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Effect of Cardiovascular Risk Screening on Cardiovascular Risk Detection among Adults in Nigeria

Abstract

Cardiovascular diseases are among the major causes of morbidity and mortality globally and represent an increasing public health concern in Nigeria. Many cardiovascular risk factors, including hypertension, diabetes mellitus, obesity, unhealthy dietary practices, physical inactivity, tobacco use, harmful alcohol consumption, and abnormal blood lipid levels, may remain undetected because affected individuals may not undergo routine health assessments. Cardiovascular risk screening provides an opportunity to identify individuals with established risk factors and those with an elevated probability of developing cardiovascular disease, thereby creating opportunities for early intervention and risk reduction. Cardiovascular risk screening refers to the systematic assessment of individuals using appropriate clinical measurements, laboratory tests, behavioural assessments, and validated risk-assessment approaches to identify cardiovascular risk factors and overall cardiovascular risk. Cardiovascular risk detection refers to the identification and classification of individuals with cardiovascular risk factors or elevated cardiovascular risk based on appropriate screening and assessment criteria. In Nigeria, limited access to preventive healthcare, inadequate awareness, financial barriers, low screening uptake, and insufficient integration of noncommunicable disease screening into routine healthcare services may contribute to the under-detection of cardiovascular risk. Strengthening cardiovascular risk screening may improve the identification of individuals who require lifestyle modification, medical assessment, monitoring, or further treatment. Against this background, this study investigates the effect of cardiovascular risk screening on cardiovascular risk detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Health Systems Framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Andersen's Behavioral Model emphasizes predisposing, enabling, and need-related factors influencing healthcare utilization. The Health Systems Framework identifies service delivery, health workforce, health information, medical technologies, and access to essential healthcare services as important components of effective health systems. Collectively, these theoretical perspectives provide a suitable framework for explaining how cardiovascular risk screening may influence the detection of cardiovascular risk among adults in Nigeria. The study will adopt a quantitative cross-sectional community-based research design. Data will be collected from adults participating in selected cardiovascular risk screening programmes across selected locations in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, screening sites, and eligible participants. Cardiovascular risk screening will be assessed using indicators such as availability of screening services, screening frequency, accessibility of screening locations, blood pressure measurement, blood glucose assessment, body mass index assessment, waist circumference measurement, lipid profile testing where available, behavioural risk assessment, family history assessment, and use of standardized cardiovascular risk-assessment tools. Cardiovascular risk detection will be assessed using indicators such as identification of hypertension, elevated blood glucose or diabetes risk, overweight or obesity, abnormal lipid levels, tobacco use, physical inactivity, unhealthy dietary practices, and elevated overall cardiovascular risk based on appropriate risk-assessment criteria. Screening records and laboratory results will be reviewed where available to validate reported findings. Descriptive statistics will be used to summarize participants' characteristics, screening exposure, and cardiovascular risk detection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of cardiovascular risk screening on cardiovascular risk detection. Diagnostic tests will also be conducted to assess the reliability of research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that cardiovascular risk screening has a significant positive effect on cardiovascular risk detection among adults in Nigeria. Adults who participate in comprehensive cardiovascular risk screening are expected to have a higher likelihood of having previously undetected cardiovascular risk factors identified than adults with limited or no access to screening. Routine assessment of blood pressure, blood glucose, body composition, lipid levels, and behavioural risk factors may facilitate early identification of individuals requiring preventive interventions or further clinical assessment. Screening may also increase awareness of personal cardiovascular risk and encourage appropriate health-seeking behaviour. Conversely, limited access to cardiovascular risk screening may result in undetected risk factors and missed opportunities for early prevention. However, cardiovascular risk screening alone may not guarantee effective detection if appropriate equipment, trained personnel, laboratory services, standardized assessment tools, and referral systems are unavailable. Therefore, screening programmes should be supported by adequate diagnostic capacity, trained healthcare workers, appropriate guidelines, and effective referral mechanisms. The study is expected to contribute to the literature on cardiovascular risk screening, cardiovascular disease prevention, noncommunicable diseases, early risk detection, community health, epidemiology, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, primary healthcare authorities, healthcare facilities, public health practitioners, community health workers, cardiovascular health programmes, development partners, and policymakers regarding strategies for improving cardiovascular risk detection. The study will also provide evidence-based recommendations for expanding cardiovascular risk screening, improving access to blood pressure and glucose assessment, strengthening lipid screening where appropriate, increasing community-based screening activities, training healthcare workers, improving cardiovascular risk assessment, strengthening referral systems, and integrating cardiovascular risk screening into routine primary healthcare and noncommunicable disease prevention programmes in Nigeria.

Keywords: Cardiovascular risk screening, cardiovascular risk detection, adults, Nigeria, cardiovascular diseases, hypertension, diabetes, noncommunicable diseases, risk factors, primary healthcare, epidemiology, public health.