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1.
Niger J Clin Pract ; 26(2): 194-200, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36876608

ABSTRACT

Background: Abnormalities of glucose metabolism are associated with abnormal left ventricular geometry (LV) independent of atherosclerosis. Abnormal LV geometry, a predictor of premature cardiovascular events, indicates presence of subclinical target organ damages. Screening for abnormal LV geometry in diseases of abnormal glucose metabolism is desirable as part of their management protocol. Aim: To assess the left ventricular geometry in normotensive type II diabetic patients. Cross-sectional, descriptive, hospital-based study. One hundred normotensive type II diabetic patients drawn from the Endocrinology and Family Medicine Clinics of a tertiary hospital were age- and gender-matched with 100 apparently healthy controls. Participants meeting the criteria and informed consent proceeded for clinical evaluation, biochemical assessment, electrocardiography, and echocardiography using the American Society of Echocardiography guideline. Materials and Methods: Data were analyzed using the Statistical Package for Social Sciences [SPSS] version 25.0 (Chicago Illinois, USA). Results: Mean age of study and control groups was (55.56 ± 9.89 versus 55.47 ± 10.7) years (χ2 = 0.062, P = 0.951). The mean duration of diabetes illness was 6.57 ± 6.26 years. Prevalence of abnormal LV geometry was 51% (study) versus 18% (control) FT, P < 0.001). Concentric remodeling was the predominant geometry in 36% of study versus 11% of controls, followed by eccentric hypertrophy in 11% (study) versus 4% (control) and concentric hypertrophy in 4% (study) versus 3% (control). Geometry was normal in 49% of study against 82% in the controls (FT, P < 0.001). Significant association existed between LV geometry and duration of diabetes (χ2 = 10.793, P = 0.005). Conclusion: Abnormal LV geometry is highly prevalent in normotensive diabetic patients.


Subject(s)
Ambulatory Care Facilities , Diabetes Mellitus, Type 2 , Humans , Adult , Middle Aged , Aged , Cross-Sectional Studies , Glucose , Hypertrophy
2.
Niger J Clin Pract ; 25(2): 205-210, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35170450

ABSTRACT

Marfan syndrome is an uncommon inheritable connective tissue disease which affects the cardiovascular system. This paper presents two cases of Marfan Syndrome with predominant aortic root disease that were seen at the Cardiology Clinic of University of Nigeria Teaching Hospital, Enugu, Nigeria. Their biography, clinical features and echocardiography parameters were captured using structured questionnaire. Both were young males in their 4th decade of life, and had advanced aortic root diseases which were complicated by left ventricular failure in both, while one of them had aortic dissection and ischemic stroke. Young adult Nigerians with Marfan syndrome presented with advanced aortic root diseases, heart failure, aortic dissection and stroke.


Subject(s)
Aortic Dissection , Heart Failure , Marfan Syndrome , Aortic Dissection/diagnostic imaging , Aortic Dissection/etiology , Aorta , Heart Failure/etiology , Humans , Male , Marfan Syndrome/complications , Marfan Syndrome/diagnosis , Nigeria , Young Adult
3.
West Afr J Med ; 32(4): 243-7, 2013.
Article in English, French | MEDLINE | ID: mdl-24488276

ABSTRACT

Changing lifestyle, driven by socio-economic trends, is changing the cardiovascular risk and disease profile in developing countries. We studied the cardiovascular risk factors of Federal Medical Centre, Umuahia hospital staff between 40 and 60 years. 297 members of hospital staff were consecutively recruited in October 2010. Data obtained include blood pressure, height and weight, body mass index (BMI), fasting blood sugar, serum cholesterol (total and differential) and serum triglyceride. The data were analysed using the SPSS package (version 10). The following prevalence levels were found: hypertension 37.5%, obesity 40.8%, diabetes mellitus 5.7%, hypercholesterolemia 18.1% and metabolic syndrome 24.7%. LDL, low HDL and elevated TG were elevated in 26.8%, 41.9% and 9.7% respectively. Only 2% had very low risk for cardiovascular disease.


