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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 27  |  Issue : 2  |  Page : 127-131

Cardiovascular risk factors among staff of a private university in South-west Nigeria


1 Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria
2 Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
3 Department of Chemical Pathology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

Date of Submission07-Dec-2019
Date of Decision17-Dec-2019
Date of Acceptance17-Feb-2020
Date of Web Publication11-Apr-2020

Correspondence Address:
Dr. Esther Ngozi Adejumo
Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/npmj.npmj_189_19

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  Abstract 

Background: Globally, the death rate arising from the cardiovascular diseases (CVDs) is high. This study assessed the prevalence of cardiovascular risk factors (CRFs) among staff of the Babcock University. Methods: This was a descriptive and cross-sectional study. Weight, height, waist circumference and blood pressure measurements were taken. Venous blood was collected for glucose and lipid profile analysis after an overnight fast. The prevalence of smoking, hypertension, diabetes mellitus, dyslipidaemia, general and abdominal obesity were determined. Results: A total of 140 participants were recruited into the study. The average age of the participants was 41.7 ± 9.4 years. The male: female ratio was 1:0.8. About 24% of the participants had no CRF, but 24.3%, 27.1%, 16.4% and 10% had 1, 2, 3 and 4 CRFs, respectively. Majority had abdominal obesity (48.6%) and dyslipidaemia (47.1%). The prevalence of hypertension, obesity and smoking was 32.9%, 31.4% and 11.4%, respectively. None of the participants had diabetes mellitus. More males smoked cigarette (20% vs. 0%) and had hypertension (50% vs. 10%) than that of females (P < 0.001), but a higher proportion of females (63.3% vs. 37.5%) had abdominal obesity (P = 0.002). Conclusion: The prevalence of CRFs among the apparently healthy staff of the Babcock University was high. Urgent measures are needed to prevent the development of CVD in this population.

Keywords: Apparently healthy, cardiovascular disease, cardiovascular risk factors, Nigeria


How to cite this article:
Adejumo EN, Adefoluke JD, Adejumo OA, Enitan SS, Ladipo OA. Cardiovascular risk factors among staff of a private university in South-west Nigeria. Niger Postgrad Med J 2020;27:127-31

How to cite this URL:
Adejumo EN, Adefoluke JD, Adejumo OA, Enitan SS, Ladipo OA. Cardiovascular risk factors among staff of a private university in South-west Nigeria. Niger Postgrad Med J [serial online] 2020 [cited 2020 Oct 31];27:127-31. Available from: https://www.npmj.org/text.asp?2020/27/2/127/282317




  Introduction Top


Cardiovascular disease (CVD) is a non-communicable disease (NCD), exerting both structural and functional changes on the heart and blood vessels.[1],[2] Globally, it is associated with high death rates, and the common types include high blood pressure, heart failure, cerebrovascular disease and peripheral vascular disease.[1] The risk factors of CVD such as smoking, obesity, low physical activity, high cholesterol and lipid levels are modifiable.[3],[4]

The World Health Organisation (WHO) estimated that CVD accounted for 36% of the deaths due to NCDs, and it is projected to rise to 23.6 million by the year 2030. Unfortunately, more than two-thirds of these deaths occurred in developing countries.[5],[6] In addition, 70% of the global burden of diabetes occurred from developing countries in 2010, and the International Diabetes Federation (IDF) predicted a 50% increase by the year 2030 if no action is taken to forestall the current trend.[7] Recently, there is a decline in CVD mortality in advanced countries which is due to the pro-active approaches to the prevention and management of cardiovascular risk factors (CRFs).[8]

Hypertension was rare in Africa in the 1950s and 1960s due to the indigenous diet and other physiological factors.[9] The narrative changed with the adoption of the Western diet and sedentary lifestyle, resulting in the increase prevalence of CVD risk factors, morbidity and mortality in Nigeria.[10],[11],[12] This calls for proactive measures to prevent the development and early identification of risk factors and prompt management of individuals with CVD. This study determined the prevalence of CRFs among the staff of a private Nigerian University.


  Methods Top


Study setting

This study was conducted at the Babcock University, a faith-based institution of higher learning established by the 7th day Adventist Church in Ilishan-Remo, Ogun State, Nigeria. The institution has over 1000 undergraduate and post-graduate students population of about 10,000.

