INFORMATION AND COMMUNICATIONS UNIVERSITY

SCHOOL OF EDUCATION

An assignment submitted in partial fulfillment of the requirements for the BA Degree in information Communication and Technology with

Education

Assignment No. 1

NAME : CHEELO CHIBAMBA

SIN : 1502397696

COURSE: E-LEARNING & DIGITAL CULTURE

Year : 2018

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Topic: PREVELANCE OF HYPERTENSION AND ITS IMPACT IN ELLAINE

BRITTEL COMPOUND LIVINGSTONE.

CHAPTER ONE

1.0 INTRODUCTION

1.1Background to the study …………………………………………………………… 4

1.2 Statement of the problem ………………………………………………………….. 4

1.3 Purpose of the study ……………………………………………………………….. 5

1.4 Objectives of the study ……………………………………………………………. 5

1.5 Research questions ………………………………………………………………… 5

1.6 Assumptions of the study ………………………………………………………….. 5

1.7 Significance of the study ……………………………………………………….….. 6

1.8 Limitations of the study ………………………………………………………..…. 6

1.9 Operational definition of terms …………………………………………………... 7

CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction ……………………………………………………………………….. 8

2.1 Diagnosis of Hypertension ……………………………………………………….. 9

2.2. High Blood Pressure: Causes, risks factors and dangers ……………………….. 10

2.3 Fast foods and hypertension ………………………………………………………. 13

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2.4 Hypertension in Pregnancy ………………………………………………………. 14

2.5 High blood pressure and HIV/AIDS ……………………………………………… 15

2.6 Hypertension in developing countries ……………………………………………. 16

2.7 Socio-economic impacts of hypertension ………………………………………… 16

2.8.0 Prevention, control and treatment of hypertension …………………………….. 18

2.8.1 Medications for high blood pressure ……………………………………………. 17

2.8.2 Prevention and control of hypertension through lifestyle changes …………….. 18

2.9 Awareness and attitudes about hypertension ……………………………………… 21

CHAPTER THREE

METHODOLOGY

3.0 Introduction ……………………………………………………………………….. 22

3.1 Research design …………………………………………………………………… 22

3.2 Location of the study ……………………………………………………………… 23

3.3 Population ………………………………………………………………………… 24

3.4 Sample Size ………………………………………………………………………… 24

3.5 Sampling Procedures ………………………………………………………………. 24

3.6 Data Collection and Procedure ……………………………………………………. 24

3.7.0 Data Analysis ……………………………………………………………………. 25

3.7.1 Qualitative data analysis ………………………………………………………. 25

3.7.2 Quantitative data analysis ………………………………………………………. 25

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CHAPTER ONE

1.0 Introduction

1.1 Background of the study

The study is to be carried out in Ellaine Brittel compound located in Livingstone town found in

the Southern Province of Zambia. The human body has blood has blood pressure created by the

force of blood pushing against the walls of arteries as it is pumped by the heart. The raise in

blood pressure is referred as high blood pressure also known as hypertension.

Hypertension is the biggest risk factor for death, responsible for 9.4 million deaths and 7% of

disability worldwide. In the year 2000, the estimated number of adults living with high blood

pressure globally was 972 million and was expected to increase to 1.56 billion by 2025. (Maher

et al. 2010). The World Health Organization report in 2008 stated that 40% of people aged more

than 25 years had hypertension and it was named the number one killer. (WHO, 2013) The

information above shows that high blood pressure is a major public health issue. It is an

important public health challenge in both economically developing and developed countries.

In the past, high blood pressure was considered to be an ailment affecting only middle aged or

older individuals but lately it has been found to be prevalent in all age groups. The researcher a

teacher at Libala primary school within Ellaine Brittel taught at the school from 2005 to date and

came across many people who were hypertensive and these included fellow teachers, relatives,

parents and a few cases of pupils at the school. The numbers of deaths and disabilities related to

hypertension have increased in the recent years. This community has people who suffered

strokes and heart attacks due to high blood pressure.

The researcher’s experience led to the need to study the causes, effects, treatment, preventive

measures of high blood pressure including knowledge and attitudes that the members of

community have about hypertension.

