KNOWLEDGE AND PERCEPTION OF HYPERTENSION AND IT'S MANAGEMENT AMONG CLIENTS / PATIENTS

1.1 Introduction

High blood pressure occurs when one’s blood move through the arteries at a higher speed than normal. It is also known that for now there is no cure for high blood pressure (Papadakis et al., 2008). Secondary hypertension has a known cause and accounts for five per cent to ten per cent of all hypertension cases. Chris (2009) maintained that the most common cause of secondaryhypertension is an abnormality in the arteries supplying blood to the kidneys. Other causes include airway obstruction during sleep, stress, diseases and tumors of the adrenal glands, lifestyle, spinal cord injury, hormone abnormalities (oral contraceptive estrogen replacement), thyroid disease, toxemia of pregnancy, renal problems such as vascular lesion of renal arteries, diabetic neuropathy, pains as well as anxiety and hypoglycemia.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

1.2 Background of Study

Hypertension remains a major global public health challenge that has been identified as the leading risk factor for cardiovascular morbidity and mortality (Kearney, Whelton, Reynolds, Muntner, Whelton& He, 2004). It increases hardening of the arteries, thus predisposing individuals to heart diseases, peripheral vascular diseases, stroke, heart failure and kidney failure. Hypertension is the commonest non-communicable disease in the world and all races are affected with variable prevalence.

Castelli (2004) explained that its prevalence is on the increase in developing countries where adoption of western lifestyle and stress of urbanization, both of which are expected to increase morbidity associated with unhealthy lifestyle are not on the decline. Andreoli, Carpenter, Grigs and Loscalzo (2004) were of the opinion that hypertension produces disruptions in health, disability and death in the adult population worldwide.

Ejike, Ezeanyika and Ugwu (2010) stated that hypertension causes one in every eight deaths worldwide, making it the third leading killer disease in the world. They also estimated that about one billion adults, the world over, had hypertension in the year 2010 and the number is expected to rise to 1.56 billion in the year 2025 if positive intervention programme is not made. Aram, George, Henry, Williams, Lee, and Joseph (2003) indicated that fifty million Americans have high blood pressure, approximately one in three adults.

In United States of America, approximately twenty eight (28) to thirty one per cent of adults have hypertension (Fields, Burt & Cutler (2004). Of this population, 90 to 95 per cent have primary hypertension (high blood pressure related to unidentified cause). The remaining five to tenper cent of this group have secondary hypertension (high blood pressure related toidentified cause). In China, almost 130 million people aged 35-74 years are estimated to be hypertensive (Camel & Delene, 2006). Similarly in Ghana, studies revealed a hypertension prevalence of forty per cent among rural dwellers and eight per cent to thirteen per cent in the urban areas. In sub-Saharan Africa, it is the most rapidly rising cardiovascular disease and affecting over 20 million people (Kadiri, 2005). He also stated that in Nigeria, hypertension is the commonest non-communicable disease with over 4.3 million Nigerians above the age of fifteen years classified as being hypertensive.

Hypertension, also known as high blood pressure is the persistent blood pressure in the arteries above ninety millimetres of mercury (mmHg) between the heart beats (diastolic) or over 140 millimetres of mercury (mmHg) at the beats (systolic) (Aquilla, 2008). According to Hyman and Parlik (2003), hypertension is the persistent raised levels of blood pressure in which the systolic pressure is above 140 mmHg and diastolic pressure above 90 mmHg. The normal blood pressure is below 120/80 mmHg; blood pressure between 120/80 and 139/89 is called ‘Pre-hypertension, and a pressure of 140/90 or above is considered high (abnormal) blood pressure.

