Zewde GT            

Department of Midwifery, Harar Health Science College, Harar, Ethiopia

^*Corresponding author: Gosaye Teklehaymanot Zewde, Department of Midwifery, Harar Health Science College, Harar, Ethiopia, Tel: 0913227450

Abstract
Background
Hypertension clinically defined as a blood pressure of 140/90 mmHg or more on at least two readings on separated time. It is one of the most prevalent non communicable diseases and the most important preventable risk factor for premature death worldwide, due to heart disease and stroke. It is the most important modifiable risk factor for coronary heart disease, stroke, congestive heart failure, end stage renal disease and peripheral vascular diseases

Objective
To assess the prevalence of hypertension and its associated factors among bank workers in Harar town, Eastern Ethiopia 2018

Methods and material
Institutions based cross sectional study was conducted on 149 Bank workers in 6 governmental and 19 private banks which were found in Harar Town. Sample was allocated proportionately, and study participant was selected by simple random sampling. Collected and checked data were entered into Epi Data software version 3.02 and exported and analyzed using SPSS version 21. Descriptive statistics were used to determine prevalence such as frequency, percentage, mean and ratio. Both Bivariate and multiple logistic regressions were used to observe the association between the outcome variable and associated factors. P value less than 0.2 in Bivariate analysis was transferred to multivariate analysis and P value less than or equal to 0.05 was considered as level of statistically significance.

Result
The prevalence of hypertension on this study was 27.5 %. Among study participant 6(4 %) had diagnosed with hypertension and only 3 (2 %) had on treatment and follow- up. 26(17.4 %) bank workers BMI Was obsessed. In multivariable logistic regression analysis Age, Sedentary lifestyle and BMI of bank workers had significant association with hypertension.

Conclusion and recommendation
The prevalence of Hypertension in the study was 27.5 % Age, Sedentary lifestyle and BMI (Obesity) in this study was positively associated with higher odds of having hypertension. Regular blood monitoring, conducting physical exercise and reduction of Alcohol consumption and street Treatment care and follow-up strategy need to be maintained.

Statement of the problem
Globally, the overall prevalence of Hypertension in adults aged 25 and over was around 40% and was estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths worldwide and the number of people with uncontrolled hypertension increased by 70% between 1980 and 2008 The rising epidemic of hypertension is thought to be due to mechanization, population growth and ageing [4,5] By 2025 the number of hypertensive people is expected to increase by 60 % and reach 1.56 billion people [6]. The prevalence of hypertension varies worldwide in Africa indicated the overall prevalence of hypertension have been increasing since 1990. In adults aged ≥ 20 years, in 1990 the prevalence was 19.1 %, in 2000 prevalence were estimated 24.3 %, in 2010 with prevalence of 25.9% and it will projected to 25.3 % by 2030 [7]. In sub-Saharan Africa estimated in 2008 was 13.7 % in rural areas, 20.7 % in urban area, 16.8 % in males, and 15.7 % in women [8]. The pooled prevalence of hypertension among the Ethiopian population was 19.6 % and 20.6% in male and 19.2 % in female. There is no sufficient data in the study area therefore this study was intended to provide compressive and up to date evidence on the prevalence and investigate the associated factors of Hypertension among Bank Workers of Harar town, Eastern Ethiopia.

Significance of the study: The study will describe the current situation of HPN in among bank workers in Harar town and it will be helpful for sampled population to know their BP status and for early linked to health institution to management if they have HTN. It will also be important for concerned bodies for prevention and management of hypertension. It will be serving as a base line data for other researchers.

Objectives
General objective: To assess the prevalence of hypertension and its associated factors among bank workers in Harar town, Eastern Ethiopia 2018

Methods
Study area and period: The study was conduct in Harar town. Harari region is located in eastern part of Ethiopia, 525 km away from Adiss Abeba capital of Ethiopia. In the region there are 6 governmental and 19 private banks with a total of 25 branches was found. And the total numbers of bank workers were 313, of which 142 were found in governmental and the rest were found on private. The study was conducted from January 12-18/2018 G.C.

Study design: Institutional based cross- sectional descriptive study design was used.

Study population

Source population

• All Bank workers who are working in Harar town.

Study population

• Selected Bank workers in Harar town who are alive on their work during data collection period.

