Assessment of pesticide use patterns among farmers in the Jamuna riverside regions of Tangail and Sirajganj districts, Bangladesh.

Cardiovascular disease (CVD) is responsible for approximately 17.9 million deaths annually, representing 32% of all global mortality, with more than 80% of these deaths occurring in low- and middle-income countries (LMICs) []. In sub-Saharan Africa, the epidemiological transition toward non-communicable diseases — driven by urbanisation, dietary change, and physical inactivity — has placed CVD at the centre of public health planning []. Nigeria, as Africa’s most populous LMIC, exemplifies this transition acutely: CVD accounts for approximately 11% of all national mortality, and hypertension — the single most important modifiable cardiovascular risk factor — has reached epidemic proportions, with national prevalence estimates of 30–33% among adults [, ]. Critically, fewer than 40% of those affected are aware of their condition, fewer than 20% receive treatment, and fewer than 5% achieve adequate blood pressure control [], reflecting a healthcare system with severely limited capacity for systematic cardiovascular screening and prevention. University students represent a population of particular strategic importance for primordial CVD prevention. Behaviours and risk perceptions established during the university years track powerfully into middle age [], and prospective cohort data confirm that childhood and adolescent cardiovascular risk factors — elevated blood pressure, dyslipidaemia, smoking — predict subclinical and clinical cardiovascular events in adulthood after follow-up periods exceeding 30 years []. Nigerian university students face a distinctive constellation of cardiovascular risk exposures: transition from structured family meals to irregular dietary patterns determined by campus food vendor availability; sedentary academic routines replacing habitual physical activity; chronic psychosocial stress from academic pressure and financial insecurity; and near-complete absence of systematic cardiovascular health monitoring within university health services [, ]. Clinical evidence confirms a substantial and largely undetected hypertension burden in this population. A clinical assessment conducted as part of the present research found that 26% of purposively selected high-risk University of Jos students met WHO 2021 hypertension criteria (≥ 140/90 mmHg), rising to 50% under ACC/AHA 2017 criteria (≥ 130/80 mmHg), with complete unawareness in all cases — a 100% within-sample detection gap under both classification systems []. Comparable hypertension burden has been documented among university students in other Nigerian geopolitical zones, with pre-hypertension and hypertension rates of 22–50% reported in south-east Nigerian universities []. A further dimension specific to sub-Saharan African populations is the well-documented pattern of salt-sensitive hypertension, operating independently of excess body weight through exaggerated renal sodium retention and heightened vascular reactivity [, ]. This was confirmed in the clinical assessment: 76% of participants meeting hypertension criteria had normal BMI [], establishing that obesity-centred cardiovascular risk frameworks are insufficient for this population.