1.2 statement of the problem

Hypertension has always been regarded as a disease of affluence but this has changed drastically

in the last two decades. The problem of blood pressure is now a common feature in Zambia and

its prevalence is increasing among less privileged sections of society. Hypertension is not only a

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major public health problem but also a big economic problem. There are many people who are

chronically ill or die due to high blood pressure leaving their families in poverty. It is referred to

as a “silent killer” because it often has no warning signs or symptoms, and many people do not

realize they have it. (Medical journal of Zambia 2016).

These views have brought concern to the local people in Ellaine Brittel and a great need to

prevent and control this deadly condition. Hence it became important to undertake this study.

1.3 Purpose of the study

The purpose of this study is to investigate the causes, effects, treatment, preventive measures,

including the knowledge and attitudes of people in different age groups about high blood

pressure in Ellaine Brittel Compound in Livingstone.

1.4 Objectives of the study

1.4.1 To ascertain the causes of high blood pressure in Ellaine Brittel.

1.4.2 To investigate the effects of hypertension on human health and on the economy.

1.4.3. To find out the treatment and preventive measures of hypertension.

1.4.4 To investigate the awareness and attitudes that people in Ellaine Brittel have about

hypertension.

1.5 Research questions

1.5.1 What are the causes of high blood pressure in Ellaine Brittel?

1.5.2 How does hypertension affect human health and the economy in Ellaine Brittel?

1.5.3 What treatment and preventive measures of hypertension are available?

1.5.4 What attitudes and knowledge do the people have about hypertension in Ellaine Brittel?

1.6 Assumption of the study

In this study it is assumed that:

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1.6.1 High prevalence of hypertensions affects human health and decreases the population.

1.6.2 Healthy lifestyles reduce the risk of hypertension.

1.6.3 Appropriate knowledge about hypertension prevents and controls it.

1.6.4 Hypertension affects economic development.

1.7 Significance of study

Hypertension is an important contributor to global burden of disease and is a growing public

health problem in Sub-Saharan Africa. Hypertension is a risk factor for coronary heart disease

and the single most important risk factors for stroke. It is responsible for at least 45% of deaths

to heart disease, and at least 15% of deaths due to stroke, (Guwatudde 2015).

High blood pressure is referred to as a “silent killer” so many people including breadwinners die

and leave behind their families in poverty without experiencing symptoms of high pressure. Over

the years, the numbers of orphans who drop out of school and get involved in criminal activities

have increased due to the high rate of high blood pressure. Deaths and disabilities that are caused

by hypertension also reduce the productivity in industries hence affecting the economy

negatively.

The Zambian government allocates a large sum of funds to the ministry of health to control and

reduce the prevalence of different diseases. Since hypertension is a condition that causes stroke,

heart attack, kidney failure and other disabilities it influences the ministry of health to spend

more money on equipment and medication to address the above mentioned diseases (medical

journal in Zambia 2016).

The knowledge that was obtained from this research would be used to sensitize the citizens on

the negative effects of high blood pressure in relation to sustainable development. The findings

of this research would instill health lifestyles in the control or prevention of hypertension. It

would also motivate the interest for further research on hypertension by scholars in Zambia.

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1.9 Definitions of terms

1. Hypertension – It is a long term medical condition in which the blood pressure in the

arteries is persistently elevated.

2. Prevalence – The condition of being wide spread.

3. Sedentary Lifestyle – A type of lifestyle where an individual does not receive regular

amounts of physical activity. ( Farlex 2009)

4. Silent killer – Without warning signs or symptoms

5. Risk – To expose to the chance of injury or loss.

6. Diagnosis – An analysis of the cause or nature of a problem.( Farlex 2009)

7. Blood vessel - Any of the vessels, as arteries, veins or capillaries through which the blood

circulates.

8. Treatment – Management in the application of medicines.

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CHAPTER TWO

LITERATURE REVIEW

2.0 Introductions

Blood pressure is the measure of the pressure or force of the blood against the walls of the blood

vessels. It is the product of the amount of blood pumped by the heart each minute and the degree

of dilation or constriction of the arteries. A normal blood pressure allows blood to flow and

deliver oxygen to different parts of the body. Blood pressure is one of the most important

indicators of health, (woods 2005).

