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Impact of Cardiovascular Health Screening on Cardiovascular Risk Detection among Women Aged 40 Years and Above in Nigeria

Abstract

Cardiovascular disease is a major public health concern and an important cause of illness, disability, and premature death among women. The risk of cardiovascular disease generally increases with age and may be influenced by hypertension, diabetes, obesity, dyslipidaemia, physical inactivity, unhealthy dietary practices, smoking, and other modifiable and non-modifiable factors. Women aged 40 years and above may therefore benefit from regular cardiovascular health assessment and early identification of risk factors. However, many women may remain unaware of their cardiovascular risk because some risk factors, particularly hypertension and dyslipidaemia, may occur without obvious symptoms. Limited awareness, financial barriers, inadequate access to preventive healthcare, geographical constraints, and low utilization of routine screening services may further delay identification of cardiovascular risk. Cardiovascular health screening provides an opportunity to identify individuals with elevated cardiovascular risk and facilitate timely counselling, monitoring, treatment, and referral. Against this background, this study investigates the impact of cardiovascular health screening on cardiovascular risk detection among women aged 40 years and above in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how women's perceptions of their susceptibility to cardiovascular disease, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in cardiovascular health screening. Andersen's Behavioral Model explains how predisposing characteristics, enabling resources, and healthcare needs influence utilization of preventive screening services. The Social Ecological Model emphasizes the interaction between individual, family, community, healthcare-system, and broader societal factors in determining access to and utilization of cardiovascular health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how cardiovascular health screening may influence cardiovascular risk detection among women aged 40 years and above in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 40 years and above residing in selected communities and attending primary healthcare centres, hospitals, community health programmes, workplaces, women's organizations, and other relevant settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible women. Cardiovascular health screening will be assessed using indicators such as availability and accessibility of screening services, screening coverage, frequency of screening, blood pressure measurement, blood glucose assessment, body mass index or waist circumference measurement, lipid assessment where available, cardiovascular risk assessment, health counselling, result communication, referral, and follow-up arrangements. Cardiovascular risk detection will be assessed using indicators such as newly identified hypertension, elevated blood glucose or diabetes risk, overweight or obesity, abnormal lipid levels where testing is available, elevated cardiovascular risk scores, newly identified cardiovascular risk factors, and referral for further clinical assessment. Data will be collected using structured questionnaires, screening records, clinical measurements, laboratory results where available, cardiovascular risk assessment tools, referral registers, and relevant healthcare records. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, cardiovascular risk factors, and patterns of risk detection. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of cardiovascular health screening on cardiovascular risk detection. Where a quasi-experimental design is adopted, cardiovascular risk detection before and after implementation of the screening programme may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that cardiovascular health screening has a significant positive impact on cardiovascular risk detection among women aged 40 years and above in Nigeria. Women who participate in systematic cardiovascular screening are expected to have a higher likelihood of having previously undetected cardiovascular risk factors identified than women without access to routine screening. Screening may identify hypertension, elevated blood glucose, unhealthy weight, dyslipidaemia, and other cardiovascular risk factors before the development of clinically apparent cardiovascular disease. Early identification may facilitate lifestyle counselling, appropriate medical evaluation, treatment where indicated, risk monitoring, and referral to specialized healthcare services. Community- and facility-based screening may also reduce barriers related to distance, cost, limited awareness, and infrequent contact with healthcare providers. However, financial constraints, limited availability of laboratory services and screening equipment, inadequate healthcare personnel, low awareness, poor follow-up, and unequal access to healthcare may reduce the effectiveness of cardiovascular screening programmes. The study therefore expects accessible, affordable, comprehensive, and well-organized cardiovascular health screening to contribute significantly to improved cardiovascular risk detection among women aged 40 years and above in Nigeria. The study is expected to contribute to the literature on cardiovascular health screening, cardiovascular risk detection, women's cardiovascular health, hypertension screening, diabetes risk assessment, preventive healthcare, non-communicable disease prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, healthcare providers, women's health organizations, development partners, and policymakers regarding strategies for improving early identification of cardiovascular risk among women. The study will also provide evidence-based recommendations for integrating cardiovascular risk assessment into routine women's health services, expanding community-based screening programmes, improving access to blood pressure and metabolic screening, strengthening referral and follow-up systems, increasing awareness of cardiovascular risk among middle-aged and older women, and promoting early intervention for identified cardiovascular risk factors across Nigeria.

Keywords: Cardiovascular health screening, cardiovascular risk detection, women aged 40 years and above, hypertension, diabetes risk, cardiovascular disease prevention, non-communicable diseases, preventive healthcare, women's health, risk assessment, Nigeria, public health.