Lipid and Some Other Cardiovascular Risk Factors Assessment in a Rural Community in Eastern Nigeria.

BACKGROUND: Continuous re-evaluation of modifiable cardiovascular risk factors (cardiovascular diseases [CVDs]) in developing nations is imperative as it lays foundation for early preventive/intervention measures at grass root level to improve/prevent CVD morbidity and mortality in those nations where health indices still score below the standard. AIM: The aim was to assess CVD risk factors as a continuous re-evaluation of these may underscore the need for early intervention measures at grass root level. SUBJECTS AND METHODS: A total of 257 apparently healthy inhabitants aged 18-85 years were recruited in a rural community in South Eastern Nigeria by convenient sampling. Blood pressure, waist circumference and blood lipid analysis were done procedurally and data analyzed using SPSS 16.0 statistical software. RESULTS: The males were older (59.41 [5.22]) than the females (53.31 [16.90]). 69.2% (133/192) were low level farmers, retirees and dependents. Total cholesterol (TC), low density lipoprotein (LDL), and risk predictive index were higher in females while triglyceride (TG), high density lipoprotein and very LDL (VLDL) were higher in males. The middle aged and elderly respectively had higher TG and VLDL compared to the young. Aside hypertriglyceridemia, all lipid abnormalities were higher in females than males both singly (high TC: 28.9% [35/121] vs. 16.9% [12/71]; high LDL cholesterol: 52.0% [63/121] vs. 31.0% [22/71]) and in combination hypercholesterolemia with hypertriglyceridemia (42.9% [52/121] vs. 36.6% [26/71]). "Multiple risk factors" also occurred more in females with seeming further increase in older age. CONCLUSION: The chances of a female having CVD after menopause seemed to outweigh that of the male. CVD preventive measures should be focused at the primary/community level as a means to curtailing the increasing morbidity and eventual mortality from CVDs.

Renal function in patients with hypertension associated congestive cardiac failure seen in a tertiary hospital.

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.

Evaluation of blood pressure and indices of obesity in a typical rural community in eastern Nigeria

Aim: With increasing urbanization of lifestyle; cardiovascular morbidity and mortality have been on the increase in Africans. Studies on cardiovascular risk factors in rural communities in South East Nigeria are scarce. This study focused on hypertension and obesity in adult Nigerians dwelling in a rural setting in Eastern Nigeria. Materials and Methods: A total of 218 participants from the rural community were recruited into the study. A questionnaire was used to assess prior knowledge of their weight and blood pressure status as well as drug history for those found to have ypertension. Each participant's blood pressure was measured and any value =140/90 mmHg was regarded as high blood pressure (HBP). Their heights and weights were measured and their body mass indices (BMI) calculated using the standard formula of BMI = Weight in Kg/Height in m 2 ; BMI =30 Kg/m 2 was referred to as global obesity. Their waist circumferences (WC) were also measured and any value =102 cm for males and =88 cm for females was regarded as abdominal obesity. Results: The general prevalence of HBP in the rural community was 44.5. The prevalence of HBP increased as age increased and awareness about HBP was low (15.2). Females were more aware than the males. The prevalence of HBP was higher in males (49.3) compared with their female counterparts (42.3); whereas the females had a higher prevalence of all forms of obesity (abdominal: 36.2; global: 14.8) compared with the males (abdominal: 14.5; global: 10.1). Higher BMI was associated with higher systolic and diastolic BP values. Hypertensive participants had higher BMI and WC than those who had normal BP. Conclusion: The prevalence of both hypertension and obesity seems to be increasing in rural communities in Nigeria and thus; the available prevalence documented in previous studies for rural communities may no longer represent the current trend. Awareness of the participants about these major cardiovascular risk factors is still very low. Higher BMI was associated with higher values of both systolic and diastolic BP

Serum urea and uric acid concentration in pregnant women in sub-urban commercial community in Africa.

Serum uric acid and urea levels were determined in 27 pregnant and 17 non-pregnant black African women. Uric acid levels for the pregnant women were significantly raised, and the relationship between uric acid elevation and gestational proteinuric hypertension was discussed. In conclusion, we recommend that uric acid estimation should be included during routine antenatal clinics in normal pregnancy. That the use of uric acid levels should be encouraged for the diagnosis and management of gestational proteinuric hypertension in African pregnant women. The above recommendation will help to reduce prenatal morbidity and mortality in African pregnant women.

Utilisation of clinical chemistry tests, with special reference to lipid profile, in disease management in a Nigeria setting.

BACKGROUND: Previous reports show that most Nigerian patients have not been subjected to detailed clinical chemistry investigations, especially lipid profiles during the course of their management. OBJECTIVE: To evaluate the level of utilisation of clinical chemistry tests, especially lipid profile, in the management of certain selected diseases. DESIGN: Analytical study of clinical chemistry tests done in patients with hypertension, liver diseases, nephrotic syndrome and peripheral neuropathy and in control subjects between January 1995 and December 1996. SETTING: Department of Chemical Pathology, Nnamdi Azikiwe University Teaching Hospital, Nigeria. RESULTS: The distribution of the chemical pathology tests in all the disease groups varied significantly. The mean values of TC, LDLC, TG and VLDLC increased while HDLC/TC ratio reduced in the hypertensive patients when compared with the control subjects. The variations in the mean values of HDLC and urea among the hypertensive patients and controls were not statistically significant. CONCLUSION: Our findings suggest an increase in the risk of cardiovascular disease in hypertensive patients and these observations should be remembered by all clinicians and other health workers during the management of hypertension and other diseases. We recommend that the investigations of lipid and lipoprotein indices and other clinical chemistry parameters should be encouraged during management of disease in Nigerians.

Lipid and lipoprotein cardiovascular risk factor changes during normal pregnancy in Africans.

OBJECTIVES: The study was designed to determine how pregnancy affects lipid and lipoprotein profiles among women living in a typical suburban commercial community in Africa, and to highlight the consequences of such changes. STUDY DESIGN: Lipid and lipoprotein levels and coronary heart disease (CHD) risk predictor index [High density lipoprotein-cholesterol (HDLC)/Total cholesterol (TC)] were evaluated in 27 African pregnant and 17 non-pregnant women of the same age and demographic profiles. RESULTS: Total cholesterol and low density lipoprotein-cholesterol (LDLC) levels increased, while HDLC level and HDLC/TC ratio decreased in the pregnant women. CONCLUSIONS: These findings suggest that African women are more prone to hyperlipidemia during normal pregnancy. The consequences of the adverse lipid and lipoprotein changes as seen in the pregnant women, on the fetal development and welfare should be explored in further studies. In general, these results have added to our understanding and knowledge of the numerous factors that could cause abnormal lipid and lipoprotein levels in African women.