High blood pressure is also referred to as hypertension. It is defined as a systolic blood pressure

at or above 140 mm Hg and or a diastolic blood pressure at or above 90 mm Hg. It happens when

the force on the walls of the arteries from blood within them is more than normal. This means the

heart has to work harder and the arteries are under more strain, making hypertension a major risk

factor for heart disease, stroke and other serious conditions. Hypertension is a long-term medical

condition in which the blood pressure in the arteries is persistently elevated. It is a complex,

chronic condition that is often referred to as the “the silent killer” (World Health Organization

2013).

Blood Pressure is measured in millimeters of mercury (mmHg). The device used to measure

blood pressure is known as sphygmomanometer. It is also known as the blood pressure meter.

Blood pressure is expressed as two numbers as 110/70. The top number represents the systolic

blood pressure while the bottom number represents the diastolic blood pressure. Systolic blood

pressure is the maximum pressure in the arteries when the heart contracts. Diastolic blood

pressure is the minimum pressure in the arteries when the heart relaxes.

High blood pressure is classified in two main categories, primary and secondary hypertension.

Primary hypertension is also known as essential hypertension. Most cases of cases of high blood

pressure are classified under primary hypertension and it occurrences can be due to natural

factors such as age, gender, race and hereditary pre-conditions. Secondary hypertension can be

caused by various conditions and medications such as kidney problems, thyroid problems,

blocked arteries and many others. (Ministry of Health, 2013).

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Low

Ideal Blood Pressure

Pre-high blood pressure

High blood pressure

According to John (2017), there are five categories that define blood pressure reading for adults.

A healthy blood pressure is less than 120/80 millimeters of mercury (mmHg). Low blood

pressure is 90/60 millimeters of mercury (mmHg). An elevated blood pressure occurs when the

systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm

Hg. In stage 1 hypertension, the systolic number is between 130 and 139 mmHg, or the diastolic

number is between 80 and 89 mmHg. In stage 2 hypertension, the systolic number is 140 mmHg

or higher, or the diastolic number is 90 mmHg or higher. For the hypertensive crisis, the systolic

number is over 180 mmHg, or the diastolic number is over 120 mm Hg. Blood pressure in this

range requires urgent medical attention. (Vasan et al 2002). The blood pressure chart below

shows ranges of high, low and healthy blood pressure readings.

Figure 1.0: Blood Pressure chart for adults

Source: Moore. R. D. etal (2001)

2.1 Diagnosis of Hypertension

An official diagnosis of high blood pressure requires two or three blood pressure readings each at

three or more separate appointments at clinic. This is because blood pressure normally varies

through the day. One high reading does not mean one has high blood pressure. . It is necessary to

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190180170160150140130120110100908070

40 50 60 70 80 90 100

Syst

olic

(top

num

ber)

Diastolic (Bottom number)

measure the blood pressure at different times, while the person is resting comfortably for at least

five minutes, (John 2017).

Figure 1.1: Showing a patient taking blood pressure reading

Source: www.medindia.net

Apart from measuring the blood pressure, doctor need to know the medical history in order to

assess the risk factors and conduct physical examinations. In the case that the blood pressure of a

patient is found to be persistently high then the doctor may recommend routine tests such as

urine test, blood test, a cholesterol test and a test that measures the heart’s electrical activity. The

results of the mentioned tests would help the doctor to recommend the lifestyle changes and

medication to be administered to the patients to control the hypertension, (Ministry of Health

2013).

2.2. High Blood Pressure: Causes, risks factors and dangers

The causes of high blood pressure are not known except for the causes of secondary

hypertension. There are many risk factors associated with hypertension. These factors include:

Age, genetic factors, Stress, obesity, excessive salt intake, sedentary lifestyle and alcohol

consumption.

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According to Schofield (1999), aging is a biological process which has a decline in the

performance of most organs. When one gets old the artery walls lose their elasticity. This means

there are less activities and a lot of hormonal changes in the body hence causing high blood

pressure. Blood pressure tends to rise as one gets older, the risk for high blood pressure increases

with age. It is common among adults. It is a common medical condition and by the time one

reaches 55 to 65 years, the chances of being diagnosed with high blood pressure is increases by

40%. If an individual by the age of 55 to 65 years is diagnosed with hypertension, there is 90%

chance of developing it in the next few years of one’s life

According to the 2004 Singapore national health survey, 24.9 % of Singapore residents between

the ages of 30 and 69 years suffer from high blood pressure. This is evidence of the prevalence

of hypertension among adults. (National Heart Centre Singapore 2016). The United States of

America conducted a research where one in three adults had high blood pressure which

accounted to 32 percent of the population but in the recent research the adult population with

hypertension is 46 percent (Paul et al 2017).