Subject(s)
Cardiovascular Diseases/etiology , Dyslipidemias/epidemiology , Glucose Metabolism Disorders/epidemiology , Hypertension/epidemiology , Medical Staff, Hospital , Obesity/epidemiology , Adult , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/metabolism , Cross-Sectional Studies , Dyslipidemias/complications , Dyslipidemias/diagnosis , Female , Glucose Metabolism Disorders/complications , Glucose Metabolism Disorders/diagnosis , Humans , Hypertension/complications , Hypertension/diagnosis , Male , Middle Aged , Nigeria , Obesity/complications , Obesity/diagnosis , Prevalence , Risk Factors
4.
Niger J Med ; 22(4): 286-91, 2013.
Article in English | MEDLINE | ID: mdl-24283085

ABSTRACT

Cardiovascular diseases (CVD) were previously considered a problem of the developed nations only. Emerging facts show that CVD and their risk factors are now prevalent in developing countries. We carried out a cross-sectional, population-based survey to determine the relation between place residence (rural or urban) and the burden of CVD risk factors in South East Nigeria. Hypercholesterolaemia, hypertension, abnormal blood glucose and obesity were assessed for, in middle-aged and elderly residents of two communities in Enugu, South East Nigeria. A total of 543 adults (308 at Ogwofia Owa and 235 at Emene) participated in the study. The mean and 95% CI for mean of the characteristics of subjects showed that they were in the middle-age group with apparently normal mean cardiovascular risk indices except for systolic and diastolic blood pressure indices which suggested pre-hypertension. The subjects residing in the rural area were older than those residing in the urban area but cardiovascular risk factors had higher mean values in urban residents except systolic blood pressure (SBP). The most prevalent cardiovascular risk factors in the study group were hypertension and obesity. Urban residence was found to influence the prevalence of risk factors, specifically obesity and diastolic hypertension.


Subject(s)
Hypertension/epidemiology , Obesity/epidemiology , Urbanization , Adult , Aged , Cross-Sectional Studies , Female , Humans , Life Style , Male , Middle Aged , Nigeria/epidemiology , Prevalence , Risk Factors
5.
Niger J Clin Pract ; 16(3): 360-4, 2013.
Article in English | MEDLINE | ID: mdl-23771462

ABSTRACT

BACKGROUND: Transthoracic echocardiography (TTE) is one of the most commonly performed cardiac investigations. It can provide comprehensive information about cardiac structure and function, helping to establish a diagnosis and guide therapy, and it is no longer the preserve of the specialist cardiology department. Previous studies on echocardiographic findings in our environment had documented valvular heart disease, hypertensive heart disease and congenital heart diseases as the commonest echocardiographic findings in Nigerians. AIMS: The study aimed to provide an update on the common echocardiographic findings in different age groups in this part of the world, since some of the previous similar studies were done over a decade ago. MATERIALS AND METHODS: We reviewed the echocardiogram reports of 608 consecutive patients done from July 2009 to October 2011 at a private echocardiographic laboratory in Enugu, South-East Nigeria. Data was analyzed for age, gender and echocardiographic findings. RESULTS: The age range of the patients was from 3 days to 98 years with a mean age of 46.4 ± 21.4 years. The mean age of the males was 47.6 ± 21.3 years, while the mean age of the females was 45.2 ± 21.1 years. The commonest echocardiographic abnormality in children was atrial septal defect, while rheumatic heart disease was the commonest in adolescents and young adults. Left ventricular diastolic dysfunction and degenerative valvular diseases respectively were the commonest in the middle-aged and elderly populations in this study. CONCLUSION: This study has reaffirmed rheumatic heart disease (predominantly mitral valve regurgitation) as the commonest cardiac abnormality in adolescents and young adults. Degenerative valvular diseases, left ventricular diastolic dysfunction, and atrial septal defects were the commonest abnormalities in the elderly, middle-aged population and children, respectively.