The risk factors of hypertension are genetic factor which can be inherited from parents, age which when the body does not retain the amount of elasticity as it used to in the early years of life, obesity which is an increase in weight of over ten per cent above normal body index due to generalized deposition of fat in the body, excessive salt intake which increases blood pressure, stress which produces chemical substances that cause generalized vasoconstriction, oral contraceptive which contains estrogen that causes salt retention that increases the volume of blood, sedentary lifestyle which has the tendency of increasing body weight and directly raises blood pressure, elevated levels of plasma lipids particularly cholesterol, excessive alcohol consumption which increases blood pressure and tobacco use (cigarette smoking) that contains nicotine which causes constriction of the blood vessels.

Therefore, in Edo State where the research was carried out, the activities that was conducted is to know the Knowledge and Perception of Hypertension and It’s Management among Clients / Patients.

1.3 Statement of Problems

Investigation reveals the Challenges of Knowledge and Perception of Hypertension and It’s Management among Clients / Patients in St Philomena’s Hospital Benin City research work:

1. A lot of patients have died as a result of Hypertension.
2. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
3. Heart failure: To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart's pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
4. Hypertension among pregnant women can affect the blood vessels. It may decrease blood flow in liver, kidneys, brain, uterus, and placenta in pregnant women.

1.4 Aim and Objectives of Study

The aim of the study is to examine the Knowledge and Perception of Hypertension and It’s Management among Clients / Patients in St Philomena’s Hospital Benin City. In achieving this aim, the following specific objectives were laid out as follows:

1. To evaluate the knowledge, perception, attitudes and life-style practices of hypertensive patients in St Philomena’s Hospital Benin City;
2. To examine the perception of clients towards the management of hypertension;
3. To describe the barriers to effective management of hypertension;
4. To determine the level of knowledge and perception of hypertension and its management possessed by hypertensive patients; and
5. To determine the extent and direction of the relationship between the socio-demographic variables and hypertension among Patients in St Philomena’s Hospital Benin City.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the knowledge, perception, attitudes and life-style practices of hypertensive patients in St Philomena’s Hospital Benin City?
• What is the extent and direction of the relationship between the socio-demographic variables and hypertension among Patients in St Philomena’s Hospital Benin City?
• What are the barriers to effective management of hypertension?
• What is the level of knowledge and perception of hypertension and its management possessed by hypertensive patients?
• What is the extent and direction of the relationship between the socio-demographic variables and hypertension among Patients in St Philomena’s Hospital Benin City?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no relationship between the socio-demographic variables and hypertension among Patients in St Philomena’s Hospital Benin City
• H1: There is relationship between the socio-demographic variables and hypertension among Patients in St Philomena’s Hospital Benin City

Hypothesis Two

• H0: There is no significant effect of hypertension among Patients in St Philomena’s Hospital Benin City
• H1: There is significant effect of hypertension among Patients in St Philomena’s Hospital Benin City

1.7 Significance of Study

The results of this study will be useful to health educators, medical and paramedical officers, public health officers, counsellors, media educators, researchers, curriculum planners, government and adults in many ways. The study may help to develop a positive regard towards hypertension.

The ministry of health may benefit from the study by discovering a gap in knowledge of the population, and emphasize strategies to teach the adult population on how to prevent the risk factors. It may also be useful to other researchers to carry out this study in areas where disease prevention measures and health promotion are needed with regards to hypertension.

The relevance of this research work will help individuals to predict their blood pressure given their weight and will equally help them to know what to do when their blood pressure (Hypertension) rises. This study will be of immense benefit to researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Knowledge and Perception of Hypertension and It’s Management among Clients / Patients using St Philomena’s Hospital in Benin City of Edo State as a case study.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.10 Operational Definition of Terms

Hypertension: Abnormally high blood pressure, a state of great psychological stress.

Hypertension Management: Hypertension is managed using lifestyle modification and antihypertensive medications. Hypertension is usually treated to achieve a blood pressure of below 140/90 mmHg to 160/100 mmHg.

Knowledge: Facts, information, and skills acquired through experience or education; theoretical or practical understanding of a subject.

Perception: Perception is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information, or the environment.