Study duration

Data collection commenced on 2nd May 2018 and ended on 30th July 2018.

Study design

We conducted a descriptive, cross-sectional study.

Sample size

A prevalence of CRFs of 90%,[13] standard normal deviation of 1.96 and degree of precision of 95% was used in the sample size formula for the cross-sectional study. A sample size of 138 was calculated. However, 140 participants were recruited for the study.

Sampling technique

Eligible volunteer staff were consecutively recruited for the study.

Selection criteria

Inclusion criteria

Apparently healthy staff of the Babcock University were included in the study.

Exclusion criteria

Participants were excluded from the study if they were febrile based on the temperature recorded by a thermometer (temperature above 37.4°C), if participants were taking antibiotics, insulin, lipid-lowering drugs and contraceptives.

Study procedure

On recruitment, the participants' details such as age and gender were collected on a pro forma after which the weight, height, waist circumference and blood pressure measurements were taken. About 6 ml of venous blood was collected for blood glucose and lipid profile analysis. Enzymatic methods (Randox laboratories, County Antrim BT29 4QY United Kingdom)were used for the analysis of blood glucose and lipid profile. Low-density lipoprotein-cholesterol (LDL-C) was calculated using the Friedewald's equation: LDL-C (mg/dl) = (total cholesterol – high-density lipoprotein-cholesterol [HDL-C] − [triglyceride/5] mg/dl).[14]

Measurements and definition of the outcome variables

Weight

Body weight measurement was done using a standardised weighing scale.

Height

A standard stadiometer was used for the height measurement in meters. The participant wore light clothing during the measurement.

Body mass index

Body mass index was calculated by weight in kg/height in m2. Participants with body mass index (BMI) ≥30 kg/m2 were classified as obese according to the WHO classification.[15]

Waist circumference

The waist circumference was measured done using the superior border of the iliac crest as landmark. The measurements of ≥94 cm in men and ≥80 cm in women were considered as abnormal based on the IDF definition.[16]

Blood pressure

Blood pressure measurement was taken twice in the sitting position using a sphygmomanometer with adult cuff size and the average recorded. Participants who were known hypertensive and those with blood pressure ≥140/90 mmHg were classified as having hypertension according to the European Society of Cardiology guidelines.[17]

Diabetes

Participants were classified as patients with diabetes when the fasting glucose level was ≥126 mg/dL as described by the American Diabetes Association.[18]

Lipid classification

Cholesterol values ≥200 mg/dL were classified as hypercholesterolaemia, triglyceride ≥150 mg/dL as hypertriglyceridaemia, LDL-C ≥130 mg/dL as high, HDL-C ≤40 mg/dL (in men) and ≤50 mg/dL (in women) as low HDL-C.[16]

Dyslipidaemia

Participants were classified as having dyslipidaemia when any of the lipid profile is above (total cholesterol, triglyceride and LDL-C) or below (HDL-C) the normal values.

Smokers

Participants were termed smokers if they are currently smoking or smoked previously.

Cardiovascular risk factors

Six risk factors were considered in this study, namely general obesity, abdominal obesity, diabetes mellitus, dyslipidaemia, hypertension and smoking.

Ethical considerations

The Institution Review Board of the Babcock University granted the ethical approval for the study (Protocol number BUHREC 372/18. Approved 25th April 2018).

Data analysis

Data analysis was conducted using the Statistical Package for the Social Sciences (IBM version 22, IBM Armonk, NY USA). Numerical variables were represented as percentages, mean and standard deviation. Student's 't'-test was used to compare the numerical variables of two independent groups. The confidence interval was set at 95%, and statistical tests were adjudged to be statistically significant if the P value was <0.05.


