CHAPTER ONE

INTRODUCTION

1. BACKGROUND OF THE STUDY

Hypertension is one of the most common chronic non-communicable diseases worldwide and represents a major public health challenge due to its high prevalence and serious complications. It is often referred to as a “silent disease” because many individuals remain asymptomatic for years, allowing vascular and organ damage to progress unnoticed. As populations grow and age, the burden of hypertension continues to rise, placing increasing strain on health care systems and societies (Bin Dahman et al., 2024). Elevated blood pressure is a leading modifiable risk factor for cardiovascular diseases, including coronary artery disease, heart failure, stroke, and peripheral vascular disease. It also contributes significantly to chronic kidney disease, visual impairment, and cognitive decline. The strong association between hypertension and these adverse outcomes highlights the importance of early detection, effective management, and prevention strategies at the primary care level (Noah et al., 2020). Family medicine clinics play a crucial role in the identification and long-term management of hypertension. These clinics often serve as the first point of contact between individuals and the health care system, providing comprehensive and continuous care. Adults attending family medicine clinics represent a diverse population with varying socioeconomic, behavioral, and clinical characteristics, making them an ideal group for studying the prevalence and determinants of hypertension (Belay et al., 2022). Despite the availability of effective antihypertensive therapies, blood pressure control remains suboptimal in many populations. Poor awareness of hypertension status, inadequate adherence to treatment, and limited access to regular follow-up contribute to uncontrolled blood pressure. Understanding the magnitude of hypertension among adults attending family medicine clinics can help identify gaps in screening, diagnosis, and management (Ondimu et al., 2019). The prevalence of hypertension varies widely across different regions and populations, influenced by demographic and lifestyle factors. Age is one of the strongest predictors, with blood pressure tending to increase as individuals grow older. Gender differences have also been observed, with variations in prevalence and risk profiles across different stages of life. These variations underscore the need for population-specific data to inform targeted interventions (Shah et al., 2025). Lifestyle-related factors play a significant role in the development of hypertension. Unhealthy dietary habits, including high salt intake and low consumption of fruits and vegetables, contribute to elevated blood pressure. Physical inactivity, obesity, tobacco use, and excessive alcohol consumption further increase the risk. These modifiable risk factors are particularly relevant in primary care settings, where preventive counseling can be effectively implemented (Al-Ahmari, 2022). Socioeconomic and psychosocial factors are increasingly recognized as important determinants of hypertension. Lower educational levels, unemployment, and financial stress have been associated with higher blood pressure levels. Chronic stress, poor sleep quality, and mental health conditions may also contribute to the development and persistence of hypertension, especially among adults facing daily life pressures (Zheng et al., 2024). Comorbid conditions such as diabetes mellitus, dyslipidemia, and chronic kidney disease frequently coexist with hypertension. The presence of these conditions not only increases the likelihood of developing hypertension but also amplifies the risk of cardiovascular complications. In family medicine clinics, patients often present with multiple comorbidities, highlighting the need for an integrated approach to chronic disease management (Tilea et al., 2018). Urbanization and changes in lifestyle patterns have led to an increased prevalence of hypertension in many communities. Sedentary behavior, reliance on processed foods, and reduced physical activity are common features of modern life. Adults attending family medicine clinics may reflect these broader societal changes, making them an important population for studying current trends in hypertension (Alshuhri et al., 2024).

1. STATEMENT OF THE PROBLEM

Assessing the prevalence and risk factors of hypertension among adults attending family medicine clinics is essential for guiding public health planning and clinical practice. Identifying high-risk groups allows for the development of targeted prevention and early intervention strategies. Such research can support family physicians in optimizing screening programs, improving patient education, and ultimately reducing the burden of hypertension and its complications (Belayachi et al., 2024).

1.3 AIM AND OBJECTIVES OF THE STUDY

The study seeks to determine the effect of high blood pressure and diabetes on kidney function among older adults in Makurdi, Benue state. The objectives of the study are:

1. To determine the relationship between high blood pressure and well being of older adults 
2. To examine whether diabetes influence high blood pressure among older adults
3. To identify the factors affecting high blood pressure among older adults
4. To recommend ways to improve the kidney function among older adults 

1.4 RESEARCH QUESTIONS

The following research questions guide the objectives of the study:

1. What is the relationship between high blood pressure and well being of older adults? 
2. Does diabetes influence high blood pressure among older adults?
3. What are the factors affecting high blood pressure among older adults?
4. What are the ways to lower hypertension among older adults 

1.5 STATEMENT OF THE HYPOTHESIS

H0: there is no significant relationship between high blood pressure and well being of older adults 

H1: there is significant relationship between high blood pressure and well being of older adults 

1.6 SIGNIFICANCE OF THE STUDY

The study on the effect of high blood pressure among older adults will be of immense help to the entire health centres  towards creating awareness on the implication of high blood pressure. The study findings of the study will also establish a correlation between high blood pressure and well being of older adults. The study will also serve as a source of information to health centres in Benue state and other researchers and contribute to the body of the existing literature on the effect of high blood pressure among older adults.

1.7 SCOPE OF THE STUDY

The study covers on the prevalence and risk factors of hypertension among adults

1.8 LIMITATION OF THE STUDY

TIME CONSTRAINTS: One the challenges experienced by the researcher is the issue of time; the research will simultaneously engage in departmental activities like seminars and attendance to lectures. But the researcher was able to meet up with the deadline for the submission of the project.

FINANCIAL CONSTRAINTS: Every research work needs funding; however lack of adequate funds might affect the speed of the researcher in getting materials for completion of the project

1.9 DEFINITION OF TERMS

BLOOD PRESSURE: Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood