title: Blood pressure gradients and cardiovascular risk factors in urban and rural populations in Abia State South Eastern Nigeria using the WHO STEPwise approach.
abstract: BACKGROUND
  Developing countries of sub-Saharan Africa (SSA) face a double burden of non-communicable diseases (NCDs) and communicable diseases. As high blood pressure (BP) is a common global cardiovascular (CV) disorder associated with high morbidity and mortality, the relationship between gradients of BP and other CV risk factors was assessed in Abia State, Nigeria.
  
  
  METHODS
  Using the WHO STEPwise approach to surveillance of chronic disease risk factors, we conducted a population-based cross-sectional survey in Abia state, Nigeria from August 2011 to March 2012. Data collected at various steps included: demographic and behavioral risk factors (Step 1); BP and anthropometric measurements (Step 2), and fasting blood cholesterol and glucose (Step 3).
  
  
  RESULTS
  Of the 2983 subjects with complete data for analysis, 52.1% were females and 53.2% were rural dwellers. Overall, the distribution of selected CV disease risk factors was diabetes (3.6%), hypertension (31.4%), cigarette smoking (13.3%), use of smokeless tobacco (4.8%), physical inactivity (64.2%) and being overweight or obese (33.7%). Presence of hypertension, excessive intake of alcohol, smoking (cigarette and smokeless tobacco) and physical inactivity occurred more frequently in males than in females (p<0.05); while low income, lack of any formal education and use of smokeless tobacco were seen more frequently in rural dwellers than in those living in urban areas (p<0.05). The frequency of selected CV risk factors increased as BP was graded from optimal, normal to hypertension; and high BP correlated with age, gender, smokeless tobacco, overweight or obesity, annual income and level of education.
  
  
  CONCLUSIONS
  Given the high prevalence of hypertension in this part of Nigeria, there is an urgent need to focus on the reduction of preventable CV risk factors we have observed to be associated with hypertension, in order to effectively reduce the burden of NCDs in Africa.
authors.affiliation: Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Ikechi Gareth
authors.initials: IG
authors.lastname: Okpechi
authors.forename: Innocent Ijezie
authors.initials: II
authors.lastname: Chukwuonye
authors.forename: Nicki
authors.initials: N
authors.lastname: Tiffin
authors.forename: Okechukwu Ojoemelam
authors.initials: OO
authors.lastname: Madukwe
authors.forename: Ugochukwu Uchenna
authors.initials: UU
authors.lastname: Onyeonoro
authors.forename: Theophilus Ifeanyichukwu
authors.initials: TI
authors.lastname: Umeizudike
authors.forename: Okechukwu Samuel
authors.initials: OS
authors.lastname: Ogah
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D014030:Tobacco, Smokeless / Q000009:adverse effects; D014505:Urban Population; D055815:Young Adult
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