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Background: This study aimed to determine the prevalence of hyperhomocysteinemia and folate status in a sample of normal healthy Nigerians living in Zaria as well as assess the relationship between homocysteine, folate, and blood pressure (BP) levels. Methods: It was a cross-sectional analytical study carried out among 65 normal healthy volunteers aged 18–65 years. Participants were randomly selected from willing patient escorts, hospital employees, and willing staff presenting at the Ahmadu Bello University Medical Centre, Zaria and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The percentage of participants who had high homocysteine levels as well as their plasma folate status was determined. Results: There were 9.2% with hyperhomocysteinemia >15 μmol/L and 51% with hyperhomocysteinemia >10 μmol/L. The mean plasma homocysteine level was 10.8 ± 2.7 μmol/L with male and female values of 10.7 ± 2.6 and 10.8 ± 2.8, respectively ( P = 0.87). The mean plasma folate level was high (116.7 ± 44.0 ng/mL) with male value of (111.5 ± 44.9 ng/mL) which did not differ significantly ( P = 0.37) from that of females (121.4 ± 43.3 ng/mL). Homocysteine showed a positive significant ( P = 0.01) relationship with folate but not with BP's ( P > 0.05). Conclusion: There is a high prevalence of hyperhomocysteinemia in normal healthy Northern-Nigerians which cannot be accounted for by suboptimal folate levels. Hyperhomocysteinemia may not be a risk factor for cardiovascular disease in normal healthy Nigerians despite its high levels as it showed no significant relationship with BP. Context: L’ étude vise à determiner la prévalence de l’hyper-homocystéinémie de l’état du folate en prenant comme echantillon dans le cas du nigérian en bonne santé vivant à Zaria, ainsi que l’évaluation de la relation qui existe entre l’homocystéine, le folate par rapport au niveau de croissance de la pression artérielle.

Objectives: This study was aimed at determining the effect of folic acid adjunct therapy on homocysteine (HCY) and blood pressure (BP) levels in hypertensive subjects. Method: The study was a double blind placebo-controlled trial on 100 hypertensive patients randomised into 50 folate and 50 placebo groups, where the folate group had 5 mg folic acid daily for 8 weeks. Fasting plasma homocysteine, folate and blood pressure levels were determined at baseline, at 4 and at 8 weeks. The Mixed Model Repeated Measures analysis of variance was applied for data analysis. Results: Hyperhomocysteinaemia was found at baseline in the folate (21.3 ± 5.7 µmol/L) and placebo (21.6 ± 4.9 µmol/L) groups which did not differ statistically (p > 0.05). Folic acid adjunct therapy, reduced homocysteine levels at 4 weeks by 2.0 µmol/L (9.2 %, p < 0.05) and at 8 weeks by 1.2 µmol/L (5.6 %, p < 0.05), with no significant (p > 0.05) systolic and diastolic blood pressure lowering effect. High base-line folate levels were found in both folate (113.8 ± 51.2 ng/ml) and placebo groups (109.5 ± 51.4 ng/ml) with no statistically significant difference (p > 0.05). Conclusion: Short-term daily folic acid supplementation over 8 weeks had a significant homocysteine reduction effect with no significant reduction in systolic and diastolic blood pressures of hypertensive subjects in Zaria, Nigeria. Hyperhomocysteinaemia could not be accounted for by suboptimal folate levels. Keywords: Hypertension, Homocysteine, Blood pressure, Folate, Placebo, Nigeria.

INTRODUCTION Cardiovascular disease has been leading cause of early disability and worldwide, and hypertension is the most important preventable risk factor for the development of cardiovascular disease Oliveira-Filho et al., 2014; Irazola Adherence to blood pressure lowering agents has been shown to be the cornerstone for achieving hypertension control, h developing countries, the effective treatment of blood pressure among people taking antihypertensive medication, wa average, particularly due to ABSTRACT Adherence to antihypertensive medication is the cornerstone for achieving hypertension control. Morisky Medication Adherence Scale (MMAS reported medication adherence measures. The aim of this study was to examine the evidence of the validity of adapted Hausa MMAS hypertensive patients in North individuals with hypertension, self treatment was measured using the Morisky Medication Adherence Scale consistency of the Morisky Medication Adherence Scale factorial validity was assessed by identifying the underlying components using principal component analyses (PCA). A total of 130 individuals completed the study. Cronbach's alpha was 0.79. Two components were identified. One component comprised medication when hypertension is under control, stopping when feeling hassled abou to the prescription. The second component comprised two other items that were all related to forgetfulness. A significant relationship between MMAS and control (t = 2.2; p = .030), (χ specificity, with positive and negative predictive values were respectively. The results suggest that the adapted Hausa Morisky Medication Adherence Scale-8 is a two-dimensional scale assessing intentional (first co (second component) non-adherence to the antihypertensive drug treatment. The findings of this validation study indicate that the Hausa version of the MMAS is a reliable and valid measure of medication adherence among hypertensive

Medication errors occur frequently and have significant clinical and financial consequences, which could be preventable. Unsafe medication practices and errors have been found to be amongst the leading cause of injury and avoidable harm in both developed and developing countries. The World Health Organisation (WHO) has recommended implementation of basic solutions to improve medication safety. This study assessed the presence of basic medication safety practices in four (4) public health facilities in Kaduna State, Nigeria. A validated survey tool was adopted which contains sections that assessed practices such as look-alike, sound-alike (LASA) medications, transitions in care, use of information technology, drug information and other practices. A structured interview was conducted with each head of Pharmacy department of the facilities after obtaining their consent. Only one facility had a medication safety committee, none of the facilities had a list of LASA medications nor a list of error proneabbreviations. Only one facility involved pharmacists in obtaining medication histories and none of the facilities uses ‘high risk’ warning label on diluted electrolyte solutions. Basic practices to improve medication safety were not implemented in the facilities. Effort must be put in place for the adoption of medication safety practices. Regulations and policies need to be implemented regarding these practices. Keywords: Medication safety; Health facilities; Kaduna State; Nigeria; Medication errors