Clustering of cardiovascular disease risk factors among first-year students at the University of Ibadan, Nigeria

a cross-sectional study

Authors

Keywords:

Cardiovascular diseases, Cluster analysis, Risk factors, Sedentary behavior

Abstract

BACKGROUND: Cardiovascular disease (CVD) is the second leading cause of death in sub-Saharan Africa. Globally, there is substantial evidence that modifiable risk factors for CVD are increasing in adolescents. Unfortunately, there is a paucity of information on the prevalence and clustering of these risk factors in adolescents. OBJECTIVES: This study explores the modifiable risk factors for CVD among first-year students at the University of Ibadan, Nigeria. DESIGN AND SETTING: This cross-sectional study was conducted at the University of Ibadan, Nigeria. METHODS: A total of 546 newly admitted students at the University of Ibadan, Nigeria, were recruited using stratified random sampling. An interviewer-administered questionnaire was used to obtain information from study participants between January and February 2016. RESULTS: The mean age of respondents was 19 ± 2.2 years with a male-to-female ratio of 1:1. The reported risk factors for CVD were smoking (1.6%), abdominal obesity (3.3%), alcohol consumption (3.7%), overweight/obesity (20.7%), unhealthy diet (85.3%), and physical inactivity (94.5%). Clustering of ≥ 2 risk factors was reported in 23.4% of students. Female students were twice as probably overweight/obese as male students (adjusted odds ratio [AOR] = 2.2; confidence interval [CI] = 1.41–3.43). Students whose fathers were skilled workers were 3.5 times more likely to be physically inactive (AOR = 1.7; CI = 0.97–2.96). The clustering of ≥ 2 risk factors was significantly higher among women and Muslims in bivariate analysis, whereas no significant association was found in multivariate analysis. CONCLUSIONS: Public health strategies to prevent CVD risk factors should begin in schools and extend to the entire community.

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Author Biographies

Olumide Ebenezer Olufayo, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan

MD, MSc. Post-Master’s Student, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Ikeoluwapo Oyeneye Ajayi, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan

MD, PhD. Professor, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria; Medical Consultant, Epidemiology and Biostatistics Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Samuel Osobuchi Ngene, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan

MD, MPH. Research Coordinator, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria; Research Office, Division of Cardiothoracic Surgery, Department of Surgery, University College Hospital, Ibadan, Nigeria.

References

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22. Erratum in: Lancet. 2020;396(10262):1562. PMID: 33069326; https://doi.org/10.1016/S0140-6736(20)30925-9.

Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals.Nat Rev Cardiol. 2018;15(4):230-40. PMID: 29022571; https://doi.org/10.1038/nrcardio.2017.154.

Odunaiya NA, Grimmer K, Louw QA. High prevalence and clustering of modifiable CVD risk factors among rural adolescents in southwest Nigeria: implication for grass root prevention. BMC Public Health. 2015;15:661. PMID: 26169588; https://doi.org/10.1186/s12889-015-2028-3.

Yuyun MF, Sliwa K, Kengne AP, Mocumbi AO, Bukhman G. Cardiovascular diseases in Sub-Saharan Africa compared to high-income countries: an epidemiological perspective. Global Heart. 2020;15(1):15. PMID: 32489788; https://doi.org/10.5334/gh.403.

World Heath Organization. Noncommunicable diseases. Available from: https://www.who.int.news-room/fact-sheets/detail/noncommunicable-diseases. Accessed in 2022 (Mar 30).

Ejike CE, Ijeh II. Obesity in young-adult Nigerians: variations in prevalence determined by anthropometry and bioelectrical impedance analysis, and the development of % body fat prediction equations. Int Arch Med. 2012;5(1):22. PMID: 22818201; https://doi.org/10.1186/1755-7682-5-22.

Nasser AM, Zhang X. Knowledge and factors related to smoking among university students at Hodeidah University, Yemen. Tob Induc Dis. 2019;17:42. PMID: 31516485; https://doi.org/10.18332/tid/109227.

Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29. PMID: 22818936; https://doi.org/10.1016/S0140-6736(12)61031-9.

Malambo P, Kengne AP, Lambert EV, De Villiers A, Puoane T. Prevalence and socio-demographic correlates of physical activity levels among South African adults in Cape Town and Mount Frere communities in 2008-2009. Arch Public Health. 2016;74:54. PMID: 28042473; https://doi.org/10.1186/s13690-016-0167-3.

