CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the Study

The word hypertension is defined as a persistence increase in systemic arterial blood pressure (Sembulingam and Sembuligam, 2006). Clinically, when the systolic pressure remains elevated above 140mmHg and diastolic pressure remains elevated above 90mmHg, it is considered as hypertension. The prevalence varies with age, race, education, occupation and many other variables (Benowitz, 2009). In Nigeria for example, the true incidence of hypertension remains unknown but its prevalence among male and female is estimated to be 11.2% with age adjusted figure of 9.3% (Nurudeenet al., 2013). This translates into approximately 13.4 million Nigerians becoming hypertensive at the age of 15years and above, using the projected national population census figure of 120million (Akinkungbe, 1998). In fact, hypertension is reported to be next to malaria as most serious health problems in developing tropical countries (Agunwa, 1988).

The global dimension of hypertension is immense, as it ranks the most common cardiovascular ailment afflicting about one billion people in the world and causing roughly 7.1 million deaths annually (Brundtland, 2002). Hypertension is said to be the most common cardiovascular disease among Africans and congestive cardiac failure its commonest complication (Akinkungbe 1972, 1985). Earlier studies suggested that hypertension was rare in African population (Sharper et al., 1969, Pobeeet al., 1977), however, epidemiological transition, urbanization, adoption of urban and foreign lifestyles and improved case findings, among others, have made hypertension more prevalent as shown in some studies (Cooper et al., 1998). The last Nigerian National Non-communicable Disease Survey (NNCDS) conducted in 1997 reported 11.4% prevalence of adult hypertension, varying from 14.8% in urban to 9.8% in rural residences respectively. However, a report on Nigeria from the World