Although the diet and physical activity levels can primarily be the main reason for high blood

pressure, some risks are out of control. High blood pressure can be genetic and can be passed on

if the disease runs in the family. If one has a family history of hypertension and does not have it

at present, he or she needs to keep a regular check of his or her blood pressure in order to catch it

early.

Genetic factor play some role in high blood pressure, heart disease and other related conditions.

People with a family history of high blood pressure share common environments and other

potential factors that increase their risk. The risk of hypertension increases when heredity

combines with unhealthy lifestyle.

Stress does not directly cause hypertension but can have an effect on its development. Stress is

an unavoidable fact of life. Since people are involved in a lot of activities such as working to

raise money to take care themselves and their families, stress has become a prevalent part of

people’s lives. This means stress can lead to repeated blood pressure elevations, which

eventually may lead to hypertension. Stress related to depression, social isolation and lack of

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quality support increases the risk of coronary artery disease and hypertension. (Kulkarni et al

1998).

Unhealthy habits such as alcohol consumption and smoking can lead to high blood pressure.

Nicotine and cigarette smoke raises blood pressure and heart rate; it narrows the arteries and

hardens their walls, and makes the blood more likely to clot. It stresses the heart and can cause

heart attack or stroke. Women with hypertension that more are at high risk of cerebral stroke,

specifically if they are also taking hormone therapy. Alcohol Consumption can cause damage to

the heart, but more directly, having several drinks within a short period of time can temporarily

raise the blood pressure. A study done in Canada in 1999 indicated that 75% of Canadians over

the age of 15 consumed alcohol and 6.1% of adult Canadians consumed 15 or more drinks per

week. This showed that alcohol consumption is a strong predictor of hypertension in men up to

33% and in women up to 8% Excessive alcohol consumption raises blood pressure independent

of other risk factors. (Nursing management of hypertension 2005).

Dietary salt intake is a known risk factor for hypertension. Salt is mostly sodium, a mineral that

occurs naturally in foods. Sodium is the substance that may cause the blood pressure to increase.

Salt is not a major cause of high pressure but a contributing factor especially among salt sensitive

persons. The excessive intake of salts accounts greatly to the occurrence of high blood and other

cardiovascular diseases. Research done in Finland shows that since the early 1970’s, Finland

reduced its incidence of Heart attacks and strokes by 75% to 80%. Over the last 30 years the

country has reduced salt consumption by one-third, accompanied by large decreases in rates of

hypertension. (Jelakovic et al 2010).

A sedentary lifestyle involves little exercise, even of the least strenuous type. (Farlex 2009).

There has been a steady rise in cases of youngsters being affected by high blood pressure over

the last decades. Sedentary lifestyle results in a range of health problems including hypertension.

The high growing rate of sedentary lifestyle could be attributed to economic growth,

modernization, as well as globalization of food. The advancement of technology has reduced the

amount of exercise that people under take. Most Jobs demand sitting behind the desks for long

hours during the day, followed by long hours of watching television at leisure time. According to

WHO (2002), 60 to 85% of people in the world from both developed and developing countries

lead sedentary lifestyles making it one of the serious public health problems which is

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insufficiently addressed. It is estimated that nearly two-thirds of children are also insufficiently

active, with serious implications for their future health. Sedentary life-styles increase the risks of

cardiovascular diseases, diabetes, colon cancer, high blood pressure and obesity.

Obesity is excess body fat. It is a risk factor for high blood pressure and lead to heart disease and

diabetes. Almost two-thirds of the people suffering from obesity are at risk of hypertension.

