Target organ damage among subjects with high­normal blood pressure in a Nigerian tertiary health institution

Background: There is paucity of data on the relationship between high ­ normal blood pressure (BP) and target organ damage (TOD) in sub-Saharan Africa including Nigeria. This study therefore, aimed to assess target organ damage (TOD) among subjects with high ­ normal BP in comparison with hypertensives and subjects with optimal BP. Materials and Methods: The study was crosssectional and comparative conducted at Aminu Kano Teaching Hospital, Kano on eligible subjects aged 18 years and above. Three groups comprising of randomly selected subjects (high -normal (group 1), hypertension (group 2) and optimal BP (group 3)), with each group having 100 in number were studied. Funduscopy and relevant investigations including transthoracic echocardiography were carried out. High ­ normal BP was defined as systolic BP of 130 -139mmHg and/or diastolic BP of 80-89mmHg. Results: The mean age of subjects in group 1 was 27.32 ± 8.20 years and 60% were female, 34.04±6.25 years for group 2 and 53% were female, and 52.81 ± 13.3 years for group 3 and 56% were female (P = < 0.001). The most prevalent TOD was left ventricular hypertrophy,present in 62% of hypertensives, 14% of those with high-normal BP and 2% of those with optimal BP(P = <0.001). Micro albuminuria and slight increase in creatinine were found in 12.9% and 6% of subjects with high-normal BP; 25.7% and 25% of hypertensives and 4.1% and 3% of subjects with optimal BP. The study found a significant progressive increase in both cardiovascular disease risk factors and target organ damage (TOD) as BP increased across the blood pressure categories from optimal BP to high ­ normal BP and to hypertension (P = <0.05). Conclusion: Subjects with high-normal BP had significantly higher prevalence of both TOD and cardiovascular disease risk factors than those with optimal BP but lower than hypertensives, suggesting that efforts to control BP should start early to reduce the complications of high BP

QT Interval Prolongation in Patients with Hypertensive Heart Disease

Background: The study assessed the prevalence of QT interval prolongation and identified its associated factors Methods: The study was cross-sectional in design. Subjects confirmed on echocardiography to have HHD were recruited consecutively from 3 echocardiography laboratories in the Kano City; Nigeria; over 7 months. Prolonged QTc was defined as QTc 440 ms in males and 460 ms in females; or more than 500ms in both sexes in the presence of complete bundle branch block. A p-value of

Impact of Income on the Profile of Cardiovascular Risk Factors among Hypertensives in a Nigerian Tertiary Health Centre: a Cross-Sectional Study : Cardiovascular Topics

Background: In most developed countries; risk factors for cardiovascular diseases (CVD) are more prevalent in low socioeconomic classes. However; the pattern in developing countries appears to be different. This study sought to evaluate and compare risk factors for CVD as well as absolute CVD risk in hypertensive subjects grouped by income in Kano; Nigeria. Methods: The study was cross-sectional in design and carried out in Aminu Kano Teaching Hospital; Kano; Nigeria. Seventy treatment-naIve hypertensives and an equal number of hypertensives on treatment were recruited by balloting from the outpatient clinics; and then regrouped into low- and high-income earners. These two groups were then compared in terms of their profile of CVD risk factors and absolute CVD risk. All the assessed CVD risk factors are recognised in standard guidelines for the management of persons with systemic hypertension. Results: The low-income group comprised 45 patients (32.1) while the remaining 95 (67.9) had a high income. The most prevalent CVD risk factor was dyslipidaemia; found in 77.8 and 71.6of low- and high-income earners; spectively (p = 0.437). The prevalence of proteinuria was significantly higher among low-income earners (42.2) compared with high-income earners (15.8) (p = 0.001). Mean serum creatinine was also higher among low-income earners but the difference did not reach statistical significance (p = 0.154). Very high CVD risk was found in 75.6 and 70.5of low- and high-income earners; respectively (p = 0.535). Conclusion: Dyslipidaemia and very high CVD risk were found in over 71of the patients regardless of their level of income. Low-income earners had a higher prevalence of indices of renal damage. These findings pose a great challenge to the present and future management of all subjects; particularly those in the low-income group; given that in Nigeria; healthcare is largely paid for directly out of their pockets

