ABSTRACT
BACKGROUND:Hypertension results in structural and functional changes in the heart. Early detection of abnormalities of cardiac structure and function is important in the assessment and treatment of hypertensive subjects. The aim of this study was to evaluate the utility of the tissue Doppler echocardiographic technique in characterising diastolic and systolic functions in untreated native black African hypertensive subjects.MATERIALS AND METHODS:Forty consecutive, newly diagnosed, untreated hypertensives with adequate conventional echocardiographic (2-D, M-mode, transmitral and pulmonary Doppler flow velocities) and tissue Doppler echocardiographic images were recruited into the study. The control subjects were apparently normal individuals. Each arm of the study consisted of 21 male and 19 female subjects.RESULTS:The two groups were comparable by age (48.6 +/- 11.35 years in the hypertensives vs 48.1 +/- 11.33 years in the controls; p = 0.844) and gender distribution (M/F: 21/19 in both groups). Other baseline characteristics, except for blood pressure parameters, which were predictably higher in the hypertensive subjects, were comparable between the two groups. The hypertensive subjects had a lower systolic myocardial velocity (Sm) and early diastolic myocardial velocity (Em) in comparison with the controls (p = 0.033 and p = 0.018, respectively). The late diastolic myocardial velocity (Am) was comparable in the two groups (p = 0.430). CONCLUSIONS:Tissue Doppler echocardiography demonstrates diastolic dysfunction relatively early in native African hypertensives and may be useful for detecting subtle deterioration in systolic function
Subject(s)
Africa , Echocardiography , Hypertension/diagnostic imaging , Hypertension/physiopathology , Ultrasonography, Doppler , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/physiopathologyABSTRACT
Nous avons realise une etude transversale allant d'octobre a decembre 2002. Nos objectifs ont ete : - determiner la prevalence de l'HTA dan le district de Bamako - Rechercher les principaux facteurs de risque de l'HTA - Preconiser les mesures de prevention de l'HTA. Ce travail a permis de trouver les caracteristiques epidemiologiques de l'HTA. - Bamako a varie de 23;5au premier controle a 18;1au deuxieme controle. - Nous avons trouve 18;8de femmes hypertendues; versus 15;6d'hommes. - La majorite (70) de nos hypertendus ont un age superieur a 60 ans. - L'obesite est un facteur de risque important avec 55de ces patients sont hypertendus. - Chez les sedentaires; nous avons eu une frequence de 22;6de l'HTA; - 22;5de nos sujets enquetes ont des meres hypertendues (p=0;006) 43;1des sujets avaient dans la fratrie une HTA (p=0;001). - La prise en charge reste insuffisante car 70;8 des hypertendus n'etaient pas equilibres sous divers traitement
Subject(s)
Cardiovascular Diseases , Hypertension/physiopathology , Population CharacteristicsABSTRACT
Les conceptions physiopathologiques des maladies hypertensives de la grossesse ont beaucoup evolue dans les dix dernieres annees. Trois elements complementaires interviendraient: un trouble precoce de la placentation; source de resistance vasculaire elevee; un exces de thromboxane; source de vasoconstriction et hyperagregation plaquettaire; et une activation de l'hemostase; source de thrombose. Ces elements conduiraient a une hypothese uniciste: celle d'une pathologie endotheliale probablement plus generale. C'est seulement apres une assez longue evolution des anomalies placentaires qu'apparait l'hypertension et eventuellement ses signes d'accompagnement. Ce mecanisme explique assez bien l'inefficacite des traitements anti-hypertenseurs pour modifier le pronostic de ces grossesses. Cependant; des traitements preventifs precoces; semblent porteurs d'espoir pour ces patientes
Subject(s)
Hypertension , Hypertension/drug therapy , Hypertension/physiopathology , PregnancyABSTRACT
A prospective study on hypertension in childhood among Nigerian children was carried out in five centres. Four hundred and four children had complete data and were admitted into this study; out of which 226 (55.9 per cent) were males and 173 (44.1 per cent) were females. Twenty-two of the children examined were hypertensive with blood pressure more than 120/80mmHg; which was maximal in the age range 10-12 years. Females were more affected than males. Thirty-six of the children have their systolic blood pressure above 140mmHg