Serum Troponin I levels among hypertensive Military Service Personnel at a Military Health Facility in Abuja, Nigeria.

Hypertension constitutes one of the major metabolic disease in Nigeria especially among military personnel and their families. Myocardial infarction and other cardiovascular diseases may occur in this group of patient due to uncontrolled or poorly controlled hypertension. The objective of this study was to determine serum cardiac Troponin I (cTnI), levels in hypertensive Nigerian Military service personnel attending clinic in a military Health facility.  We measured the serum levels of cTnI in 126 hypertensive subjects [76 males (19-73 years) and 50 females (26-77years)] and 82 normotensive controls [41 males (19-60years) and 41 females (18-53years)] using Latex Enhanced Immunoturbidimetry technique. The data were compared between test and control group using Students't-test. Serum cTnI was detected in the sample of 95(75.4%) subjects and was not detected in 31 (24.6%) subjects. Nine subjects (2.38%) had cTnI levels within the normal range(0.00-0.01ng/mL), 85 (67.5%) subjects had significantly higher (p<0.001) cTnI levels (0.100 ± 0.091 ng/ml; CL: 0.02 - 0.47ng/mL), while one (0.8%) subject had a cTnI value of 1.09 ng/mL. Nine (10.98%) control subjects had detectable cTnI levels (0.01ng/mL) while 73(89.02%) controls had a 0.00 ng/mL cTnI level. There was no significance difference in cTnI levels when subjects on chemotherapy were compared with newly diagnosed subjects (P = 0.0694). This study revealed that cTnI was detectable in the serum of majority of the study participants which may suggest sub-clinical cardiac necrosis. There may be risk of developing adverse cardiovascular disorders and the need for appropriate intensive management is emphasized.

Thyroid hormone levels in apparently euthyroid subjects with essential hypertension in a tertiary hospital in Nigeria.

BACKGROUND: High blood pressure (BP) is a major health problem in Nigeria and the involvement of thyroid hormones in this condition has not been evaluated in this center. OBJECTIVE: The objective of this study was to evaluate the proportion of patients with an essential hypertension who had abnormal thyroid hormone levels and the type of thyroid disorders commonly observed in this group of patients. MATERIALS AND METHODS: A retrospective study of 94 patients (30 males, aged 30.4 ± 2 years and 64 females, aged 43.4 ± 1.3 years) with essential hypertension was carried out between January 2005 and December 2007. Demographic and other medical information were obtained from the health records. Analysis of laboratory results of triiodothyronine (T3), Thyroxine (T4), and thyroid stimulating hormone (TSH) were made. RESULTS: Of the 94 patients evaluated, 26 (27.7%) had abnormal thyroid hormone levels, with 23.4% having hyperthyroidism, 4.3% had sub-clinical hypothyroidism and none had overt hypothyroidism. Of the 26 subjects with abnormal thyroid hormone levels, 18 (69.2%) were females while 8 (30.8%) were males. Out of the 18 female subjects with abnormal thyroid hormone levels, 16 had hyperthyroid levels while 2 had sub-clinical hypothyroid levels. Out of the 8 male patients, 6 had hyperthyroid hormone levels while 2 had sub-clinical hypothyroid levels. CONCLUSION: Thyroid hormone abnormalities are common in patients with essential hypertension. Hyperthyroidism was the most common thyroid disorder observed. Young patients presenting with essential hypertension should be screened for thyroid hormone abnormalities since they can best be managed by treating the underlying causes.

Serum uric acid levels among Nigerians with essential hypertension.

There is an ongoing debate on the role of serum uric acid as an independent risk factor for hypertension and renal disease. This study determined the serum uric acid levels of Nigerians with essential hypertension and also evaluated the association between serum uric acid levels and blood pressure of these patients. A retrospective case-control study of three hundred and fifty one patients with essential hypertension seen at the hypertension clinic of Aminu Kano Teaching Hospital, Kano between January 2004 and December 2008. The control group comprised of one hundred apparently healthy non hypertensive subjects. The clinical characteristics including blood pressure measurement, serum uric acid, urea, creatinine, lipid profile and glucose were evaluated.The mean systolic and diastolic blood pressures of the male patients were 156mmHg and 101mmHg respectively, while those of the male controls were 120 ± 6.0 and 80 ± 5 respectively. The mean serum uric acid, fasting blood glucose, urea and creatinine were 483umol/L, 5.7mmol/L,6.61mmol/L, 93umol/l respectively compared to those of the male controls which were 326 ±10µmol/l, 5.0± 0.5mmol/l, 4.2± 0.12mmol/l, 5.16mmol/l ± 0.12 and 69±2.71µmol/l respectively. The mean systolic and diastolic blood pressures of the female patients were 158mmHg and 101mmHg, while those of the female controls were 101±2 and 62±9 respectively. The mean serum uric acid, fasting blood glucose, urea and creatinine of the female patients were 434umol/L, 5.3mmol/L 6.20mmol/L, and 88umol/L respectively while those for the female controls were 290±9µmol/l, 4.8±0.5mmol/l, 5.02±0.28 mmol/l, 62±0.36µmol/l respectively. Hyperuricaemia was observed in 59.3% of the male study patients and 62% of the female study patients. Serum uric acid correlated positively with both systolic blood pressure (r=0.192, p<0.001) and diastolic blood pressure (r=0.216; p<0.001). Hyperuricaemia is common among Nigerian patients with essential hypertension and there is an association between serum uric acid level and blood pressure. Further studies on the pathophysiologic significance of hyperuricaemia in these patients are recommended.

Impact of iodine deficiency on thyroid function in pregnant African women - A possible factor in the genesis of 'small for dates' babies.

The effect of iodine deficiency (ID) on thyroid function in African women during pregnancy and postnatal period was examined, for which very limited information is available. Serum T(4), T(3), TSH, TBG, thyroxine binding capacity (TBK), free thyroxine index (FT(4)I=T(4)/TBK) and T(4)/TBG were determined by ELISA technique in 32 pregnant women (resident of Plateau state, Nigeria- an ID zone) through pregnancy upto term delivery, and in 5 women up to 6 weeks post delivery. Urinary iodide level was measured at delivery to determine the degree of iodine deficiency. Results were matched with a non pregnant control comprising 44 subjects. 5555 birth weights (BW) of term babies in the region were analysed to determine the prevalence of 'small for dates' (SFD) babies in the population. Results show that the level of serum FT(4)I was elevated very significantly at late gestation (P<.001) but the women were not hyperthyroid, suggesting a marked disturbance in binding of T(4) with TBG during pregnancy. Five women with SFD babies were found in 'compensated hypothyroid state' and showed a significant depression (p<.01) in serum T(4)/TBG, T(4), FT(4)I and T(3) levels to a low normal range, with a concurrent significant rise (p.<.001) in TSH level (above normal range) throughout pregnancy. Incidence of SFD babies was higher (p.<.001) in ID zone (Bassa 15.2%) compared to control zone (Jos 9.8%). It is concluded that a state of maternal 'subclinical (compensated) hypothyroidism' during pregnancy possibly plays an important role in the aetiopathogenesis of SFD babies in Africans. A normal reference range for thyroid parameters at various stages of pregnancy in healthy African women is established for the first time.