Hypertension is becoming commoner in children and adolescents, but is frequently overlooked in

these age groups. With rising prevalence of obesity, hypertension is more like to develop in

younger people. Early lifestyle interventions can prevent the progress of hypertension and may

retard the onset of complication

Some prescription medication can raise blood pressure. For people who are used to relieve pain

by taking medication such as ibuprofen and naproxen or take cold medicines that contain

pseudoephedrine can increase the risk of being diagnosed with high blood pressure. It is

therefore important to consult the doctor before using any over the counter medications.

(Lifshitz 2008)

2.3 Fast foods and hypertension

Fast foods usually as they are processed, a lot of the natural nutrients which were originally in

food are removed. These foods lead to inflammation in the body equivalent to the inflammation

found in the body tissues during illness. Fast food contains a lot of sugar, unhealthy fats and high

fructose corn syrup and can eventually make the body fat. Even before one gets fat, eating a lot

of processed foods leads to the start of high blood pressure and metabolic syndrome or pre-

diabetic symptoms.

The relationship between hypertension and fast food menus comes from the use of high calories

salad dressing and high fat butter, additions that are not easily detectable and make the food less

healthy than it may seem. Eating fast foods results in the rise of blood pressure, not only for

adults, but for children as well and likely will not help someone attain, the ideal blood pressure.

These fast foods have made it more convenient to eat at the expense of health. This has led to the

development of food industry that caters to taste and profit instead of good nutrition and healthy

consumers.

13Source: Lifshitz. F. (2008)

Figure 1.2: The diagrams showings fast foods

2.4 Hypertension in Pregnancy

High blood pressure is the most common medical problem encountered during pregnancy. It is

one of the leading causes of morbidity and mortality amongst pregnant women. Hypertension in

pregnancy is categorized into three types which are chronic, gestational and preeclampsia

hypertension. Chronic hypertension is found in women who have high blood pressure over

140/90 mm Hg before pregnancy, early in pregnancy before 20 weeks and continues to have it

after delivery. Gestational hypertension is high blood pressure over that develops after week 20

in pregnancy and goes away after delivery. Preeclampsia occurs when hypertension develops

after 20 weeks of pregnancy and is associated with signs of damage to other organ systems,

including the liver, kidney or brain. Untreated preeclampsia can lead to serious complications for

the mother and baby, including development of seizures.

Hypertension in pregnancy leads to various risks such as decreased blood flow to the placenta,

placental abruption, premature delivery, injury to body organs and future cardiovascular disease.

It may decrease the blood flow to the placenta resulting in the fetus not getting enough blood

hence less oxygen and few nutrients. This can lead to slow growth, low birth weight or even

premature birth. The increase in preeclampsia can cause placenta to separate from the inner wall

of the uterus before delivery. It can cause heavy bleeding which can be life threatening for the

mother and baby. Poorly controlled hypertension in pregnancy can result in injury to the brain,

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heart, lungs, kidney, liver and other major organs. Having preeclampsia might increase the risk

of future cardiovascular disease (John 2017).

Figure 1.3: Diagram showing the dangers of hypertension in pregnancy.

2.5 High blood pressure and HIV/AIDS

Hypertension is common among HIV-infected persons and is associated with established risk

factors. The high prevalence of hypertension is associated with the duration of HIV infection.

Some HIV drugs such as protease inhibitors can cause increase in blood fats because of this,

people taking HIV treatment may be at an increased risk of high blood pressure. HIV drugs can

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Source: Mayo Clinic Staff (2014)

Normal exchange of oxygen-rich blood (red) for oxygen- poor ( blue) blood between maternal and foetal circulation

Lack of contact to maternal circulation results in placental blood loss

Cut-away view of placental attachment to uterine wall

Normal attachment of placenta to uterine wall

Separation of the placenta from the uterine wall disrupts the oxygenation to the fetus

Placental AbruptionNormal Anatomy

interact with other medicines to affect blood pressure and can be harmful. Medical advice about

different medications is vital for people taking HIV drugs to avoid complications such as

hypertension (Medina et al 2011).

2.6 Hypertension in developing countries

In Africa, more than one-third of adults are hypertensive as in the urban populations of most

developing countries. The routine screening at any point of health care is grossly underutilized in

these counties. (Tibazarwa et al 2014).