Longo M, Zatterale F, Naderi J, et al. Adipose tissue dysfunction as determinant of obesity-associated metabolic complications. Int J Mol Sci. 2019;20(9):2358. PMID: 31085992; https://doi.org/10.3390/ijms20092358.

Ukegbu PO, Uwaegbute AC, Echendu CA, et al. Obesity and associated factors in young adults attending tertiary institutions in south-eastern Nigeria. South African journal of clinical Nutrition. 2017;30(2):43-8. https://doi.org/10.1080/16070658.2016.1259032.

Mogre V, Nyaba R, Aleyira S, Sam NB. Demographic, dietary and physical activity predictors of general and abdominal obesity among university students: a cross-sectional study. Springerplus. 2015;4:226. PMID: 26140255; https://doi.org/10.1186/s40064-015-0999-2.

Berenson GS, Srinivasan SR, Bao W, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338(23):1650-6. PMID: 9614255; https://doi.org/10.1056/NEJM199806043382302.

Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003;290(17):2277-83. PMID: 14600186; https://doi.org/10.1001/jama.290.17.2277.

Kemper HC, Snel J, Verschuur R, Storm-Van Essen L. Tracking of health and risk indicators of cardiovascular diseases from teenager to adult: Amsterdam Growth and Health Study. Prev Med. 1990;19(6):642-55. PMID: 2263575; https://doi.org/10.1016/0091-7435(90)90061-n.

Khan A, Uddin R, Islam SMS. Clustering patterns of behavioural risk factors for cardiovascular diseases in Bangladeshi adolescents: A population-based study. Health Policy and Technology. 2019;8(4):386-92. https://doi.org/10.1016/j.hlpt.2019.09.003.

Lourenço CLM, Silva Filho RCS, Hauser E, Barbosa AR, Mendes EL. Cluster and simultaneity of modifiable risk factors for cardiovascular diseases in adolescents of Southeast Brazil. Motriz: Rev Educ Fis. 2020;26(2):e10200033. https://doi.org/10.1590/s1980-6574202000020033.

Seo YG, Choi MK, Kang JH, et al. Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study.Arch Dis Child. 2018;103(10):968-73. PMID: 29650509; https://doi.org/10.1136/archdischild-2017-313226.

Thangiah N, Chinna K, Su TT, et al. Clustering and tracking the stability of biological CVD risk factors in adolescents: the Malaysian health and adolescents longitudinal research team study (MyHeARTs). Front Public Health. 2020;8:69. PMID: 32257989; https://doi.org/10.3389/fpubh.2020.00069.

Craig CL, Marshall AL, Sjöström M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. PMID: 12900694; https://doi.org/10.1249/01.MSS.0000078924.61453.FB.

World Health Organization. Obesity and overweight. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed in 2022 (Mar 30).

World Health Organization. WHO STEPS Instrument (Core and Expanded).The WHO STEPwise approach to chronic disease risk factor surveillance (STEPS). Geneva: WHO; 2005.Available from: https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fcdn.who.int%2Fmedia%2Fdocs%2Fdefault-source%2Fncds%2Fncd-surveillance%2Fsteps%2Fsteps-instrument-v3-2.docx%3Fsfvrsn%3D972ebeca_8&wdOrigin=BROWSELINK. Accessed in 2022 (Mar 30).

National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined. Available from: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking. Accessed in 2022 (Mar 30).

Global Adult Tobacco Survey Collaborative Group. Global Adult Tobacco Survey (GATS): Fact Sheet Templates. . Atlanta, GA: Centers for Disease Control and Prevention. 2020; https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/gats/18_gats_analysispackage_final_23nov2020.pdf?sfvrsn=67e2065f_3

Oluyombo R, Olamoyegun MA, Olaifa O, Iwuala SO, Babatunde OA. Cardiovascular risk factors in semi-urban communities in southwest Nigeria: Patterns and prevalence. J Epidemiol Glob Health. 2015;5(2):167-74. PMID: 25922326; https://doi.org/10.1016/j.jegh.2014.07.002.

Eker HH, Taşdemir M, Mercan S, et al. Obesity in adolescents and the risk factors. Turk J Phys Med Rehabil. 2017;64(1):37-45. PMID: 31453487; https://doi.org/10.5606/tftrd.2018.1402.

