Burden and Determinants of Hypertension in Adult Residents of Ekiti State: A Population Based Study

Background Hypertension is the leading risk factor for cardiovascular disease in Nigeria and sub-Saharan Africa, contributing substantially to morbidity and mortality. It is influenced by multiple factors among which are diet, stress, and physical inactivity—all affected during the COVID-19 lockdown. Many individuals faced increased stress due to financial insecurities, restricted access to healthcare, and limited opportunities for physical activity, which are known to contribute to elevated blood pressure. Objective This study investigated the burden and the determinants of hypertension in Ekiti State. Methods A cross-sectional, multi-stage cluster survey was conducted between June and September 2020 to assess the burden and prevalence of hypertension. Utilising the World Health Organisation STEP-wise approach to chronic disease risk factor surveillance, a representative sample of 3,910 adult residents was selected. Binary logistic regression was employed to identify significant associations between cardiovascular risk factors and hypertension. Results Women comprised 73.9% of the study population. Participants’ mean age, waist circumference, and body mass index were 43.1 ± 17.1 years, 85.3 ± 12.1 cm, and 25.1 ± 11.3 kg/m² respectively. Hypertension prevalence in Ekiti State was 23.4%, with awareness, treatment, and control rates at 36.9%, 29.9%, and 18.7%, respectively. Hypertension determinants included age (45-64 and > 65 years), truncal obesity, and semi-urban/urban residence. Regular moderate-intensity exercise was associated with a lower likelihood of hypertension, although not statistically significant. In the multivariate regression analysis, hypertension determinants included age (45-64 years) [AOR = 32.42; C.I 95%: (23.51-44.69) p <0.001], age (> 65 years) [AOR = 44.71; C.I 95%: (30.28 - 66.00) p <0.001], Primary Education [AOR = 0.69; C.I 95%: (0.48 - 0.99) p = 0.042], increased waist circumference [AOR = 1.80; C.I 95%: (1.37 - 2.35) p<0.001], Semi-Urban[AOR = 1.66; C.I 95%: (1.26 - 2.19) p<0.001] and Urban [AOR = 1.66; C.I 95%:(1.20 - 2.30) p = 0.002. Conclusion The prevalence of hypertension in Ekiti State is lower than the national average, and its determinants include advancing age, primary education, truncal obesity, and semi-urban/urban residence. This calls for scaling up public health interventions for controlling hypertension targeted at those living in Ekiti, Nigeria.