Prevalence of Prehypertension, Hypertension, and its Determinants Among Young Adults in Enugu State, Nigeria.

Main Article Content

Obinna C Nwoke
Nkoyo I Nubila
Onyekachi E Ekowo
Nwabunwanne C Nwoke
Edwin N Okafor
Raphael C Anakwue


Prehypertension, Hypertension, Medical Students, Risk Factors, Blood Pressure


Background: Emerging epidemiological data suggest that Hypertension (HTN) has become a significant public health challenge in sub-Saharan Africa. HTN in young adults is a problem lacking relevant attention because it is still erroneously considered a disease of the old. This study aimed to determine the prevalence of hypertension and its associated risk factors in undergraduate medical students at the University of Nigeria, Enugu Campus, Enugu State, Nigeria.

Methodology: This was a cross-sectional study conducted between March and April 2021. This study recruited 279 consenting medical students (136 males and 143 females) aged 18–35 years. They were administered with a structured questionnaire. Data on sociodemographic information and risk factors for hypertension were collected. Blood pressure, waist circumference, weight, height, and body mass index were measured using standard methods. All data collected were carried out following the Institutional ethical guidelines and that of the Helsinki as revised in 2000. Data were analyzed using IBM Statistical Package for Social Sciences version 25, and statistical tools employed include descriptive statistics and Chi tests. Results were recorded as mean standard deviation, and statistical significance was taken at p<0.05. 

Results: This present study has shown a prevalence rate of 19.93% for hypertension. Isolated diastolic hypertension constituted a greater burden with a prevalence of 13.65% than systolic Hypertension (0.74%) and systolic-diastolic Hypertension 5.4%. The prevalence of prehypertension was 48.7%, with a higher incidence observed in females (25.8%), individuals aged 21-25 years (26.4), and those with normal BMI (35.1%). A significant association was observed between the stage of hypertension and gender (p = 0.005), and age category (p = 0.037). Of the examined cohort, 7.75% were underweight, 16.5% overweight, and 2.2% obese. Notably, systolic, and diastolic blood pressure, weight, as well as waist circumference showed significant (p = 0.01, p = 0.007, p =0.01 and p<0.0001 respectively) increases concomitant with advancing age.

Conclusion: There is an increased prevalence of prehypertension and hypertension among young adults. This calls for a comprehensive national screening, public enlightenment, and targeted prevention programs that foster healthy lifestyle behaviours, physical activity, and healthy eating among students

Abstract 1 | PDF Downloads 0 EPUB Downloads 0


1. Chijioke C, Anakwue R, Okolo T, Ekwe E, Eze C, Agunyenwa C, Nwosu N, amah C, Nwadike K, Chijioke U. Awareness, treatment, and control of hypertension in primary health care and secondary referral medical outpatient clinic settings at Enugu, Southeast Nigeria. Inter. J. Hypertens.2016: 1-5.

2. Nwaneli CU, Omejua EG. Clinical presentation and aetiology of hypertension in young adults in Nnewi South East Nigeria. AFRIMEDIC Journal 2010:1(1):24-6.

3. Choi J, Oh C, Shim SJS, Kim HS and Kim M. Reduction in prevalence of hypertension and blood heavy metals among curry-consumed Korean. TJEM.2018: 244:219-29.

4. Pawliczak F, Bielecka-Dabrowa A, Maciejewski M, Banach M. Treating mild hypertension in young adults: is pharmacotherapy necessary? Exp Opi on Pharmaco.2020: 21(10):1115-8.
5. Xu J, White AJ, Niehoff NM, O’Brien M, Sandler DP. Airborne metals exposure and risk of hypertension in the Sister Study. Environ Res. 2020:119: 110144

6. Odili AN, Chori BS, Danladi B, Nwakile PC, Okoye IC, Abdullah U, et al. Prevalence, Awareness, Treatment and Control of Hypertension in Nigeria: Data from a Nationwide Survey 2017. Glob. Heart; 2020;15(1):47.

7. Banigbe BF, Itanyi IU, Ofili EO, Ogidi AG, Patel D, Ezeanolue EE. High prevalence of undiagnosed hypertension among men in North Central Nigera: Results from the Healthy beginning Initiative. PLoS One 2020;15 (11): e0242870. 1-15.

8. Oguanobi NI, Ejim ECE, Onwubere BJB, Ike SOS, Anisiuba BBC, Ikeh VVO, et al. Pattern of cardiovascular disease amongst medical admissions in a regional teaching hospital in Southeastern Nigeria. Nigerian Journal of Cardiology. 2013;10:77–80.

9. Okubadejo NU, Ozoh OB, Ojo OO, Akinkugbe AO, Odeniyi IA, Adegoke O, Bello BT, Agabi OP (2019). Prevalence of hypertension and blood pressure profile amongst urban-dwelling adults in Nigeria: a comparative analysis based on recent guideline recommendations. Clin Hypertens 2019;25:7.

10. Umegbolu EI, Ogamba JO. Primary hypertension in young adults (18-40 years) in Enugu State, Southeast Nigeria: a cross-sectional study. IJCMPH 2016; 3(10):2825-31.

11. Hinton TC, Adams ZH, Baker RP, Hope KA, Paton JFR, Hart EC, Nightingale AK. Investigation and treatment of high blood pressure in young people. Too much medicine or appropriate risk reduction? Hypertension. 2020; 75:16-22.