Subject(s)
Echocardiography , Heart Diseases/diagnostic imaging , Heart Diseases/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Nigeria/epidemiology
6.
Clin Auton Res ; 22(3): 137-45, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22261695

ABSTRACT

BACKGROUND: There is a lack of data on the relationship between cardiovascular autonomic neuropathy (CAN) and electrocardiographic parameters in sickle cell anaemia. AIMS AND OBJECTIVES: The purpose of the study was to compare the electrocardiographic findings in adult sickle cell anaemia patients with CAN with those of patients without this complication. METHODS: A cross sectional study was done using 62 consecutively recruited sickle cell anaemia patients who met the inclusion criteria for the study. Cardiovascular autonomic dysfunction was determined based on abnormal values in at least two of five non-invasive tests: Valsalva manoeuver, heart rate variation during deep breathing, heart rate response to standing, blood pressure response to sustained hand grip, and blood pressure response to standing. The subjects were subsequently evaluated with electrocardiography. RESULTS: Sickle cell anaemia patients with CAN had statistically significantly increased P-wave duration (p < 0.001), PR-interval (p < 0.05) and QTc dispersion (p < 0.05) compared with patients without CAN. Significantly increased frequencies of Q waves and first degree atrio-ventricular block were found in patients with CAN than in those without CAN (p = 0.026, p = 0.014, respectively). Significant correlations were noted between the severity of CAN [number of abnormal autonomic function tests (AFT)] and (1) P-wave duration (p = 0.008), (2) PR- interval (p = 0.013). Significant association was found between the number of abnormal AFT and (1) presence of Q-waves, and (2) degree of anaemia (haematocrit class). CONCLUSION: Electrocardiographic features consistent with atrio-ventricular and ventricular repolarization abnormalities are associated with CAN in sickle cell anaemia. Further studies are required to evaluate the prognostic implications of these findings in sickle cell patients with cardiovascular autonomic dysfunction.


Subject(s)
Anemia, Sickle Cell/physiopathology , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/physiopathology , Autonomic Nervous System Diseases/diagnosis , Autonomic Nervous System Diseases/physiopathology , Heart Conduction System/physiopathology , Adolescent , Adult , Anemia, Sickle Cell/epidemiology , Arrhythmias, Cardiac/epidemiology , Autonomic Nervous System Diseases/epidemiology , Case-Control Studies , Comorbidity/trends , Cross-Sectional Studies , Female , Humans , Male , Young Adult
7.
Niger J Med ; 21(1): 6-10, 2012.
Article in English | MEDLINE | ID: mdl-23301439

ABSTRACT

Various forms of cardiac arrhythmias have been documented in hypertensive subjects, and hypertension is an important risk factor for the development of atrial and ventricular arrhythmias and sudden death. Electrocardiography at rest easily documents significant arrhythmias in patients, and this study was carried out to determine the types and frequency of arrhythmias in hypertensive subjects at first presentation in the Hypertension Clinics of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. The study was hospitalbased and retrospective in nature. The resting 12lead ECG reports of 346 consecutive hypertensive subjects seen at the Hypertension clinics of the UNTH Enugu over a 14 month period were retrieved from the case files and studied. Other information obtained from the case files included the age and gender of the subjects. The mean age of the subjects was 57.3 years. Ninety-five of the subjects had arrhythmias representing 27% of the study population, out of which fifty-five were males (57.9%) and forty were females (42.1%). However 26.9% of all the male subjects had arrhythmias while 28.2% of all the females had arrhythmias. Multiple ventricular ectopics, sinus tachycardia, sinus bradycardia and atrial fibrillation were the most prevalent arrhythmias. This study showed that a significant proportion of hypertensive subjects present initially with significant rhythm disturbances.


Subject(s)
Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/etiology , Electrocardiography , Hypertension/complications , Adult , Aged , Aged, 80 and over , Arrhythmias, Cardiac/physiopathology , Female , Humans , Hypertension/physiopathology , Male , Middle Aged , Nigeria/epidemiology , Retrospective Studies
8.
Niger Postgrad Med J ; 15(3): 175-8, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18923592

