EXPERTS, in a new survey, said that 13.3 per cent of Nigerians whose blood pressure reading is normal when taken at the hospital actually turned out to have high blood pressure when the same measurement is repeated at home, a condition they termed masked hypertension.
The experts said though doctors do not routinely tell people to measure their blood pressure at home if it is normal, masked hypertension MH is common in Nigeria and tend to increase in incidence with increasing age, systolic blood pressure reading at the hospital and randomly blood glucose level.
The survey, which included 933 adult Nigerians, had obtained their clinic blood pressure and out-of-clinic blood pressure readings by self-measured home blood pressure semi-automated oscillometric device. It was in the April edition of the American Journal of Hypertension.
Removing the Mask on Hypertension (REMAH) study was a nationwide survey on hypertension that deployed the WHO stepwise methodology. Twelve communities (rural and urban) from the six geopolitical zones of Nigeria were selected through multistage sampling.
Houses within each Independent National Electoral (INEC) polling area were systematically numbered and 100 houses were randomly selected for visitation on the assumption that each household had at least four adults.
Among 933 participants, the prevalence of sustained hypertension, masked hypertension, and white-coat hypertension was 28.3%, 7.9%, and 11.9%, respectively. Also, among subjects whose clinic blood pressure was in the normal range, the prevalence of masked hypertension was 13%; 12% among untreated and 27% among treated individuals.
The expert declared, “Our present study raises some concerns about the current public health strategies aimed at controlling hypertension. Our group recently reported that the prevalence of hypertension following a nationwide survey according to the STEPS protocol was 38%.
“This translates to about 76 million Nigerians who are living with hypertension. The remaining 124 million are adjudged as having normal blood pressure based on their blood pressure reading at the hospital.
“Extrapolating from the current report, an additional 15 million (12%) Nigerians with normal blood pressure have hypertension that is masked to clinic measurement and as such exposed to cardiovascular risk similar to those who have a sustained hypertension.”
While identifying individuals who have MH should be a public health priority, they declared that community screening of blood pressure using non-health personnel volunteers could be used, in addition to hypertensive patients also engaging in self-monitoring of BP to help detect those with masked uncontrolled hypertension.
They added that self-measurement of blood pressure empowers patients, increases adherence to antihypertensive therapy, allows detection of symptoms that occur between clinic visits, and reduces the number of clinic visits required for follow-up in the management of hypertension.
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