12. Ujunwa AF, Ikefuna NA, Nwokocha RCA, Chinawa MJ. Hypertentsion and prehypertension among adolescents in secondary schools in Enugu, South East Nigeria. Ital. J Pediatr.2013; 39(70):1-6.

13. Ezeudu CE, Chukwuka JO, Ebenebe JC, Igwe WC, Egbuonu I. Hypertension and prehypertension among adolescents attending secondary schools in urban area of South- East, Nigeria. PAMJ. 2018;31(145): 1-9.

14. Ugochukwu EF, Onubogu CU, Ofora VC, Okeke KN, Uju CM. Blood pressure profiles and determinants of hypertension among public secondary school students in Nnewi, Southeast Nigeria. EJMED. 2020;2(3): 1-7.

15. Jones SWE, Esack I, Mangena P, Rayner LB. Hypertension in adolescents and young adults referred to a tertiary hypertension clinic in cape Town, South Africa. Medicine.2020; 99(48): 1-5.

16. Liu X, Xiang Z, Shi X, Schenck H, Yi X, Ni R, Liu C. The risk factors of high blood pressure among youg adults in the Tujia-Nationality settlement of China. Biomed. Res. Int. 2017: 1-6.

17. Dahiru T, Aliyu A, Kene TS. Statistics in medical research: Misuse of sampling and sample size determination. Ann. Afri. Med.. 2006; 5(3):158-61.

18. Onwubere BJC, Ejim EC, Okafor CI, Emehel A, Mbah AU, Onyia U, Mendis S. Pattern of blood pressure indices among the residents of a rural community in South East Nigeria. Int. J. Hypertens 2011:ID 621074. 1-6. Doi:10.4061/2011/621074.

19. Donato KA. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch. Intern. Med. 1998; 158:1855–67.

20. Chobanian AV, Bakris GL, Black H.R, Cushman WC, Green LA, Izzo J.L, et al . The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA .2003; 289:2560–72.

21. Peters JL, Fabian MP, Levy JI. Epidemiologically-informed cumulative risk hypertension models simulating the impact of changes in metal, organochlorine, and non-chemical exposures in an environmental justice community. Environ Res. 2019;176:108544.

22. Adeloye D, Owolabi EO, Ojji DB, Auta A, Dewan MT, Olanrewaju TO, et al. Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence. J Clin Hypertens (Greenwich). 2021 May;23(5):963-977.

23. Ondimu DO, Kikuvi GM, Otieno WN. Risk factors for hypertension among young adults (18-35) years attending in Tenwek mission hospital, Bomet County, Kenya in 2018. PAMJ.2019; 33:210 doi:10.11604/pamj.2019.33.210.18407.

24. De Venecia T, Lu M, Figueredo VM. Hypertension in young adults. Postgrad Med. 2016;128(2):201-7.

25. Chattopadhyay A, Taraphdar P, KumarSahu B, Maulik S, Ghosh R, Sinha A, Biswas M. A study on prevalence of Hypertension and its related risk factors among undergraduate medical students in Kolkata. IOSR-JDMS.2014;13: 01-07.

26. Abd-Elaziz KM, Dewedar SA, Sabbour S, El Gafaary MM, Marzouk DM, Aboul Fotouh A, Allam MF. Screening for hypertension among adults: community outreach in Cairo, Egypt. J Public Health (Oxf). 2014;37(4), 701–6.

27. AlWabel AH, Almufadhi MA, Alayed FM, Aloraini A.Y, Alobaysi HM, Alawi RM. Assessment of hypertension and its associated risk factors among medical students in Qassi University. Saudi J. Kidney Dis Transplant 29:1100-8.

28. Isezuo SA, Sabir AA, Ohwovorilole AE, Fasanmade OA. Prevalence, associated factors and relationship between prehypertension and hypertension: a study of two ethnic African populations in Northern Nigeria 2011. J Hum Hypertens. 25: 224-230.

29. Tadesse T, Alemu H. Hypertension and associated factors among university students in Gondar, Ethiopia: a cross-sectional study. BMC Public Health 14, 937 (2014).

30. Al-Majed H, Sadek A: Pre-hypertension and hypertension in college students in Kuwait: a neglected issue. J Family Community Med. 2012, 19: 105-10.4103/2230-8229.98296.

31. Hajer A-S, Jalila El A, Pierre T, Habiba B, Sabrina E, Francis D, Noureddine A, Bernard M. Blood pressure and associated factors in a North African adolescent population. A national cross-sectional study in Tunisia. BMC Public Health. 2012, 12: 98-10.1186/1471-2458-12-98.

32. Van der Sande MA, Milligan PJ, Nyan OA, Rowley JT, Banya WA, Ceesay SM, Dolmans WM, Thien T, McAdam KP, Walraven GE: Blood pressure patterns and cardiovascular risk factors in rural and urban Gambian communities. J Hum Hypertens. 2000, 14: 489-496. 10.1038/sj.jhh.1001050.

33. Awoke A, Awoke T, Alemu S, Megabiaw B: Prevalence and associated factors of hypertension among adults in Gondar. Northwest Ethiopia: a community-based cross-sectional study. BMC Cardiovasc Disord. 2012, 12: 113-10.1186/1471-2261-12-113.

34. World Health Organisation (2013). A global brief on hypertension, Geneva: WHO Press.2013.