RESUMO
Hypertension remains the dominant cardiovascular risk factor worldwide. May Measurement Month (MMM) is an annual global programme of the International Society of Hypertension aimed at screening for undetected hypertension in the general population. We report the outcome of MMM 2018 in Nigeria. An opportunistic screening of adults aged at least 18 years was conducted in the six geopolitical zones of Nigeria in the month of May, 2018. Screening for hypertension was done by trained volunteers with the use of validated digital and mercury sphygmomanometers following the MMM protocol. Hypertension was defined as blood pressure (BP) ≥140/90 mmHg or the use of BP-lowering medication. There were 6398 participants (53.0% female) with a mean (SD) age of 41.7 (15.0) years. Hypertension was present in 36.4% of the participants with 51.1% of the hypertensives aware of their status, 41.8% on medication, of whom 43.1% were controlled. Overall, only 18.0% of all hypertensive participants had their BP under control. The proportion with hypertension is high, and awareness, treatment, and control rates are low. Concerted efforts are needed to improve awareness and treatment of hypertension in Nigeria in order to reduce the high rate of complications associated with uncontrolled BP.
RESUMO
Trans-thoracic echocardiography (TTE) is an important non-invasive cardiac examination that provides structural and functional information. It is useful in the diagnosis of cardiac diseases and often guides the management and follow-up of patients with cardiovascular diseases (CVD). The study aimed to present an audit of the echocardiograms performed in an urban private hospital over a two-year period in order to define the pattern of cardiac diseases in our center. Echocardiogram reports of 168 consecutive patients performed between May 2011 and April 2013 at an organized private sector hospital in Lagos, south-west Nigeria were reviewed. Studies were performed with a Toshiba Nemio XG ultrasound machine. The data obtained were analyzed for mean age, sex, clinical indications, and echocardiographic diagnosis in the study subjects. A total of 168 echocardiography reports were examined, comprising of 92 males (54.8%) and 76 females (45.2%). The age range of the subjects was 10-76 years (mean 42.5 ± 12.1 years). The commonest indication for echocardiography was systemic hypertension and hypertension related causes (38.1%), followed by abnormal resting electrocardiogram (14.9%). Routine annual medical screening was the next most common indication, representing 13.1% of the indications for echocardiography. The other indications are as presented in Table 1. The echocardiogram was normal in 64.3% of the subjects. The commonest abnormality detected was hypertensive heart disease (HHD); accounting for 9.6% of the subjects studied. Isolated atrial enlargement (left, right, or bi-atrial) was the next most common abnormality accounting for 6% of the echocardiographic diagnosis. Pulmonary hypertension was the next most common diagnosis accounting for 4.8% of our findings. The other echocardiographic diagnoses are as listed in Table 2. Hypertension represents the commonest indication for echocardiography. Normal echocardiogram was the commonest echocardiographic finding while HHD was the commonest echocardiographic abnormality. The prevalence of ischemic heart disease by echocardiography was 2.4%. There was no case of rheumatic heart disease (RHD). The prevalence of hypertrophic cardiomyopathy (HCM) was 1.2%. Ease of access to echocardiography may influence the findings in an echocardiographic audit and policy makers should incorporate appropriateness criteria into their guidelines for reimbursement.