ABSTRACT
Background and Objectives: There is paucity of reliable information on knowledge about hypertension and cardiovascular disease (CVD) risk factors in rural southwestern Nigeria. This study assessed the level of awareness, basic knowledge and management of hypertension and CV risk factors among people living in rural south western Nigeria. Methods: A population based cross-sectional survey was conducted in Egbeda local government area of Oyo State, Nigeria. A structured questionnaire was used to interview 2000 subjects in order to assess knowledge of various aspects of modifiable CV risk factors. Results: The commonest source of medical information was the family/friend/opinion leaders of trusted groups in 1198(59.9%), the media (including radio, public enlightenment programmes, and newspapers) in 492(24.6%), and the doctor/nurse/health worker in 183(9.1%) of the respondents. The overall knowledge of CVD and its risk factors was poor. About 56% of the respondents could not identify a single risk factor. Of those who were able to, only a few could correctly identify the relationship between CV risk factors and CVD with some misconceptions. . We found that subjects who had more years of formal education, a positive family history of CVD, and self reported history of diabetes mellitus were more likely to have a good level of knowledge of hypertension and other CV risks when adjusted for age, gender and marital status. Conclusion: Our study confirms a limited knowledge and misconceptions of CVD and its risk factors in this population. Early detection and preventive practices were significantly lacking due to these gaps in Knowledge. There is an urgent need to design and implement culturally appropriate public awareness, health educational and health promotional programmes about CV risk factors and CVD for this community which can be adapted for other rural population in the country.
ABSTRACT
Background : Hypertension is a disease characterized by end-organ complications; leading to high morbidity and mortality in many cases. People with untreated or uncontrolled hypertension often run the risk of developing complications directly associated with the disease. Left ventricular hypertrophy (LVH) has been shown to be a significant risk factor for adverse outcomes both in patients with hypertension and in the general population. We investigated the prevalence and pattern of LVH in a treated hypertensive population at the University College Hospital; Ibadan; Nigeria; using non-hypertensive subjects as control. Design and Setting : A prospective observational study performed at the University College Hospital; Ibadan; Nigeria. Methods : Patients had 6 visits; when at least one blood pressure measurement was recorded for each hypertensive subject and average calculated for systolic blood pressure (SBP) and diastolic blood pressure (DBP) separately. The values obtained were used for stratification of the subjects into controlled and uncontrolled hypertension. Subjects also had echocardiograms to determine their left ventricular mass. Results : LVH was found in 14 (18.2) of the normotensive group; 40 (20.8) of the uncontrolled hypertensive group and 14 (24.1) of the controlled hypertensive group when left ventricular mass (LVM) was indexed to body surface area (BSA). When LVM was indexed to height; left ventricular hypertrophy was found in none of the subjects of the normotensive group; while it was found present in 43 (22.4) and 14 (24.1) subjects of the uncontrolled and controlled hypertensive groups; respectively. Significant difference in the prevalence of LVH was detected only when LVM was indexed to height alone. Conclusion : Clinic blood pressure is an ineffective way of assessing BP control. Thus in apparently controlled hypertensive subjects; based on office blood pressure; cardiac structural changes do remain despite antihypertensive therapy. This population is still at risk of cardiovascular events
Subject(s)
Blood Pressure , Hypertension , HypertrophyABSTRACT
Background: Electrocardiographic left ventricular hypertrophy with strain pattern has been documented as a marker for left ventricular hypertrophy. Its presence on the ECG of hypertensive patients is associated with a poor prognosis. This review was undertaken to report the prevalence; mechanism and prognostic implications of this ECG abnormality. Materials and methods: We conducted a comprehensive search of electronic databases to identify studies relating to the title of this review. The search criteria were related to the title. Two of the reviewers independently screened the searches. Results: Results were described qualitatively. The data were not pooled because there were no randomised studies on the topic. The prevalence of ECG strain pattern ranged from 2.1 to 36. The highest prevalence was reported before the era of good antihypertensive therapy. The sensitivity as a measure of left ventricular hypertrophy ranged from 3.8 to 50; while the specificity was in the range of 89.8 to 100. Strain pattern was associated with adverse cardiovascular risk factors as well as increased all-cause and CV morbidity and mortality. ST-segment depression and T-wave inversion on the ECG was recognised as the strongest marker of morbidity and mortality when ECG-LVH criteria were utilised for risk stratification in hypertensive subjects. Conclusion: Electrocardiographic strain pattern identifies cardiac patients at higher risk of cardiovascular-related as well as all-cause morbidity and mortality
Subject(s)
Antihypertensive Agents , Electrocardiography , Hypertension , Hypertrophy , ReviewABSTRACT
Background: Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity and mortality. Various electrocardiographic (ECG) criteria for LHV give poorer performance in black subjects when compared with white subjects. Araoye proposed a code system for improved ECG diagnosis of LVH in blacks. The Araoye's criteria are yet to be validated in black subjects.Study design: Electrocardiograms and echocardiograms were obtained from 100 hypertensive subjects and 60 controls. ECG LVH was determined by the Araoye's code criteria; Sokolow-Lyon; Cornell voltage; and Romhilt-Estes point score. Echocardiographic LVH was defined by LV mass indexed for height at 97.5 percentile of the controls (126g.m-1 and 130g.m-1 in females and males respectively). Results: The prevalence of echocardiographic LVH indexed for height was 34and 1.67in the hypertensive and controls respectively while the prevalence of electrocardiographic LVH among the hypertensives were 18by Romhilt Estes score; 48by Sokolow-Lyon's criteria; 22by Cornell's criteria and 51by Araoye's criteria. The sensitivity and specificity respectively of the various electrocardiographic criteria were 65.7and 76.8for Sokolow-Lyon; 25.7and 88.8for Cornell's criteria 25.7and 92.8for Romhilt-Estes score and 71.4and 74.4for Araoye's criteria. Araoye's criteria did not differ significantly from Sokolow-Lyon criteria in identifying LVH but differed significantly from Cornell and Romhilt-Estes criteria. The number of positive codes in Araoye's criteria was significantly associated with the blood pressures; LV dimensions; and LV mass. Conclusion: The Araoye's code system for electrocardiographic diagnosis of LVH offer no comparative advantage over Sokolow-Lyon's criteria. However; the number of positive codes in Araoye's criteria identifies those individuals with more severe LVH