Pattern of Left Ventricular Geometry in Hypertension: a Study of a Hypertensive Population in Nigeria

Background: Hypertension is a leading cause of cardioxasular morbidity and mortality in Nigeria. The main aim of this study was to deterine the prevalence of left ventricular hypertrophy and left ventricular geometric patterns among hypertensives in Kano; Nigeria. Methods: The study was cross-sectional in design; and carried out in 3 echocardiography laboratories within the City of Kano; Nigeria. Patients with hypertension without other cardiac disorders were serially recruited and studied after obtaining informed consent. Results: A total of 186 patients were studied over 7 months; 89 males (47.9) and 97 females (52.1). The prevalence of left ventricular hypertrophy was 61.8. Thirty five patients (18.8) had normal left ventricular geometry and these were predominantly females and had the lowest mean age and shortest duration of hypertension. Sixty eight patients (36.6) had eccentric hypertrophy; 47 (25.3) had concentric hypertrophy and 36 (19.4) had concentric remodelling. Independent predictors of the various geometric patterns were identified. Conclusion: A high prevalence of left ventricular hypertrophy was observed with eccentric hypertrophy being the most common geometric pattern. Gender influenced the pattern of left ventricular geometry

The Impact of Income on the Echocardiographic Pattern of Heart Diseases in Kano; Nigeria

Background:The aims of the present study were to assess the echocardiographic pattern of heart diseases; and to compare the pattern seen in a private echocardiography centre patronized by high income earners (group 1); with that in Murtala Mohammed Specialist Hospital patronized by low income earners (group 2); in Kano; Nigeria.Methods: the study was retrospective in design.The records of patients aged =15 years for a one year period (July 2006-June 2007) were reviewed. Results: Hypertensive heart disease (in 56.7) was the most common heart disease; more common among group 1 patients (p=0.027). Dilated cardiomyopathy was the 2nd most common heart disease (in 15.2); more common among group 2 patients (p=0.037). Ischemic Heart Disease (IHD) was the 3rd most common (in 8.7) heart disease in the study; more common than rheumatic heart disease (in 8.3). Peripartum cardiomyopathy was exclusively found among group 2 patients (4.3). Conclusion:The pattern of heart diseases in Kano differs between low and higher income earners. HHD was the commonest heart disease among both low income and higher income earners.The relatively high frequency of IHD might be a demonstration of the advanced stage of epidemiologic transition in Kano Nigeria

The Impact of Income on the Echocardiographic Pattern of Heart Diseases in Kano; Nigeria

Background:The aims of the present study were to assess the echocardiographic pattern of heart diseases; and to compare the pattern seen in a private echocardiography centre patronized by high income earners (group 1); with that in Murtala Mohammed Specialist Hospital patronized by low income earners (group 2); in Kano; Nigeria.Methods: the study was retrospective in design.The records of patients aged =15 years for a one year period (July 2006-June 2007) were reviewed. Results: Hypertensive heart disease (in 56.7) was the most common heart disease; more common among group 1 patients (p=0.027). Dilated cardiomyopathy was the 2nd most common heart disease (in 15.2); more common among group 2 patients (p=0.037). Ischemic Heart Disease (IHD) was the 3rd most common (in 8.7) heart disease in the study; more common than rheumatic heart disease (in 8.3). Peripartum cardiomyopathy was exclusively found among group 2 patients (4.3). Conclusion:The pattern of heart diseases in Kano differs between low and higher income earners. HHD was the commonest heart disease among both low income and higher income earners.The relatively high frequency of IHD might be a demonstration of the advanced stage of epidemiologic transition in Kano Nigeria