Oludayo OA, Popoola SI, Akanbi CO, Atayero AA. Gender disparity in admissions into tertiary institutions: Empirical evidence from Nigerian data (2010-2015). Data Brief. 2019;22:920-33. PMID: 30766907; https://doi.org/10.1016/j.dib.2019.01.031.

Oladoyinbo C, Fadipe Y, Sobo A. Dietary Habits and Portion Sizes Associated with Overweight and Obesity Among Undergraduate Students in Ogun State, Nigeria (P04-184-19). Current developments in nutrition. 2019;3 Supplement_1:nzz051.P004-184-019. https://doi.org/10.1093/cdn/nzz051.P04-184-19.

Omage K, Omuemu VO. Assessment of dietary pattern and nutritional status of undergraduate students in a private university in southern Nigeria. Food Sci Nutr. 2018;6(7):1890-7. PMID: 30349678; https://doi.org/10.1002/fsn3.759.

Kabir A, Miah S, Islam A. Factors influencing eating behavior and dietary intake among resident students in a public university in Bangladesh: A qualitative study. PloS One. 2018;13(6):e0198801. PMID: 29920535; https://doi.org/10.1371/journal.pone.0198801.

Telayneh AT, Gedefaw M, Haile D, et al. Cigarette smoking prevalence and associated factors among college students, Amhara, Ethiopia. Pan Afr Med J. 2021;40:170. PMID: 34970412; https://doi.org/10.11604/pamj.2021.40.170.24413.

Salami A, Nnawuihe U, Ogundana O, Adeosun P, Soyoye O. Cigarette Smoking, Knowledge of Associated Health Risks and Legislation Amongst Undergraduate Students of a Nigerian University. Nigerian Journal of Medical and Dental Education. 2021;3(1):6-11. Available from: https://publications.nomiot.com.ng/index.php/njdme/article/view/82/70. Accessed in 2022 (Mar 30).

Al Omari O, Abu Sharour L, Heslop K, et al. Knowledge, attitudes, prevalence and associated factors of cigarette smoking among university students: a cross sectional study. J Community Health. 2021;46(3):450-6. PMID: 32632644; https://doi.org/10.1007/s10900-020-00874-0.

Wamamili B, Wallace-Bell M, Richardson A, Grace RC, Coope P. Cigarette smoking among university students aged 18-24 years in New Zealand: results of the first (baseline) of two national surveys. BMJ Open. 2019;9(12):e032590.PMID: 31857310; https://doi.org/10.1136/bmjopen-2019-032590.

Karadoğan D, Önal Ö, Kanbay Y. Prevalence and determinants of smoking status among university students: Artvin Çoruh University sample. PloS One. 2018;13(12):e0200671. PMID: 30532238; https://doi.org/10.1371/journal.pone.0200671.

Hussain M, Walker C, Moon G. Smoking and religion: untangling associations using English survey data. J Relig Health. 2019;58(6):2263-76. PMID: 28667475; https://doi.org/10.1007/s10943-017-0434-9.

Garrusi B, Nakhaee N. Religion and smoking: a review of recent literature. Int J Psychiatry Med. 2012;43(3):279-92. PMID: 22978085; https://doi.org/10.2190/PM.43.3.g.

Kandel D, Chen K, Warner LA, Kessler RC, Grant B. Prevalence and demographic correlates of symptoms of last year dependence on alcohol, nicotine, marijuana and cocaine in the US population. Drug Alcohol Depend. 1997;44(1):11-29. PMID: 9031816; https://doi.org/10.1016/s0376-8716(96)01315-4.

Omigbodun OO, Babalola O. Psychosocial dynamics of psychoactive substance misuse among Nigerian adolescents. An Afr Med. 2004;3(1):111-5.

Ács P, Bergier J, Salonna F, et al. Gender Differences in Physical Activity among the University Students in the Visegrad (V4) Countries. Studia Educatio Artis Gymnasticae. 2017:62(1):5-17. https://doi.org/10.24193/subbeag.62(1).01.

Pyky R, Puhakka S, Ikäheimo TM, et al. Parental Factors Related to Physical Activity among Adolescent Men Living in Built and Natural Environment: A Population-Based MOPO Study. J Environ Public Health. 2021;2021:3234083. PMID: 34122561; https://doi.org/10.1155/2021/3234083.