ABSTRACT

BACKGROUND: Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous studies on rheumatic heart disease in Nigeria were either clinical or retrospective echocardiographic studies. This study was aimed at determining the burden of chronic rheumatic mitral valve disease, pattern of valvular involvement, severity and associated valvular lesions, using echocardiography. PATIENTS AND METHODS: Between May, 2004 and April 2005, patients with symptomatic rheumatic heart disease, seen in the cardiac clinics of University of Nigeria Teaching Hospital, Enugu, were recruited for the study. The patients were investigated non-invasively with M-mode, Two-dimensional, Pulsed wave, Continuous wave and colour flow Doppler echocardiographic techniques in order to assess the mitral and other intracardiac valves for evidence of rheumatic heart disease. RESULTS: There were a total of 55 patients, 39 (70.9%) females and 16 (29.1%) males with a mean age of 29.34 +/- 11.57 years. Mitral valve disease was found in 54 (98.2%) and isolated aortic valve disease in 1 (1.8%) of cases. Mitral regurgitation occurred in 64.8%, mixed mitral valve disease in 25.9% and pure mitral stenosis in 9.3%. Mitral valve disease was associated with aortic valve disease in 33.3%, with tricuspid valve disease in 24.1% and with functional pulmonary incompetence in 9.3% of cases. CONCLUSION: Rheumatic heart disease in Nigeria is essentially a disease of the mitral valve as seen elsewhere in the world. Echocardiography should be done routinely for patients with rheumatic heart disease to facilitate accurate diagnosis and definitive treatment.


Subject(s)
Echocardiography, Doppler, Color , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Stenosis/diagnostic imaging , Rheumatic Heart Disease/diagnostic imaging , Adolescent , Adult , Age Distribution , Child , Chronic Disease , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Mitral Valve Insufficiency/etiology , Mitral Valve Stenosis/etiology , Nigeria/epidemiology , Rheumatic Heart Disease/complications , Severity of Illness Index , Sex Distribution
10.
Cardiovasc J Afr ; 27(4): 252-257, 2016.
Article in English | MEDLINE | ID: mdl-27841913

ABSTRACT

BACKGROUND: Electrocardiographic (ECG) abnormalities are prevalent in subjects with human immunodeficiency virus (HIV) infection. In this study, three groups of subjects were investigated and the prevalence of ECG abnormalities was analysed. METHODS: A cross-sectional study was carried out on adults between November 2010 and November 2011 at the University of Nigeria Teaching Hospital, Enugu, Nigeria. One hundred HIV-infected patients on highly active anti-retroviral therapy (HAART), 100 HIV-infected HAART-naïve patients and 100 HIV-negative controls were recruited. Twelve-lead electrocardiograms were done on all subjects. Data were analysed using the chi-squared, Student's t-, one-way ANOVA and Duncan post hoc tests. RESULTS: Left-axis deviation was seen in 15 (16%) of the HIV-positive subjects on HAART, 10 (13.7%) of the HAART-naïve subjects and eight (21%) of the controls (p = 0.265). Eight (11%) subjects with left ventricular hypertrophy (p < 0.001) and two (2.7%) with ST-segment elevation were found among the HIV-positive HAART-naïve subjects (p = 0.134). Prolonged QTc interval was seen in 17 (18.2%) of the HIV-positive patients on HAART, 12 (16.4%) of the HIV-positive HAART-naïve patients and four (10.5%) of the controls (p = 0.012). CONCLUSION: The prevalence of ECG abnormalities was higher in the HIV-positive patients on HAART (93%) and the HIV-positive HAART-naïve patients (73%) compared to the controls.


Subject(s)
Arrhythmias, Cardiac/diagnosis , Electrocardiography , HIV Infections/epidemiology , Adult , Analysis of Variance , Antiretroviral Therapy, Highly Active/adverse effects , Arrhythmias, Cardiac/epidemiology , Arrhythmias, Cardiac/physiopathology , Case-Control Studies , Chi-Square Distribution , Cross-Sectional Studies , Female , HIV Infections/diagnosis , HIV Infections/drug therapy , Hospitals, University , Humans , Male , Nigeria/epidemiology , Predictive Value of Tests , Prevalence , Risk Factors , Time Factors
11.
Ethn Dis ; 13(4): 463-9, 2003.
Article in English | MEDLINE | ID: mdl-14632265

