Left ventricular mass estimation by different partition values in a large population of black hypertensive subjects.

AIMS: Our aim is to compare the impact of the 2 most widely used methods of indexing left ventricular mass (LVM) on the distribution of abnormal left ventricular (LV) geometric patterns, in a large sample of untreated asymptomatic black hypertensive subjects. METHODS AND RESULTS: All patients with hypertension referred to the Cardiology unit of University of Abuja Teaching Hospital, Abuja, Nigeria from 2006 to 2013, who gave informed consent, and underwent physical examination and echocardiography. LVM indexation was classified into 4 geometric patterns after echocardiography: normal geometry, concentric hypertrophy, concentric remodeling, and eccentric hypertrophy. Concentric hypertrophy was the commonest geometric pattern and was detected in 33.6% to 39.5% of the patients. LVM/height2.7 was a better method to detect abnormal geometric pattern than LVM/BSA (P < 0.0001). CONCLUSION: In a large cohort of hypertensive subjects with no clinical evidence of cardiovascular disease, abnormal LV geometry was found in greater than four-fifths of the population. In addition, LVM indexed for height 2.7 was found to be a better method for detecting LVH than LVM indexed for BSA, as the highest prevalence of abnormal geometry was diagnosed when LVM was indexed for height2.7.

Risk-Factor Profile and Comorbidities in 2398 Patients With Newly Diagnosed Hypertension From the Abuja Heart Study.

Risk factors, comorbidities, and end-organ damage in newly diagnosed hypertension (HT) are poorly described in larger cohorts of urban African patients undergoing epidemiological transition. We therefore decided to characterize a large cohort of hypertensive subjects presenting to a tertiary health center in sub-Saharan Africa. It is an observational cross-sectional study. We prospectively collected detailed clinical, biochemical, electrocardiography, and echocardiography data of all subjects with HT as the primary diagnosis in patients presenting at the Cardiology Unit of the University of Abuja Teaching Hospital over an 8-year period. Of 2398 subjects, 1187 patients (49.4%) were female with a mean age of 51 ± 12.8 years. Presenting symptoms and signs were most commonly palpitation in 691 (28.8%) followed by dyspnoea on exertion in 541 (22.6%), orthopnea in 532 (22.2%), pedal oedema in 468 (19.5%), paroxysmal nocturnal dyspnoea in 332 (13.8%), whereas only 31 (1.3%) presented with chest pain. Risk factors were obesity in 671 (28%); 523 (21.8%) had total cholesterol >5.2 mmol/L, diabetes mellitus was present in 201 (8.4%) and 187 (7.8%) were smokers. End-organ damage was present in form of echocardiographic left ventricular hypertrophy in 1336 (55.7%) followed by heart failure in 542 (22.6%). Arrhythmias occurred in 110 (4.6%) of cases, cerebrovascular accident in 103 (4.3%), chronic kidney disease in 26 (1.1%), hypertensive encephalopathy in 10 (0.4%), and coronary artery disease in 6 (0.26%). There were marked differences in sex as women were more obese and men presented with more advanced disease. The burden of HT and its complications in this carefully characterized African cohort is quite enormous with more than three-fourth having one form of complication. The need of effective primary and secondary preventive measures to be mapped out to tackle this problem cannot be overemphasized.

Characteristics of self-measured home blood pressure in a Nigerian urban community: the NIPREGH study.

OBJECTIVE: We investigated the characteristics of self-measured home blood pressure (HBP) in a randomly selected population of Nigerians living in Abuja, Nigeria. METHODS: HBP was the average of 28 measurements comprising duplicate morning and evening readings obtained over a 7-day period by the participants using a semiautomated oscillometric device. Blood pressure measured five consecutive times by trained observers using mercury sphygmomanometer was averaged as the office blood pressure (OBP). RESULTS: Among the 337 participants included in the analysis, 46.6% were women and their mean age (SD) 40.3 (11.3). The mean, mean+2 SD and 95th percentile of HBP and OBP were 117/76, 147/96 and 145/93 mmHg and 114/73, 147/97 and 142/73 mmHg, respectively. The corresponding values in normotensive individuals were 113/73, 137/89 and 132/88 mmHg and 108/70, 130/88 and 128/84 mmHg. Morning HBPs were significantly higher than that of the evening, with a mean difference (confidence interval) of 1.8 mmHg (1.1-2.5 mmHg) and 1.9 mmHg (1.4-2.3 mmHg) for systolic and diastolic pressures, respectively (P<0.0001). There is a strong correlation between the office and home systolic (r=0.8, P<0.0001) and diastolic (r=0.7, P<0.0001) pressures. Overall, the HBP values were significantly higher than OBP, with a mean difference (confidence interval) of systolic/diastolic of 3.6 mmHg (2.5-4.6 mmHg)/2.3 mmHg (1.4-3.1 mmHg) (P<0.0001). The HBP/OBP difference was maintained in men and normotensive individuals, but in women and hypertensive participants, there was no significant difference between HBP and OBP. CONCLUSION: Our findings have shown that self-measured blood pressure is feasible and can be used to evaluate blood pressure outside the clinic environment among Nigerians.