Pluta B, Korcz A, Krzysztoszek J, Bronikowski M, Bronikowska M. Associations between adolescents’ physical activity behavior and their perceptions of parental, peer and teacher support. Arch Public Health. 2020;78:106. PMID: 33110599; https://doi.org/10.1186/s13690-020-00490-3.

Sabageh A, Ojofeitimi EO. Prevalence of obesity among adolescents in Ile-Ife, Osun state, Nigeria using body mass index and waist hip ratio: A comparative study. Niger Med J. 2013;54(3):153-6. PMID: 23900669; https://doi.org/10.4103/0300-1652.114566.

Csongová M, Volkovová K, Gajdoš M, et al. Gender-associated differences in the prevalence of central obesity using waist circumference and waist-to-height ratio, and that of general obesity, in Slovak adults. Cent Eur J Public Health. 2018;26(3):228-33. PMID: 30419627; https://doi.org/10.21101/cejph.a4719.

Alex-Hart BA, Opara PI, Okagua J. Prevalence of alcohol consumption among secondary school students in Port Harcourt, Southern Nigeria. Niger J Paed. 2015;42(1):39-45. https://doi.org/10.4314/njp.v42i1.9.46.

Ajayi AI, Owolabi EO, Olajire OO. Alcohol use among Nigerian university students: prevalence, correlates and frequency of use.BMC Public Health. 2019;19(1):752. PMID: 31196039; https://doi.org/10.1186/s12889-019-7104-7.

Reznik A, Isralowitz R, Gritsenko V, Khalepo O, Kovaleva Y. Russian Federation university student alcohol use: Smolensk City-a case example. J Ethn Subst Abuse. 2019;18(4):549-57. PMID: 29308996; https://doi.org/10.1080/15332640.2017.1417188.

Olawuyi AT, Adeoye IA. The prevalence and associated factors of non-communicable disease risk factors among civil servants in Ibadan, Nigeria. PloS One. 2018;13(9):e0203587. PMID: 30212508; https://doi.org/10.1371/journal.pone.0203587.

Peters SAE, Wang X, Lam TH, et al. Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: results from the Asia Pacific Cohort Studies Collaboration. BMJ Open. 2018;8(3):e019335. PMID: 29511013; https://doi.org/10.1136/bmjopen-2017-019335.

El Ansari W, Khalil KA, Ssewanyana D, Stock C. Behavioral risk factor clusters among university students at nine universities in Libya. AIMS public health. 2018;5(3):296-311. PMID: 30280117; https://doi.org/10.3934/publichealth.2018.3.296.

Nansseu JR, Kameni BS, Assah FK, et al. Prevalence of major cardiovascular disease risk factors among a group of sub-Saharan African young adults: a population-based cross-sectional study in Yaoundé, Cameroon. BMJ Open. 2019;9(10):e029858. PMID: 31594879; https://doi.org/10.1136/bmjopen-2019-029858.

Fawibe AE, Shittu AO. Prevalence and characteristics of cigarette smokers among undergraduates of the University of Ilorin, Nigeria. Niger J Clin Pract. 2011;14(2):201-5. PMID: 21860140; https://doi.org/10.4103/1119-3077.84016.

Peltzer K, Pengpid S. Prevalence, risk awareness and health beliefs of behavioural risk factors for cardiovascular disease among university students in nine ASEAN countries. BMC Public Health. 2018;18(1):237. PMID: 29433473; https://doi.org/10.1186/s12889-018-5142-1.

Güneş FE, Bekiroglu N, Imeryuz N, Agirbasli M. Awareness of cardiovascular risk factors among university students in Turkey. Prim Health Care Res Dev. 2019;20:e127. Erratum in: Prim Health Care Res Dev. 2019;20:e148. PMID: 31477189; https://doi.org/10.1017/S146342361900063X.

Johnson OE, Adedoyin RA, Awotidebe TO, et al. Cardiovascular risk among undergraduates in a Nigerian University. International Journal of Public Health and Epidemiology. 2013;2(5):85-9. Available from: https://www.researchgate.net/publication/316240649_Cardiovascular_risk_among_Undergraduates_in_a_Nigerian_University. Accessed in 2022 (Mar 30).

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2023-03-02

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Olufayo OE, Ajayi IO, Ngene SO. Clustering of cardiovascular disease risk factors among first-year students at the University of Ibadan, Nigeria: a cross-sectional study. Sao Paulo Med J [Internet]. 2023 Mar. 2 [cited 2025 Mar. 12];141(2):98-106. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/412

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