ABSTRACT

INTRODUCTION AND OBJECTIVE: Patients with essential hypertension are predisposed to impaired left ventricular relaxation, and consequently, diastolic dysfunction. Because diastolic dysfunction is an early marker of the pathological effects of hypertension on the heart, evaluating the relationship between the development of diastolic dysfunction and the level of blood pressure becomes pertinent. The aim of our study was to evaluate this relationship. PATIENTS AND METHODS: Between November 1998 and January 2000, 692 consecutive hypertensive patients, all Blacks, attending the medical outpatient and cardiac clinics of the University of Nigeria Teaching Hospital, Enugu, Nigeria were screened for the study. One hundred five of them, divided into 3 groups of 35 each according to levels of blood pressure, met the inclusion criteria. Thirty-five age and sex-matched normotensives were used in the control group. Clinical parameters, including systolic and diastolic blood pressures, and echocardiographic indices, were measured. RESULTS: A definite positive relationship between diastolic dysfunction and the level of the blood pressure was established, with the degree of diastolic dysfunction proportionate to increasing level of blood pressure (P<.001). A significant difference between the mean values of the diastolic dysfunction index (A/E ratio) in the hypertensive groups was evident (P<.05). While there was virtually no correlation found between normotensives and diastolic dysfunction (r=0.07), direct relationships existed between moderate and severe hypertensives and diastolic dysfunction (r=0.24 and 0.39 respectively). CONCLUSION: This study has demonstrated that diastolic dysfunction was significantly and progressively higher in the hypertensive groups when compared to the normotensive control group. Further studies, with a large number of patients, are recommended to determine population-based data on diastolic dysfunction and its other confounding variables in our environment, independent from the level of blood pressure.


Subject(s)
Black People , Diastole , Heart Failure/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Analysis of Variance , Blood Pressure , Blood Pressure Determination , Echocardiography, Doppler , Female , Heart Failure/epidemiology , Heart Failure/ethnology , Humans , Male , Middle Aged , Nigeria/epidemiology , Ventricular Dysfunction, Left/etiology
12.
East Afr Med J ; 76(6): 341-3, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10750523

ABSTRACT

OBJECTIVE: To determine the reference values for heat-stable alkaline phosphatase in apparently healthy non-pregnant and in normal pregnant females and to assess the suitability of this parameter as a measure of placental function and indirectly as a measure of foetal survival. DESIGN: A prospective study. SETTING: Ante-natal clinic, University of Nigeria Teaching Hospital, Enugu, Nigeria. PARTICIPANTS: Ninety eight apparently normal pregnant females in various gestational ages and 47 apparently healthy non-pregnant females. MAIN OUTCOME MEASURES: The serum heat-stable alkaline phosphatase activity. RESULTS: Variability in values exists between individuals in the same gestational age. The mean and standard deviation of serum heat-stable alkaline phosphatase was found to be 0.79 +/- 1.54 iu/L in the control group. No significant difference was found (p < 0.05) between this and the mean and standard deviation of serum alkaline phosphatase of 0.98 +/- 1.28 iu/L found in the first eight weeks of gestation. However the means and standard deviations of first trimester, second and third trimester were significantly higher than the controls. CONCLUSION: In the face of worsening economic situation in third world countries this simple method could be used in urban and some rural hospitals in assessing placenta insufficiency.


Subject(s)
Alkaline Phosphatase/blood , Pregnancy/blood , Adolescent , Adult , Case-Control Studies , Female , Fetal Distress/enzymology , Gestational Age , Hot Temperature , Humans , Nigeria , Parity , Placental Insufficiency/enzymology , Predictive Value of Tests , Pregnancy Trimester, First , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Prospective Studies , Reference Values , Reproducibility of Results
13.
West Afr J Med ; 22(3): 246-9, 2003 Sep.
Article in English | MEDLINE | ID: mdl-14696951