Eligible criteria

Inclusion criteria

• Bank workers who are volunteer to participate will participate on the study.

Exclusion criteria

• Bank workers who are not presented on their work during data collection period.

Sample size determination
Sample size was determined by using a single population proportion formula by assuming 5 %  marginal error and 95 % confidence interval (∂ (alpha) = 0.05) and prevalence of  hypertension, which was 19.1 % from study conducted in Addis Abeba [9] and the sample become 237. After calculating finite population correction formula and adding 10% non-response rate the final sample size will be come 149.

Sample technique and procedure
Sample was allocated for each private and governmental Banks based on their number of workers. Simple random sampling was used to select study participants.

Variables
Dependent variable: Hypertension status

Independent variables

Socio demographic Variable: Sex, Age, Marital status, Educational level, Job description

Medical history: Parental History of HTN, Previous History of HTN

Dietary and Behavioral Habit: Overweight, Obesity, Salt Consumption, Smoking, Excessive alcohol consumption

Work-related risk factors: Sedentary lifestyle, Work schedule, and less physical activity.

Data collection tolls and method
A semi- structure questioner was developed by English version after literature review, and it was translated into local language and return back to English version to check its consistency. The questioner had 4 parts socio-demographic, Medical History, Hypertension risk assessment and measurements parts. Data was collected by face-to-face interview and objective data was selected through measuring height, weight, Blood pressure and BMI also calculated.

Operational definitions
Sedentary lifestyle
A type of lifestyle with little or low physical activity, sitting or lying while reading, socializing etc or using mobile phone / computer for more than 4 hours per day.

Low physical activity: is aerobic physical activity less than 10 minutes per day.

Normal work schedule: Participants who work within 8 hours per day.

Extra work schedule: Participants who work more than 8 hours per day.

Current daily cigarette smoking: is a person who smokes cigarette one or more days per week.

Obesity: BMI > 30kg/m² and overweight - 25-29.9 kg/m²

Blood Pressure Measurement: Collecting of data by using mercury sphygmomanometer twice with ten-minute difference from different hand while the participant was seated.

Result
Socio-demographic characteristics of the study participants
A of total 149 workers from twenty-five bank branches were participated in the study. Majority 90 (60.4 %) of study participants were female. The mean age of participants was 33.48 ± 26.43 years. Two thirds of them (66.4 %) were married while 51 (34.2 %) were single. Majority 115 (77.2 %) and 69 (46.3 %) of respondent was First degree holder and Customer service officer. Regarding service year 69 (46.3) of the study participant were served for less than 5 years (Table 1).

Table 1: Socio demographic characteristic of bank workers in Harar town, Eastern Ethiopia, January 12-18/2018

Medical history of the study participants
Among study participant 6(4 %) was replied that they had diagnosed HTN in previous time and among those only 3(2 %) started treatment and follow- up. While regarding their parents thirty-eight (25.5 %) participant  biological parents had history of Hypertension and 95(63.8 %) was reported that their parents were Checked their BP previously (Figure 1).

Figure 1: Medical History of bank workers in Harar town, Eastern Ethiopia, January 12-18/2018

Behavioral and work-related characteristic
From total of participants responding, Forty- nine (32.9 %) of participants drunk alcohol. Eight (5.4 %) were lifetime smokers. Majority of the participants 105 (70.5 %) used /added salt to food without tying. Ninety (60.4 %) of participant were involved in physical activity and 39 (26.2 %) stated that there was conduct exercise every day. (Table 2)

Table 2: Behavioral and work-related characteristic of participated bank workers of Harar town, Eastern Ethiopia, January 12-18/2018

Anthropometric measurements of study participants
Among the study subject, 74 (49.7 %) participants had BMI < 25 kg/m² and 49 (32.9 %) were overweight while 26 (17.4 %) were obesity. There mean and SD of BMI 25.41 ± 4.546. Regarding BP Majority eighty-three participants systolic blood pressure was ≤ 120 mmHg and Diastolic Blood Pressure was ≤ 80 mmHg. There mean and SD of DBP was 81.13 ± 11.231.