Findings from several surveys show an increasing prevalence of hypertension in developing

countries, possibly caused by urbanization, aging of population, changes to dietary habits,

poverty, and social stress. High illiteracy rates, poor access to health facilities, bad dietary habits,

poverty, and high costs of drugs contribute to poor blood pressure control. The health system in

many developing countries is inadequate because of low funds, poor infrastructure, and

inexperience. (Ibrahim et al 2012).

The high prevalence of hypertension in urban areas compared with rural areas strongly

implicates differences in lifestyle as an explanatory factor. Higher levels of obesity and increased

salt and fat intake from consuming more processed foods and engaging in jobs with minimal

physical activity are likely explanation for higher hypertension in urban populations. (Addo et al,

2000)

2.7 Socio-economic impacts of hypertension

Hypertensive individuals are at greater risk for disability and earlier death than individual s with

normal blood pressure. It usually affects individuals in their peak mid-life years disrupting the

future of the family dependence on them. It also undermines the development of nations by

depriving valuable human resources in their most productive years high blood pressure affects

business and threatens economic sustainability due to disability and unplanned absences. The

victims of high blood pressure may mainly lose employment, reduced business activity and even

loss of business. (World Health Organization, 2008)

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The medical, economic and human costs of untreated and inadequately controlled high blood

pressure are enormous. The adequate management of hypertension can be hampered by

inadequacies in the diagnosis, treatment and control and control of high blood pressure. This

means the conditions and diseases caused by uncontrolled hypertension such as kidney disease,

heart failure and stroke are expensive to treat. The cost of medications and equipment to treat

hypertension, heart disease, kidney disease and stroke is high for developing countries like

Zambia. (William 2003).

2.8.0 Prevention, control and treatment of hypertension

2.8.1 Medications for high blood pressure

There are excellent blood pressure medications which when prescribed wisely can control

hypertension in almost everyone. Many of the nearly 70 million Americans with hypertension

would like to bring it under control through lifestyle changes. But most of them require

medications to get their blood pressure where it needs to be.

The classes of blood pressure medications include diuretics, beta blockers, Angiotensin,

Angiotensin II, receptor blockers, renin inhibitors and calcium channel blockers. Diuretics help

the body to get rid of excess sodium (salt) and water to help control blood pressure. They are

sometime referred to as water pills and often the first but not the only choice in high blood

pressure medications. Thiazide diuretics include hydrochlorothiazide (microzide)

chlorothalidone and others. A common side effect of diuretics is increased urination. Diuretics

are often used in combination with additional prescription therapies, (Ministry of Health 2013).

Beta blockers are medications that reduce the workload on the heart and open the blood vessels,

causing the heart to beat slower and with less force. Beta blockers include acebutolol, atenolol

and others. They are usually combined with other blood pressure medications. Angiotensin-

converting enzyme (ACE) imitators are medications such as lisipril, benazepril, captopril and

others. They help to relax blood vessels by blocking the formation of a natural chemical that

narrows the blood vessels. Angiotensin II receptor blockers (ARBS) are medications such as

candesartan and losartan. They block the receptors to make the angiotensin to fail to constrict the

blood vessel. This means blood vessels stay open and blood pressure is reduced (Mann 2012).

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Calcium channel blockers include amlodipine, diltiazem and others. These help relax the muscle

of the blood vessels and some slow the heart rate. Renin inhibitors slow down the production of

rennin, an enzyme produced by the kidneys that start a chain of chemical steps that increases

blood pressure. There many more classes of high blood pressure medications.

2.8.2 Prevention and control of hypertension through lifestyle changes.

Hypertension is preventable, without reliance on synthetic drugs. Lifestyle changes can help

control and prevent high blood pressure. A decrease in salt (sodium) consumption of 5 grams per

day would reduce blood pressure and the risk of cardiovascular disease. The maintenance of the

proper ratio of potassium to sodium in the diet can regulate blood pressure at the cellular level,

preventing the development of hypertension and the high incidence of strokes and heart attacks.

A scientific research was done in Finland on the prevention of high blood pressure for several

decades sodium chloride (salt) was replaced nationwide with a commercial sodium and

potassium mixture. This resulted in 60% decline national wide in deaths attributed to strokes and

heart attacks. The Finnish statistics showed that 360, 000 strokes were prevented and 96, 000

lives were saved every year. (Moore et al 2001).