ABSTRACT

Systemic hypertension, High Blood Pressure (HBP) is common in Nigeria with up to 10 to 15% prevalence among adults. HBP is readily complicated by left ventricular hypertrophy (LVH), recognised to herald a series of adverse outcomes in cardiovascular health. In order to device a method of assessment of LVH that is objective, readily available, affordable and easily operable in the face of soaring cost of the more recent techniques, correlation of electrocardiographic (ECG) LVH parameters was done with echocardiographic (ECHO) left ventricular mass (LVM). ECG is objective, affordable and easily operable, while ECHO is highly accurate for measurement of LVM. One hundred and fifty-five hypertensives were studied (123m; 32f). A statistically significant correlation was found with a maximum coefficient of 0.36 in males only. ECG can thus offer an objective alternative for assessment of LVH in HBP in males where ECHO is not available or practicable.


Subject(s)
Echocardiography , Electrocardiography , Hypertension/diagnosis , Hypertrophy, Left Ventricular/diagnosis , Adult , Comorbidity , Female , Humans , Hypertension/epidemiology , Hypertrophy, Left Ventricular/epidemiology , Male , Middle Aged , Nigeria/epidemiology , Statistics as Topic
14.
West Afr J Med ; 20(4): 196-202, 2001.
Article in English | MEDLINE | ID: mdl-11885871

ABSTRACT

The efficacy and tolerability of Felodipine extended-release was compared with Nifedipine retard in the management of patients with mild-to-moderate hypertension. A total of one hundred and thirty three patients were screened out of which one hundred and twenty-one patients were enrolled in a 9-week multicentre open, randomised rising-dose trial to receive either Felodipine 5-10 mg once daily or Nifedipine 10-20 mg twice daily. Blood pressure was measured at the end of the dosing interval that is 24 hours and 12 hours after Felodipine and Nifedipine respectively. Both drugs, Felodipine and Nifedipine were found to lower blood pressure significantly compared with baseline. After three weeks of treatment, seated blood pressure was reduced by 20/14 mmHg (systolic/diastolic) and by 24/16 mmHg after 6 weeks in the felodipine group. Corresponding values in the Nifedipine group were 16/09 mmHg and 24/13mmHg. Pulse rate was not significantly affected by either drugs. The percentage of patients who had satisfactory control after 3 weeks treatment was 57.6% for Felodipine and 33.3% for Nifedipine (significant). After dose titration (where necessary), at the end of the study the response rates were 76.3% (n=45) and 79.6% (n=43) for Felodipine and Nifedipine respectively (non significant). Both drugs were metabolically inert and did not derange the haematologic and biochemical profile of patients. They produced no significant weight changes. The pattern of side effects were similar in both groups but tended to be more severe with Nifedipine necessitating withdrawal of two patients in this group. In conclusion, Felodipine ER 5mg - 10mg once daily, and Nifedipine Retard, 20mg twice daily were equally effective medications for mild-to-moderate hypertension but Felodipine was better tolerated.


Subject(s)
Calcium Channel Blockers/therapeutic use , Felodipine/therapeutic use , Hypertension/drug therapy , Nifedipine/therapeutic use , Black or African American , Black People , Calcium Channel Blockers/adverse effects , Felodipine/adverse effects , Female , Humans , Male , Middle Aged , Nifedipine/adverse effects , Nigeria , Statistics as Topic
15.
Int J Nephrol ; 2012: 769103, 2012.
Article in English | MEDLINE | ID: mdl-23094157

ABSTRACT

Background. Chronic kidney disease is frequently seen in patients with congestive cardiac failure and is an independent risk factor for morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease in patients with hypertension associated congestive cardiac failure. Method. One hundred and fifty patients with hypertension associated congestive cardiac failure were recruited consecutively from the medical outpatient department and the medical wards of the Nnamdi Azikiwe University Teaching Hospital Nnewi over a one year period, January to December 2010. Patients' biodata and medical history were obtained, detailed physical examination done and each patient had a chest X-ray, 12 lead ECG, urinalysis, serum urea and creatinine assay done. Ethical clearance was obtained from the Ethical Review Board of our institution and data analysed using SPSS-version 16. Results. There were 86 males and 64 females with mean age 62.7 ± 12.5 years. The mean blood pressures were systolic 152.8 ± 28.5 mmHg and diastolic 94.3 ± 18 mmHg. 84.7% had blood pressure ≥140/90 mmHg on presentation. The mean GFR was 70.1 ± 31.3 mls/min. 76% of subjects had GFR <90 mls/min and no statistical significant difference between males and females, P = 0.344. The mean serum urea was 7.2 ± 51 mmol/L while the mean serum creatinine was 194 ± 416.2 mmol/L. Conclusions. This study has demonstrated that majority of patients presenting with hypertension associated congestive cardiac failure have some degree of chronic kidney disease.

