Predictors of Elevated Total Cholesterol among Hypertensive Patients in Edo State, Nigeria: A Cross-sectional Study

Abstract

Background: Cardiovascular diseases remain the leading cause of death globally, with hypertension and elevated total cholesterol as key modifiable risk factors. Their coexistence markedly increases cardiovascular risk. In Nigeria, both conditions are common among hypertensive patients, yet data on the predictors of elevated total cholesterol remain limited. This study aimed to identify predictors of elevated total cholesterol among hypertensive patients in Edo State, Nigeria. Methodology: A retrospective hospital-based cross-sectional study was conducted. A total of 826 medical records of adult hypertensive patients were reviewed at the Medical Outpatient Clinic (MOPC), University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. Elevated TC was defined as ≥200 mg/dL. Data on sociodemographics, anthropometrics, and clinical parameters were extracted. Descriptive statistics and multiple binary logistic regression (Enter method) were used to identify independent predictors, reporting Adjusted Odds Ratios (AOR) and 95% Confidence Intervals using IBM SPSS version 27.0. Results: The prevalence of elevated TC was 38.4% (n = 317). Increasing age (AOR = 1.019 per year, p = 0.001), higher body weight (AOR = 1.027 per kg, p = 0.002), secondary education (AOR = 1.596, p = 0.027), and no formal education (AOR = 2.500, p < 0.001) were significantly associated with higher odds of elevated total cholesterol. Being married (AOR = 0.322, p < 0.001) was protective. Haematuria was also associated with increased odds (AOR = 1.970, p = 0.034), while impaired glucose tolerance (AOR = 0.484, p = 0.002), proteinuria (AOR = 0.712, p = 0.040), and elevated serum creatinine (AOR = 0.405, p < 0.001) were associated with lower odds. Conclusion: The high prevalence of elevated TC among hypertensive patients in Edo State necessitates aggressive clinical management. Targeted interventions should prioritise female, older, and obese patients alongside robust public health campaigns aimed at those with low educational attainment and stringent lipid management for patients with concurrent chronic kidney disease. The observed inverse association with impaired glucose tolerance should be interpreted with caution, as it may reflect the effects of active lipid lowering therapy in this high-risk group rather than a true protective relationship.