Relative Risk of Metabolic Syndrome Components in Nigerians: the Adult Treatment Panel III Definition

Background: The prevalence of metabolic syndrome is increasing in all populations worldwide and is associated with a substantially elevated risk of type 2 diabetes (5-fold) and of cardiovascular disease (2-3 fold). Metabolic syndrome is now established as a simple means of identifying individuals at increased risk of future cardio vascular disease and type 2 diabetes mellitus. Aim: To determine the prevalence of metabolic syndrome among adult Nigerians attending Family Medicine Clinics at two health facilities in Rivers State; Nigeria and to determine how much each diagnostic criterion contributed to the diagnosis of metabolic syndrome. Methods: Subjects were bled after an overnight fast; and venous blood obtained for lipid studies and fasting blood glucose estimation. Measurements were made to determine height; weight; waist circumference and blood pressure. The diagnosis of metabolic syndrome was based on the National Cholesterol Education Project: Adult Treatment Panel III (ATP III) definition. Results: The unadjusted and age-adjusted prevalence rates of metabolic syndrome at one centre were 19.8and 20.9respectively while they were 34.2and 31.6respectively at the other centre. The prevalence of low HDL-cholesterol was very high at both centres (78.3at one centre and 92.1at the other). Metabolic syndrome is most prevalent in females and older subjects. Conclusion: The prevalence of metabolic syndrome (19.8and 20.9; unadjusted and age-adjusted; respectively) were lower at one centre than the other (34.2and 31.6; unadjusted and age-adjusted; respectively). Despite the very high prevalence of low HDL- cholesterol; the relative risk for metabolic syndrome was not statistical significant (RR=6.73; 95CI: 0.99-45.55)

Current epidemiology of hypertension in Port Harcourt metropolis, Rivers state, Nigeria

Background: Hypertension is the sustained elevation of the blood pressure to 140/90 mmHg or more. It is the commonest non-communicable disease in the world and all races are affected with variable prevalence. In Nigeria, prevalence was between 10 and 14% based on a national survey conducted over a decade ago. Since that survey, the definition of hypertension has changed and social and demographic changes have also taken place, and so changes in prevalence and epidemiology are expected, hence the need for the present survey. Methods: A cluster sample of adult Nigerians, aged 18 years and above, living in Port Harcourt, Rivers State, drawn from civil servants at the Federal secretariat, state secretariat, six selected secondary schools, two major markets, two major motor parks and one of the higher institutions as well as staff of the University of Port Harcourt Teaching Hospital formed the cohort for this study. Their blood pressures were measured in the various locations on the day of visit using standard protocol. The height and weight of all participants were measured, social and demographic information was obtained as well as history of previous hypertension, treatment if any and family history of diabetes mellitus or hypertension. The information obtained was entered into the questionnaire designed for the survey. All pregnant females were excluded. Results: A total of nine hundred and twenty one (921) adult Nigerians made up of 449 males (48.75%) and 472 females (51.25%) participated in the survey. The age range was 19 to 68 years, mean age was 39.94 ± 8.61 years, mean systolic blood pressure was 129.99 ± 22.85 mmHg and mean diastolic blood pressure was 84.84 ± 28.02 mmHg. A total of 376 of those surveyed were hypertensive giving a prevalence of 40.82%, out of which 49 (13.03%) were aware of being hypertensive and 33 (67.35%) of these were receiving treatment. Among those found to be hypertensive, 17.55% had family history of hypertension, and 12.23% had family history of diabetes mellitus. The mean body mass index (BMI) was 26.14 ± 8.08 kg/m2, 408 (44.30%) had a normal BMI of ≤ 24.9, 343 (37.24%) were overweight (BMI = 25-29.9) and 170 (18.46%) were obese with BMI of ≥ 30. Conclusion: The prevalence of hypertension in Port Harcourt is high and only a small fraction of hypertensives are aware of their condition. There is need for large scale screening and education of the public as a major public health measure to reduce the numerous catastrophic complications of hypertension

Pattern of ECG abnormalities in Nigerian hypertensive patients seen in University of Port Harcourt Teaching Hospital

Objective: The aim of the study was to document the pattern of EGG abnormalities in the hypertensive patients in Port Harcourt and to compare their prevalence with what obtains in the apparently normal population as documented in previous studies. Methods: The electrocardiographic profile of one hundred and thirty two consecutive hypertensive patients seen at the consultant medical clinic of the University of Port Harcourt Teaching Hospital were studied prospectively. All patients were above 15 years of age with blood pressures above 140/90 mmHg taken at more than two visits. As part of their investigations, twelve lead surface electrocardiograms were recorded. They were interpreted by either of the authors and data were analyzed by simple statistical methods. P value was taken as significant if up to or below 0.5. Results: The abnormalities identified were left ventricular hypertrophy(LVH)in37.1%, left axis deviation(LAD) in 30.3%, sinus tachycardia 25.0%,left atrial enlargement(LAE) in 21.2%, atrial fibrillation(AF) in 3.8%, right bundle branch block (RBBB) in 1.5% and left anterior hemi block (LAH) in 0.8%. There were no cases of myocardial infarction nor pathological Q waves. Conclusion: The study concluded that ECG abnormalities are prevalent in our hypertensive patients and given their prognostic significance, the surface ECG remains relevant as one of the first line investigations in these patients