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

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

Familial polycystic kidney disease in Nigeria: A report of two cases

A case of familial polycystic kidney disease is reported. Although isolated cases of adult polycystic kidney disease have been reported in our environment; no case to our knowledge has been reported with a familial link. Polycystic kidney disease is said to be rare in Africans. Although it commonly terminates in chronic renal failure; it hardly features in the aetiopathogenesis of end stage renal disease requiring some form of renal replacement therapy in African series. This; some workers believe may be due to misdiagnosis and under reporting. This report is to show that it may not be as rare as suspected; and that the familial link shown in the advanced countries is also applicable here. Case 1 was diagnosed in the course of evaluation of her clinical disease. Case 2; an aunt of Case 1; was diagnosed following investigation of a casual complaint of a painless abdominal mass in the wake of her senior brother's death from haemorrhagic stroke

The role of hypertension in dilated cardiomyopathy: an echocardiographic assessment

Follow-up and radiological studies have been carried out in the past speculating on the interlationship between hypertension and dilated cardiomyopathy; and what proportion of the later would be predominantly blamed on the former. Follow-up studies have the problem of time and drop-out rate to contend with; while radiological features pathognomonic of hypertension. A 2-D echocardiographic study of cases of biventricular failure due to hypertension and dilated cardiomyopathy (because at point of admission; no cause was evident) was undertaken to see what if any relationship exists. Certain echo indices were found to be indicative of significant hypertension in patients diagnosed as having biventricular failure due to dilated cardiomyopathy. Using this method it would be possible to tell the dilated cardiomyopathy patient who will benefit at onset from some form of antihypertensive therapy