16.
Cardiovasc J Afr ; 23(1): 37-9, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22331250

ABSTRACT

AIM: There are few studies to be found in the literature on ankle-brachial index in sickle cell disease. The aim of this study was to compare ankle-brachial index of steadystate adult sickle cell anaemia patients with that of normal controls. METHODS: A descriptive cross-sectional study of 62 sickle cell anaemia patients and 62 age- and gender-matched normal controls was carried out in the adult outpatient sickle cell clinics and the cardiac centre of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria from February to August 2007. The supine brachial and ankle blood pressures were measured separately with the cuff of the mercury sphygmomanometer applied to the right arm and right calf, respectively. RESULTS: The ankle systolic blood pressure was lower in patients with sickle cell anaemia than in the controls (p < 0.001). The mean indices for ankle-brachial index were 0.88 ± 0.09 and 1.03 ± 0.06, respectively for patients and controls. This difference was statistically significant (p < 0.001). Seventy three per cent of the patients had ankle-brachial index less than 0.9 compared with controls (5%). This was also significant (p < 0.001).


Subject(s)
Ankle , Blood Pressure , Adult , Anemia, Sickle Cell , Animals , Cross-Sectional Studies , Humans , Nigeria
17.
ISRN Hematol ; 2012: 768718, 2012.
Article in English | MEDLINE | ID: mdl-22536523

ABSTRACT

Pulmonary hypertension is an emerging complication of sickle cell anaemia with associated increased risk of mortality. In order to evaluate the clinical and electrocardiographic findings in adult sickle-cell patients with pulmonary hypertension, a cross sectional study was conducted on sixty two sickle cell anaemia patients and sixty two age and sex matched normal controls. Elevated pulmonary artery pressures (PAP), defined by PAP ≥ 30 mm Hg on echocardiography, was demonstrated in 41.9% of patients with sickle cell anaemia and in 3.2% of the controls; χ(2) = 26.571, P < 0.001. Right ventricular hypertrophy, increased P-wave duration, QTc interval, and QTc dispersion were significantly associated with pulmonary hypertension. Significant correlation was found between mean PAP and (1) Frequency of crisis (Spearman correlation = 0.320; P = 0.011), (2) body mass index (Pearson's correlation = -0.297; P = 0.019), and (3) QTc interval (Pearson's correlation 0.261; P = 0.040). Pulmonary hypertension in adult sickle anaemia patients is associated with electrocardiographic evidence of right ventricular hypertrophy, and correlates significantly with frequency of vaso-occlusive crisis, and QTc interval. The observations by this study tend to suggest that these parameters could be useful for early detection and prevention of pulmonary hypertension in patients with sickle cell anaemia.

18.
Int J Hypertens ; 2011: 621074, 2011.
Article in English | MEDLINE | ID: mdl-22121475

ABSTRACT

Cardiovascular diseases (CVDs) are the main causes of death in industrialized countries, and are significant causes of morbidity and mortality in sub-Saharan Africa. Hypertension is the most common cardiovascular disease in Nigerians, and the risk of CVD associated with hypertension is independent of other risk factors. Despite the high level of awareness of its presence in the developed countries, the level of control is still poor. CVDs tend to be commoner in urban settlements, and it has been hypothesized that rural sub-Saharan Africa is at an early stage of epidemiological transition from communicable to non-communicable diseases (NCD) because of the gradual adoption of unhealthy lifestyles. This study aimed at describing the pattern of blood pressure indices among the hypertensive residents of a rural community in South East Nigeria. A total of 858 individuals comprising 247 males and 611 females took part in the study. 46.4% of the subjects had hypertension. Hypertension was commoner in the males (50.2% vs. 44.8%) (χ(2)(1) = 1.484; P = 0.223). The males were significantly older and heavier than the females while the females had higher mean values of BMI and WC. The prevalence of hypertension is becoming alarmingly high in the rural communities of sub-Saharan Africa.

