RESUMO
Offspring of hypertensive parents have been shown to be at increased risk of developing systemic hypertension and adverse cardiovascular events later in life. The pathological antecedents of this are thought to be alterations in the structure and function of left ventricle. However, it is currently unclear if these abnormalities are due to genetic factors or a result of higher biomarker levels such as highly sensitive C reactive protein (hsCRP). An improved understanding of the associations of hsCRP with left ventricular structure may offer additional insight. Therefore, this study aims at determining the correlation of left ventricular mass with hsCRP among offspring of hypertensive parentscomparedwith controls Methodology:A cross sectional Hospital based study, with 100 subjects and 100 controls. A questionnaire was administered to obtain relevant history, physical examination, blood tests, ECG, Echocardiography were done for the two groups. The results were analysed using SPSS 20.Results:The left ventricular mass and mass index wassignificantly elevated in the subjects compared with the control group. The median hsCRP was significantly higher in the subjects [1.85 (0.28-10.20) vs. 1.34 (0.17-8.49) mg/L: P<0.010]. It progressively increases significantly as the number of parent with hypertension increases [1.34(0.17-8.49), 2.00(0.28-9.66) and 2.54(0.91-10.20) mg/L P<0.001] from zero, to single and both parent respectively. There was a significant correlation between hsCRP levels, blood pressure, left ventricular mass and left ventricular mass index (R= 0.165, 0.316, 0.274: P= 0.021, 0.004, 0.014) respectively.Conclusion:The study shows that offspring of hypertensive parents had higher echocardiographic left ventricular mass, left ventricular mass index and hsCRP levels compared with controls and this hsCRP increases as the number of parents with hypertension increases. Blood pressure and left ventricular mass index increase with increasing Plasma hsCRP: This may suggest possible role of hsCRP in the development of hypertension and cardiac remodeling
RESUMO
To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Observational study. The Cardiovascular Clinic of the University of Ilorin Teaching Hospital, Nigeria, from July 2002 to June 2003. Newly diagnosed adult hypertensives, with blood pressure 140/90 mmHg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy [LVH], heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 [7.8%] were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven [35.3%] were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight [81.7%] cases had combined systolic and diastolic pressures. Twenty-nine [13.3%] patients had systolic hypertension. Twenty-five [86.2%] of these 29 were aged 50 years and above and 20 [69.0%] were aged 60 years and above. Eleven [5.0%] patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ damage than the diastolic hypertension