Eating healthy foods and adapting the Dietary Approaches to Stop Hypertension (DASH) diet

can reduce blood pressure. This diet is primarily composed of fruits; vegetables and low fat

dairy products. Fruits and vegetables high in potassium are good for preventing high blood

pressure. Potassium helps regulate the adverse effects that excess sodium has in the human body.

It is estimated that 75% to 80% of the world’s population use herbal medicines, mainly in

developing countries. These medicines are used for primary health care because of their better

acceptability with human body lesser side effects. In the last three decades, a lot of concerted

efforts have been channeled into researching the local plants with hypotensive and

antihypertensive therapeutic values. The hypotensive antihypertensive effects of some of these

medical plants have been validated and others disproved, (Kresser 2014).

There are common plants that are used to prevent and control hypertension; these herbs have

properties that help reduce blood pressure. Ginger has been used for centuries in Asian and

Indian cultures, especially for its numerous health benefits. It is good for preventing heart

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conditions, such as lowering blood pressure, decreasing cholesterol and preventing blood clots. It

acts as a blood thinner, which prevents blood clots. Moringa is another plant which is high in

Potassium, Vitamins and minerals. It is an excellent addition to a diet for preventing high blood

pressure, (Nahida & Ahmad 2011).

Figure 1.4: Diagrams showing Ginger and Moringa

Garlic is the gaining more and more popularity for its use in lowering blood pressure. It has

blood thinning properties which makes it great for improving overall cardiac health. It is a

natural diuretic, from the body through urine. This effect takes pressure off an overworked heart

and decreases blood pressure.

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Source: Hills, 2015

Source: Byrd, 2017

Figure 1.5 Diagram showing Garlic

Turmeric is one of the most studied spices in the world. It is known to significantly decrease

inflammation through the body by reducing inflammation, turmeric improved function. It is also

a natural blood thinner which lowers blood pressure are used to lower blood pressure are beet

roots, Cinnamon, hibiscus tea and basil.

Figure 1.6: Diagrams showing turmeric and cinnamon

Alcohol raises the blood pressure temporarily, so to limit or stop alcohol consumption is vital in

controlling blood pressure. Alcohol Consumption can be replaced with water. Water can keep

the body hydrated and enable the body to cope with stress. Smoking is another habit that

destroys the blood vessel walls and speed up the process of hardening of the arteries due to the

presence of tobacco in the cigarettes. Smoking must be avoided in order to reduce the risk of

hypertension.

Lifestyle changes such stress management are vital for every individual. Since stressful

situations increase the level of stress, hormones such as adrenaline and cortisol in the body,

getting more sleep and physical exercises are of great importance. Learning how to find solutions

to the problems would help individuals to feel more in control thereby lowering the level of

stress and the possibility of hypertension. An increase in Physical activity can help lower the

blood pressure and manage stress. Aerobic exercises can reduce the long-term high blood

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Source: Hills, 2015

pressure. Some of the recommended sports are cycling, walking or jogging. They have the

desired blood pressure lowering effects. However, this only occurs when the exercise is practiced

regularly and over a long period of time. The exercise should be done three to five times a week

in order to get optimal effects against high blood pressure (Paul et al 2017).

Maintaining a healthy body weight is one way of lowering blood pressure. Excess body fat can

raise blood pressure. Keeping a healthy weight or losing weight if the body is obese; can help

control high blood pressure and lower risk of related health problems.

2.9 Awareness and attitudes about hypertension

Hypertension is increasing in Africa and many hypertensive individuals are not aware of their

condition. This is due to the fact that high blood pressure does not usually have symptoms.

Mostly people may have knowledge about the risk factors of high blood pressure but cannot take

precautions to prevent the condition unless they have been diagnosed of it.

According to Adeloye (2014), the overall pooled prevalence of hypertension in Africa was

19.7% in 1990, 27.4 in 2000 and 30.8% in 2010 each with a pooled awareness rate of 16.9%,

29.2% and 33.7% respectively. This indicates that most people are not aware of hypertension and

its dangers until it affects them or a close member of their family. To determine the quality of

health care services there is need to know the level of awareness of the community about high

blood pressure. Research is required to clarify the relationship between lifestyle, health and

hypertension. More information is to be derived from the community.

