Abnormalities in the fatty-acid composition of the serum phospholipids of stroke patients.

The incidence of cardiovascular diseases, stroke, and myocardial infarction is increasing in sub-Saharan Africa. Since dietary polyunsaturated fatty acids (PUFA) are protective of the cardiovascular system in humans, we were interested in the question of the PUFA status of adults in northern Nigeria who had experienced a recent stroke. We collected blood from 21 consecutive admissions for stroke (15 male patients, mean age 39.3 years and six females, mean age 40.7 years) to the Federal Medical Centre in Gombe, Nigeria and analyzed the fatty-acid composition of the serum phospholipids. Blood was collected from 30 healthy controls for comparison. The contribution palmitic acid made to the fatty-acid total was greatly decreased in the phospholipids of the stroke patients (29.2% versus 37.2 %, p < 0.001). However, the phospholipids of the stroke patients had significantly higher percentages of 20-, 22-, and 24-carbon saturated fatty acids, as well as higher proportions of the omega-6 fatty-acid, arachidonic acid (11.4 versus 8.14%, p < 0.001), and the omega-3 fatty-acid, docosahexaenoic acid (3.21 versus 1.80%, p < 0.001). Using the percentages and melting points of the individual fatty acids, we estimated that the acyl chains of the serum phospholipids of the stroke patients had a lower mean melting point than the controls (27.8 versus 34.6 degrees C, p < 0.001). Assuming that serum phospholipids are surrogates for tissue phospholipids, we conclude that the tissue membranes of the stroke patients may be considerably more fluid than those of the controls.

Serum lipid profiles and homocysteine levels in adults with stroke or myocardial infarction in the town of Gombe in northern Nigeria.

While the incidence of infectious diseases has been on the decline in developing countries, the toll of cardiovascular diseases, including stroke and myocardial infarction, has been increasing. The impression of physicians in certain regions of the western Sahel, including the state of Gombe in northeastern Nigeria, is that macrovascular disease in the indigenous population is on the rise. This study was, therefore, undertaken to compare well-established risk factors for cardiovascular disease in a group of 53 men (n=34) and women (n=19) in the town of Gombe who had suffered a stroke or heart attack with the corresponding parameters in 48 age- and gender-matched healthy adults living in the same environment. The parameters of cardiovascular diseases considered were: overweight and obesity, blood pressure, lipid profiles, and homocysteine. While the male and female patients who had suffered stroke (n=48) or heart attack (n=5) were borderline hypertensive, their mean body mass index values were not different from the corresponding values of their control groups. Although the serum homocysteine levels of the patients and controls were not significantly different, 85% of the stroke patients had serum homocysteine levels greater than 10 microM. These high homocysteine levels could not be accounted for by sub-optimal folate or vitamin B 12 status. The serum levels of HDL-cholesterol and triglyceride were not significantly different between the male and female patients and their respective controls. However, the males, but not the females, with macrovascular disease had significantly higher levels of total cholesterol (161 vs 137 mg/dL, p=0.04) and LDL-cholesterol (91 vs 70 mg/dL, p=0.02). In addition, both female and male stroke/myocardial infarction patients exhibited an elevated LDL-cholesterol/HDL-cholesterol ratio. These results indicate that blood pressure and the LDL-cholesterol/HDL-cholesterol ratio are associated with stroke and myocardial infarction in adults in northern Nigeria, thereby creating potential opportunities for possible public-health interventions.