19.
Cardiovasc J Afr ; 22(2): 76-8, 2011.
Article in English | MEDLINE | ID: mdl-21556449

ABSTRACT

BACKGROUND: The prognostic implications of P-wave dispersion in patients with a variety of cardiac disease conditions are increasingly being recognised. The relationship between P-wave dispersion and left ventricular function in sickle cell anaemia is unknown. OBJECTIVE: This study was aimed at evaluating the relationship between P-wave dispersion and left ventricular function in adult Nigerian sickle cell anaemia patients. METHODS: Between February and August 2007, a total of 62 sickle cell anaemia patients (aged 18-44 years; mean 28.27 ± 5.58) enrolled in the study. These were drawn from patients attending the adult sickle cell clinic of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. An equal number of age- and gender-matched normal subjects served as controls. All the participants were evaluated with electrocardiography and echocardiography. P-wave dispersion was defined as the difference between the maximum and minimum P-wave duration measured in a 12-lead electrocardiogram. RESULTS: P-wave duration and P-wave dispersion were significantly higher in patients than in controls. Significant correlation was demonstrated between P-wave dispersion and age in the patients (r = 0.387; p = 0.031). A comparison of subsets of sickle cell anaemia patients and controls with comparable haematocrit values (30-35%) showed significantly higher P-wave duration and P-wave dispersion in the patients than in the controls. The P-wave duration in patients and controls, respectively, was 111.10 ± 14.53 ms and 89.14 ± 16.45 ms (t = 3.141; p = 0.006). P-wave dispersion was 64.44 ± 15.86 ms in the patients and 36.43 ± 10.35 ms in the controls (t = 2.752; p = 0.013). Significant negative correlation was found between P-wave dispersion and left ventricular transmitral E/A ratio (r = -0.289; p = 0.023). CONCLUSION: These findings suggest that P-wave dispersion could be useful in the evaluation of sickle cell patients with left ventricular diastolic dysfunction. Further prospective studies are recommended to evaluate its prognostic implication on the long-term disease outcome in sickle cell disease patients.


Subject(s)
Anemia, Sickle Cell/physiopathology , Electrocardiography , Heart Conduction System/physiopathology , Ventricular Function, Left/physiology , Adolescent , Adult , Cross-Sectional Studies , Female , Hematocrit , Humans , Male , Multivariate Analysis , Prognosis , Young Adult
20.
J Trop Med ; 2011: 308687, 2011.
Article in English | MEDLINE | ID: mdl-21577254

ABSTRACT

Cardiovascular diseases (CVDs) causes of worldwide preventable morbidity and mortality. CVDs are a leading cause of mortality and morbidity in developing countries, and rates are expected to rise over the next few decades. The prevalence of CVD risk factors is dramatically increasing in low-and middle-income African countries, particularly in urban areas. We carried out a cross-sectional population-based survey in Imezi-Owa, a rural community in South East Nigeria to estimate the prevalence of major cardiovascular risk factors in both men and women aged 40-70 years. A total of 858 individuals made up of 247 (28.8%) males and 611 (71.2%) females were recruited. The mean age of the subjects was 59.8 ± 9.9 years. The prevalence of the different cardiovascular risk factors among the 858 subjects was as follows: hypertension 398 (46.4%) subjects, generalized obesity as determined by BMI 257 (30%) subjects, abdominal obesity 266 (31%) subjects, dysglycaemia 38 (4.4%) subjects and hypercholesterolaemia 32 (3.7%) subjects. Prevalence of hypertension and dysglycaemia was higher in men while the others were higher in women. Only hypertension (P = .117) and hypercholesterolaemia (P = .183) did not reveal any significant association with gender. Prevalence of CVD risk factors was highest in subjects aged 65 to 70 years.

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