CHAPTER THREE

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METHODOLOGY

3.0 Introduction

This chapter looks at the methodology to be used in carrying out the research, which are

explained in details below.

3.1 Research design

The research design to be used in this study is a cross-sectional survey. The researcher will use it

to collect data and make inference about a population of interest at one point in time. Cross-

sectional surveys have been described as snapshots of the population about which data is

gathered. This research is focused on studying and drawing inferences from existing differences

between people, subjects or phenomenal. Cross-sectional study also involved the observational

study (Lavrakas 2008)

In this study, both qualitative and quantitative approaches will used to obtain data. Qualitative

research will be used for exploring and understanding the meaning, individuals or groups ascribe

to a social or human problem. It involved emerging questions and procedures, data typically

collected in the participants setting, data analysis inductively building from particulars or general

themes, and the researcher making interpretations of the meaning of the data. (Creswell, 2014).

Quantitative research will be used for testing objective theories by examining the relationship

among variables. These variables, in turn, was measured typically on instruments so that

numbered data was analyzed using statistical procedures.

The questionnaire will be the instrument used to measure both qualitative and quantitative data.

Charts and graphs will be used in this study to represent sizeable numerical or statistical data.

Charts, graphs and tables will be used because the displayed items provide a large amount of

information in a shorter time span. These give readers an in-depth understanding.

3.2 Location of the study

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Ellaine Brittel residential area is located in Livingstone town on the Southern edge of the

Southern Province of Zambia. The town was named after David Livingstone, the British explorer

who was the first European to explore the area. Livingstone lies 986 meters above sea level and

it covers about 695 square km of the land area. It lies 10 km to the north of the Zambezi River. It

is a tourism center. Ellaine Brittel is found on the north-west of Livingstone. It is approximately

1.5 kilometers from the town center.

Figure 1.7: Location map

Source: Livingstone City Council Archives

3.3 Populations

The study population is approximately 5000. The study will target the population confined

within Ellaine Brittel. This is the population that will provide meaningful responses to the

research study.

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3.4 Sample Size

A sample of 100 respondents will be used in this research, 41 to be male while 59 females. The

respondents will comprise of a number of those living within the area and those working within

the area and spend most of the time during the day in Ellaine Brittel.

3.5 Sampling Procedures

Simple random sampling technique will be used to select the respondents. Simple random

sampling is a probability design used to select respondents because it is free from biasness, fair

and easy to conduct.

3.6 Data Collection and Procedure

According to Dudovskly (2017), data collection is a process of collecting information from all

the relevant sources to find answers to the research problem, test the hypothesis and evaluate the

outcomes. Several tools can be used to collect the data and in this study a questionnaire was used

to collect data during the study. A questionnaire was a proper instrument that the researcher

asked the subject to complete or answer. It was designed to gather data from individuals about

knowledge, attitudes, feelings and it comprised of series of questions prepared by the researcher

that are annexed and filled in by the respondent. In this study a questionnaire was structured with

open and closed ended questions, comprising of questions written in English. Open ended

questions allowed subjects to respond to the questions written in their own words while closed

ended questions allowed the subjects to have a number of alternative replies subjectively.

Subjects who were unable to read and write English were assisted by the researcher to interact in

Tonga and Nyanja.

Some statistical data about the prevalence of hypertensions was obtained from Livingstone

Central Hospital.

3.7.0 Data Analysis

Data will be analyzed using qualitative and quantitative methods

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3.7.1 Qualitative data analysis

According to Lewins (2005) qualitative data are forms of information gathered in a non-numeric

form. Qualitative data analysis is the range of processes and procedures which enable the

collected data to be explained, understood or interpreted of the situation under investigation. The

qualitative data was derived from the open ended questions which were analyzed using content

analysis. Content analysis was used because it generates meaning and detailed data. The data was

analyzed through themes that were used to categorize the content groupings.

3.7.2 Quantitative data analysis

Quantitative data analysis will be used to turn raw numbers into meaningful data through the

application of rational and critical thinking. It involved the calculation of frequencies of variables

and differences between variables. (Lewins 2005)

Statistical package will be employed and some of the data will be presented in percentage. Excel

will be used in the analysis and tabulation of the collect quantitative data.

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