Hypertension and its Clinical Correlates in a Rural Community in South Western Nigeria.

BACKGROUND: Hypertension is the commonest cardiovascular risk factor globally and is a cause of untold morbidity and mortality. However, its clinical correlates at the community level have not been well elucidated. METHODS: History taking, anthropometric measurements, electrocardiograms and laboratory investigations were done for all the study subjects. Ethical approval was obtained from the institution's ethical body. Analysis was done using SPSS version 20. Two hundred people were recruited for the study. The prevalence of hypertension in the community was 58.5% with 31(15.5%) being newly diagnosed. The Body Mass Index [BMI] (28.2±6vs 25.6±5.3; P=0.003),Waist-Hip ratio (0.9±0.08 vs 0.86±0.06; p= 0.001), total cholesterol (5.675±1.8 vs 4.6±1.7, P=0.000), triglycerides (1.19±0.85 vs 0.91±0.59; p=0.019), LDL cholesterol (3.38±1.6 vs 2.66±1.5; p=0.002), heart rate (82.4±15.8 vs 76.8±11.2; p=0.018) QRS duration (84.8±13.4 vs 80.5±11.2; p=0.040), and QTc (0.423±0.041 vs 0.402±0.035; p=0.001) were higher in those with hypertension. NYHA functional class was worse in hypertensives (p=0.041). Prevalence of left ventricular hypertrophy (LVH) in hypertensives ranged from 2.6 to 48.2%, depending on the criteria used. Systolic blood pressure, pulse pressures, HDL levels and hip circumferences were higher in those with electrocardiographic LVH. Systolic blood pressure (OR:1.045, P=0.006; CI: 1.013-1.079) and a normal BMI (OR: 0.159, p= 0.004; CI: 0.045-0.559) were the independent predictors of LVH in this study. CONCLUSION: The prevalence of hypertension is rising, even in rural populations, with accompanying LVH, higher QTc and florid cardiovascular risk factors. It is therefore imperative to tighten the reins of control of blood pressure and other cardiovascular risk factors before the cardiovascular morbidity and mortality explode in the rural communities.

CONTEXTE: L'hypertension est le facteur de risque cardiovasculaire le plus courant dans le monde et est une cause de morbidité et de mortalité indicibles. Cependant, ses corrélats cliniques au niveau communautaire n'ont pas été bien élucidés. MÉTHODES: Des antécédents, des mesures anthropométriques, des électrocardiogrammes et des examens de laboratoire ont été effectués pour tous les sujets de l'étude. L'approbation éthique a été obtenue de l'organe déontologique de l'institution. L'analyse a été effectuée à l'aide de la version 20 de SPSS. Deux cents personnes ont été recrutées pour l'étude. La prévalence de l'hypertension dans la communauté était de 58,5%, 31 (15,5%) nouvellement diagnostiqués. L'indice de masse corporelle [IMC] (28,2 ± 6 vs 25,6 ± 5,3; P = 0,003), le rapport taille-hanches (0,9 ± 0,08 vs 0,86 ± 0,06; p = 0,001), le cholestérol total (5,675 ± 1,8 vs 4,6 ± 1,7, P = 0,000), triglycérides (1,19 ± 0,85 vs 0,91 ± 0,59; p = 0,019), cholestérol LDL (3,38 ± 1,6 vs 2,66 ± 1,5; p = 0,002), fréquence cardiaque (82,4 ± 15,8 vs 76,8 ± 11,2; p = 0,018) Durée du QRS (84,8 ± 13,4 vs 80,5 ± 11,2; p = 0,040) et l'intervalle QTc (0,423 ± 0,041 vs 0,402 ± 0,035; p = 0,001) étaient plus élevés chez les personnes souffrant d'hypertension. La classe fonctionnelle NYHA était pire chez les hypertendus (p = 0,041). La prévalence de l'hypertrophie ventriculaire gauche (LVH) chez les hypertendus variait de 2,6 à 48,2%, selon la critères utilisés. La pression artérielle systolique, les pressions de pouls, les taux de HDL et la circonférence de la hanche étaient plus élevés chez les personnes atteintes de LVH électrocardiographique. La pression artérielle systolique (OR: 1,045, P = 0,006; IC: 1,013­1,079) et un IMC normal (OR: 0,159, p = 0,004; IC: 0,045­0,559) étaient les prédicteurs indépendants de l'HGV dans cette étude. CONCLUSION: La prévalence de l'hypertension est en hausse, même dans les populations rurales, accompagnée de LVH, d'un QTc plus élevé et de facteurs de risque cardiovasculaires florissants. Il est donc impératif de resserrer les rênes du contrôle de la pression artérielle et des autres facteurs de risque cardiovasculaire avant que la morbidité et la mortalité cardiovasculaires n'explosent dans les communautés rurales. Mots clés: Hypertension, hypertrophie ventriculaire gauche, indice de masse corporelle, HDL.

