIVE

5.0 Summary, conclusion and recommendations…………………………………...25

5.1 Summary of the study…………………………………………………………...25

5.2 Conclusion………………………………………………………………………25

5.3 Recommendations……………………………………………………………….25

REFERENCES………………………………………………………………………26

APPENDIX A: WORK PLAN………………………………………………………28

APPENDIX B: BUDGET……………………………………………………………29

APPENDIX C: DATA COLLECTION SHEET………………………...…………...30

APPENDIX D: CONSENT FORM……………………………………...…………..31

APPENDIX E: MITOOMA DISTRICT MAP…………………………...………….32

APPENDIX F: AUTHORISTION LETTER………………………………………..33