  Results Top


One hundred and forty participants were recruited. The mean age was 41.7 ± 9.4 years, and male: female ratio of 1:0.8. The gender difference between the participants' anthropometric and biochemical parameters is shown in [Table 1]. The mean systolic blood pressure (130.6 ± 12.5 mm/Hg vs. 113.9 ± 11.3 mmHg), diastolic blood pressure (80.3 ± 12.2 mmHg vs. 71.4 ± 14.6 mmHg) and mean serum triglyceride levels (98.7 ± 54.4 mg/dL vs. 64.9 ± 28.6 mg/dL) were statistically significantly higher in males than females (P < 0.05). However, the mean HDL-C levels were higher in females (54.4 ± 12.9 mg/dL vs. 44.8 ± 12.8 mg/dL) (P < 0.001). There was no gender difference in the mean waist circumference, BMI, fasting plasma glucose, LDL-C and total cholesterol values (P > 0.05).
Table 1: Gender distribution of baseline parameters

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[Figure 1] shows the frequency distribution of the number of CRFs. About 24% of the participants had no CRF, but 24.3%, 27.1%, 16.4% and 10% had 1, 2, 3 and 4 CRFs, respectively. None of the participants had 6 CRFs. The prevalence of CRFs is shown in [Figure 2]. Majority had abdominal obesity (48.6%) and dyslipidaemia (47.1%). The prevalence of hypertension, obesity and smoking was 32.7%, 31.4% and 11.4%, respectively. None of the participants had diabetes mellitus.
Figure 1: Number of cardiovascular risk factors

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Figure 2: Prevalence of cardiovascular risk factors

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[Table 2] shows the age distribution of the CRFs. Participants in the age group of 40 years and older had a higher proportion of smoking (14.5% vs. 7.0%), obesity (34.9% vs. 26.3%) and abdominal obesity (49.4% vs. 47.4%), but none was statistically significant (P > 0.05). Hypertension and dyslipidaemia were also not associated with age (P > 0.05). The prevalence of hypertension was 32.9%; 34 participants (26.5%) were newly diagnosed as having hypertension.
Table 2: Age distribution of cardiovascular risk factors

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A significant proportion of males smoked cigarettes (20% vs. 0%) and had hypertension (50% vs. 10%) compared with the females (P < 0.001); however, more females (63.3% vs. 37.5%) had abdominal obesity (P = 0.002) than that of males. There were no gender differences in obesity and dyslipidaemia (P > 0.05) [Table 3].
Table 3: Gender distribution of cardiovascular risk factors

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  Discussion Top


In this study, six CRFs were considered, the proportion of participants with no CRF (24.3%) and clustering of 2 or more CRFs (55%) was at variance with the prevalence of 9.5% and 67.7%, respectively, reported in a study among out-patients in seven Nigerian hospitals.[13] This may be due to the study population of both studies. The chances of an apparently healthy population to have CRF may be much lower compared to clients seeking health-care services in the hospitals. Similar to other Nigerian studies, the prevalence of general obesity was lower as compared to the prevalence of abdominal obesity in this study.[19],[20] The prevalence of obesity was low in the last century; however, urbanisation, industrialisation and westernisation have led to an increase in the sedentary lifestyle and unhealthy habits, which has increased the prevalence of obesity in Nigeria.[21],[22] Contrary to our findings, studies have reported a gender difference in obesity either measured by BMI or waist circumference being higher in women than men.[23],[24] Our study showed that there was no gender difference or age difference in the general and abdominal obesity. The reason for this is not known, sampling variation and study population may be responsible forour finding.

The prevalence of dyslipidaemia was 48.6% in our study, lower than what was reported in previous studies.[13] Similar studies have reported dyslipidaemia to be high among healthy individuals.[25],[26] There was no gender or age difference in the prevalence of dyslipidaemia in our study. Dyslipidaemia is a major risk factor for atherosclerotic disease, and it is associated with increasing age. Sedentary lifestyle, poor diet and genetic tendencies alter the lipid levels and contribute to the development of CVD.[27]

About a third of the participants in our study had hypertension, and 26.5% were newly diagnosed. Our finding was lower than what was reported in a previous study among university staff from Northern Nigeria.[28] It has been predicted that the developing countries will account for 75% of the global burden of hypertension by the year 2025.[29] There was no age difference in the prevalence of hypertension similar to what was reported in similar Nigeria studies;[13],[19],[30],[31] however, unlike previous studies, the prevalence of hypertension was higher among males in our study.[13],[19]


  Conclusion Top


CRFs are high in apparently healthy staff of the Babcock University; the majority of which were undiagnosed and are unaware of their health risk. The need for urgent health education, frequent routine medical check-up and early intervention for people at risk to reduce the prevalence of CRF cannot be overemphasised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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