Doctor's Corner

By: Dr. Louis Chipere

Background: Hypertension (HTN) is common among patients presenting for surgery and literature has suggested that it is the commonest avoidable medical indication for postponing anesthesia and surgery. In June 2009, the Malawi government conducted a STEPS Survey for Chronic non-communicable diseases and their risk factors.  The study consisted of 5,206 participants, of which 67.5% were women. The report revealed that about 1/3 (32.9%) of the participants had raised Blood Pressure which is quite remarkable. However, studies that have reported on the prevalence of hypertension among surgical inpatients at Queen Elizabeth Central Hospital (QECH) are scarce. 

Objectives: The study aimed at determining the prevalence of hypertension among inpatient in surgical ward and it provides information on prevalence of hypertension among surgical patients at QECH that can be used by other stake holders. The study also aimed at determining prevalence of the associated risk factors of hypertension. Some are modifiable risk factors which can be adjusted through life style change. These include obesity, smoking, and lack of exercise, diet and salt intake.  There are also non modifiable ones like gender, age and family history.

Methods: A descriptive cross-sectional study was conducted at QECH in all adult surgical wards. The study population consisted of patients who were above 18 years of age and participants were sampled using consecutive sampling method. A total of 84 individuals participated in the study and data was collected using a structured questionnaire. 

Results: Overall, there were 84 participants. The mean systolic blood pressure was 128.2 mmHg with a range of 100 mmHg (range = 183-83) and standard deviation (SD) of 21.52. Out of 84 participants, 26 were found hypertensive representing a prevalence of 30.95%. Among 26 hypertensive participants, 16 were men and 10 were females representing 39.02% and 23.25% respectively.   Prevalence according to age in years was grouped as follows: 18-29, 30-39, 40-49, 50-59 and ≥60 in that order. The prevalence’s were 9.10%, 23.80%, 7.69%, 50.0% and71.14% respectively. The salt intake was categorized into 0-5 g/day and ≥6 g/day and the prevalence’s were 28% and 35.29% respectively. Prevalence of hypertension according to alcohol consumption was 37.04%. The prevalence of hypertension according to tobacco use was 44.44%. The BMI distribution was put into 4 categories: <18.5, 18.5-24.5, 25.5-29.9, and ≥30. The prevalence’s were 57.14%, 28.89%, 40% and 50% in that order. On level of activity, participants were categorized into low, moderate and vigorous. The prevalences were 30%, 46.67% and 24.14% respectively. Among participants with a family history of hypertension, the prevalence of hypertension was 41.38%. The prevalence of hypertension among participants with a family history of  diabetes was 30%. The prevalence of hypertension among participants on NSAIDS was 28% while that for participants on steroid was 50%.   

Conclusion: Hypertension and its associated risk factors are a major health problem among adult