Table 3: Anthropometric measurements characteristics of bank workers of Hara town, Eastern Ethiopia, January 12-18/2018

Prevalence of Hypertension
In this study the prevalence of hypertension was 41 (27.5 %) of which 6 (4%) were previously diagnosed with having Hypertension and 35 (23.5 %) were newly diagnosed of Hypertension. Twenty-six (63.4 %) of Hypertensive participant was male and 15 (36.6 %) were female. Majority 15 (36.6 %) of Hypertensive bank workers’ age was 25-34 years and 31 (75.6 %) was Married. Regarding working area 22 (53.7 %) had governmental and the rest 19 (47.3 %) were private bank employers. (Figure 2)
Regarding working area 22 (53.7 %) had governmental and the rest 19 (47.3 %) were private bank employers. (Figure 2)

Figure 2: Hypertension status of bank workers of Hara town, Eastern Ethiopia, January 12- 18/2018

Factors Associated with Hypertension
In multivariable logistic regression analysis Age, Sedentary lifestyle and BMI of bank workers had significant association with hypertension. Bank workers whose age 25 – 44 years had 75.8 % (AOR = 0.242, 95 % CI: 0.065 –    0.904) less likely had hypertension than age 24 years. Those who had sedentary lifestyle had 3 times (AOR = 2.925, 95 % CI: 1.085 – 7.885) more likely, Obesities bank workers were 6 times more likely (AOR = 6.113, 95 % CI: 1.030 – 36.28) having hypertension than they are in counters. (Table 4)

Table 4: Factor associated with Hypertension among bank workers of Harar town, Eastern Ethiopian, January 2018

Discussion
In this study the prevalence of hypertension was, 27.5% the finding was greater than study done in Owerri Nigeria which was 12.4% [10] and Addis Ababa the prevalence was 19.1% [9]. This discrepancy may be due to different age category of participants as well as BMI and socio-cultural variation. But the study outcome is less than the result of study done among bank workers in Surratt city of India which was 30.4 % [11] and Ghana 38 % [12]. The difference occurred possibly due to different in socio demographic and socio-cultural as well as  lifestyle and mean value different in BMI. The study found that age of bank workers was      significantly   associated with Hypertension. Those age 24 – 45 were 75.8 % less likely had hypertension than bank worker who’s their age was less than 24 years. But study conducted in Adiss Abeba on federal ministry civil servants showed that increased age was identified as a factor for hypertension. Study participants older than 48 years were more likely to be hypertensive than those less than 27 years [13] and study of bank employees of Surratt city in India also showed that age ≥ 50 years increase the risk of hypertension [11]. Even if the age associated to had hypertension there is different in association of age categories. The variance may be due to having more sedentary lifestyle in our study.  In this study the risk of being hypertensive was 3 times more likely among bank workers who had sedentary life style this finding was in line with study conducted in Surratt city of India 2 times more likely [11] and Ghana Accra. This shows that sedentary life decrease energy expenditure and increase cholesterol level in blood vessel which directly related with Cardio vascular disease i.e. Hypertension. BMI of bank workers significant association with Hypertension, in this study obese bank workers were 6 times more risked for hypertension this finding also in line with study conducted in Adiss abeba which is obese were 7.36 times more likely to be hypertensive and in Sullia Taluk, Karnataka also obesity was strongly associated with hypertension [14].

Conclusion
The prevalence of Hypertension in the study was 27.5 % which shows the high prevalence of hypertension in the study population. As in many other developing countries hypertension is becoming a serious public health concern among working bankers in Harar town, Eastern Ethiopia. Age, Sedentary life style and BMI (Obesity) in this study was positively associated with higher odds of having hypertension. However, Sex, Marital status, educational level, Job description, alcohol drinking, smoking, salt usage, physical activity and working schedule had not associated with hypertension.

Recommendations

• Regular blood monitoring should have to be maintain

• Sedentary lifestyle need to be avoid among bank workers

• Regular physical exercise needs to be conducted by all bank workers on daily based.

• Close monitoring of BMI and maintaining to normal value should have to be maintain

• Alcohol consumption reduction mechanism need to maintain through BCC

• Biological parent encouragement for close monitoring of their blood pressure by the bank worker should be encouraged as HPN is a known family associated disease.

• Treatment care and follow-up strategy for their workers need to be maintained by bank administrators.

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