Risk of Obstructive Sleep Apnoea among Adults in a Rural Community in Southwest Nigeria.

BACKGROUND: Obstructive sleep apnoea (OSA) is a common medical condition which has long been recognized as a major contributor to morbidity and mortality in developed countries but that remains underdiagnosed, particularly in rural communities. This study aimed to assess the prevalence of adults who have a high risk of obstructive sleep apnoea in a sample of adults living in Ejigbo, a rural community in south western Nigeria. METHODS: This was a community-based cross-sectional descriptive study done to assess the prevalence of high risk of obstructive sleep apnoea in adult residents of the community using the STOP-BANG questionnaire. Data collected include socio-demographic characteristics, anthropometric measurements and blood pressure. A blood sample was also taken for lipid profile. Factors associated with a high risk of obstructive sleep apnoea were identified. RESULTS: The study involved 257 participants out of which 88 (34.2%) had a high risk of OSA. Risk of obstructive sleep apnoea was significantly associated with male sex (p<0.001), age (p<0.001), body mass index (BMI) (p=0.001), neck circumference (p<0.001), cigarette smoking (p=0.039) and low density lipoprotein (p=0.043). CONCLUSION: Obstructive sleep apnoea is relatively common in the study area. This calls for urgent preventive measures to stem the tide and mitigate the associated morbidity and mortality.

Infrarenal abdominal aortic aneurysms at multi-detector row CT angiography: intravascular enhancement without a timing acquisition.

In 70 patients referred for evaluation of aortoiliac aneurysm disease, multi-detector row computed tomography was performed with a uniform 25-second delay from the initiation of intravenous administration of a 150-mL bolus of contrast material at 4 mL/sec. In all patients, adequate enhancement (>200 HU) of the aorta and intense enhancement of iliofemoral runoff was achieved without venous contamination.

Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients.

OBJECTIVE: To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification. DESIGN AND PATIENTS: We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years). Thirty-eight patients were admitted for drug detoxification, 37 for alcohol detoxification, and 75 for drug and alcohol detoxification. These patients were compared with 66 age- and sex-matched controls from our hospital's employee health service. Two radiologists reviewed all chest radiographs for the presence of anterior wedging and fish vertebrae in the thoracic spine and other nonspinal fractures. Serum calcium and inorganic phosphorus levels were recorded for the substance abuse detoxification patients. RESULTS: Forty-nine percent (n=73) of detoxification patients had complications of osteopenia in the thoracic spine including: anterior wedging (n=47), fish vertebrae (n=21), or both (n=5). Twenty-four percent (n=36) of patients had an elevated serum inorganic phosphorus level and one patient had an elevated serum calcium level. Patients with anterior wedging or fish vertebrae included: 45% (n=45) of patients below age 40 years, 35% (n=12) of women, 41% (n= 15) of drug detoxification patients, 58% (n=22) of alcohol detoxification patients, 48% (n=36) of drug and alcohol detoxification patients, and 47% (n=17) of patients with elevated serum inorganic phosphorus (P=NS). Six percent (n=9) of our study population had nonspinal fractures on their chest radiographs. Twenty-one percent (n=14) of controls had complications of osteopenia in the thoracic spine (all anterior wedging). This prevalence differed significantly (P<0.05, chi-squared) from the study population. CONCLUSION: Osteopenia-related anterior wedging and fish vertebrae in the thoracic spine are common findings on chest radiographs of patients hospitalized for substance abuse detoxification. Serum inorganic phosphorus and calcium levels did not correlate with the presence of anterior wedging or fish vertebrae.