The American Heart Association Classification of Blood Pressure and the Determinants of Hypertension among Medical Practitioners in Bayelsa State: A Cross-Sectional Study

Abstract

Hypertension is a major risk factor for cardiovascular diseases (CVD). Objective was to assess prevalence of hypertension using 2017 American Heart Association/American College of Cardiology (AHA/ACC) guideline and it's determinants among Medical Practitioners in Bayelsa State, Nigeria. Two hundred and forty-four apparently healthy medical doctors were recruited. A structured self-administered questionnaire was used to gather data on CVD risk factors. Anthropometric and blood pressure measurements were taken. Association between hypertension and sociodemographic features, anthropometric measures, smoking, alcohol, fruit and salt intake, exercise was explored with chi-square for proportions. Predictors of hypertension were identified by two-step binary logistic regression. A third of participants were women (29.9%), most were below age 30 years (40.2%) and married (54.9%). One fifth was consultant/professor cadre (18.9%) and a third had worked ≥11 years as medical practitioners. Almost 2 in every 3 of the participants (63.1%) were considered hypertensive by the AHA 2017 classification. However, using a cut off of ≥140/90mmHg used by other guidelines gave a prevalence of 25%. Only 13.5% had been diagnosed hypertensive prior to this study. The most important predictor of occurrence of hypertension was age, although marital status, salt intake, work cadre and duration of practice were also significantly associated with the occurrence of hypertension. The use of the 2017 ACC/AHA hypertension guidelines for diagnosis of hypertension with a blood pressure cut off ≥ 130/80 mmHg resulted in a marked increase in the prevalence of hypertension in medical doctors compared to other guidelines that use a cut off value of 140/90mmHg (63.1% versus 25%). Increasing age is a significant predictor of hypertension in medical doctors. Guidelines that are best suited for our local settings for diagnosis of hypertension are recommended.