The prevalence and correlations of electrocardiographic-left ventricular hypertrophy in a rural community in Africa.

INTRODUCTION: Left ventricular hypertrophy (LVH) is a major and independent risk factor for cardiovascular morbidity and mortality irrespective of aetiology. Patients with ECG -LVH from any cause are at a greater risk for major cardiovascular complications including heart failure, cardiac arrhythmias, death following myocardial infarction, decreased left ventricular ejection fraction, sudden cardiac death, aortic root dilation, and stroke. Although echocardiography has become the gold standard for LVH detection in clinical practice, electrocardiography ECG remains widely used due to its simplicity and accessibility. This study is to determine the prevalence and correlations of ECG-LVH among adult population of a rural farming community in Rivers State, Nigeria.METHODS: A cross-sectional survey involving 539 adults. A questionnaire was administered to elicit socio-demographic data, prior knowledge of blood pressure/blood sugar status and family history of hypertension and diabetes. Anthropometric and blood pressure measurements were done in a standardized manner. Blood samples were taken for blood glucose and uric acid. Twelve lead surface electrocardiograms were recorded on all the subjects using a portable ECG machine. Data obtained was analysed using SPSS version 17. LVH was determined using Sokolow-Lyon voltage criteria Mv= SV1+RV5 (or V6 if larger).RESULTS: The prevalence of ECG-LVH by the Sokolow-Lyon criterion was 16.4% with a significantly higher prevalence in males than females (20.4 % versus 8.2%, p=0.001). There was high prevalence rate in the middle age and the elderly age group with the lowest rate seen in the young age group of 18-29 years in both sexes. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking were significantly correlated with LVH.CONCLUSION: The prevalence of ECG-LVH in this rural community of the study is high. The male gender, hypertension including both systolic and diastolic blood pressure and cigarette smoking are important variables found to be significantly correlated with the development of LVH in this study. This therefore calls for urgent need to tackle these modifiable risk factors amongst others elicited in this study while developing a more comprehensive health package for our rural dwellers.KEY WORDS: Prevalence, correlations, electrocardiographic-left ventricular hypertrophy, rural community

Patient recruitment and enrolment flowchart.

FFQ: Food frequency questionnaire, 24HR: 24-hour dietary recall, n: number.</p

Perceived implementation and challenges of the new tool.

Perceived implementation and challenges of the new tool.</p

Cross-sectional measurements of patients (<i>n</i> = 58).

Cross-sectional measurements of patients (n = 58).</p

Patients feedback on the screening tool (FFQ) (<i>n</i> = 58).

Patients feedback on the screening tool (FFQ) (n = 58).</p

Participant selection and sequence of assessments flowchart.

FFQ: food frequency questionnaire, 24 HR: 24-hour dietary recalls, BP: Blood pressure, H: Height, W: Weight.</p

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Dietary risks significantly contribute to hypertension in West Africa. Food frequency questionnaires (FFQs) can provide valuable dietary assessment but require rigorous validation and careful design to facilitate usability. This study assessed the feasibility and interest of a dietary screening tool for identifying adults at high risk of hypertension in Nigeria. Fifty-eight (58) consenting adult patients with hypertension and their caregivers and 35 healthcare professionals from a single-centre Nigerian hospital were recruited to complete a 27-item FFQ at two-time points and three 24-hour recalls for comparison in a mixed method study employing both quantitative questionnaires and qualitative techniques to elicit free form text. Data analyses were conducted using R software version 4.3.1 and NVivo version 14. The trial was registered with ClinicalTrials.gov: NCT05973760. The mean age of patients was 42.6 ± 11.9 years, with an average SBP of 140.3 ± 29.8 mmHg and a BMI of 29.5 ± 7.1 Kg/m2. The adherence rate was 87.9%, and the mean completion time was 7:37 minutes. 96.6% of patients found the FFQ easy to complete, comprehensive, and valuable. A minority reported difficulty (3.4%), discomfort (10.3%), and proposed additional foods (6.9%). Healthcare professionals considered the dietary screening tool very important (82.9%) and expressed a willingness to adopt the tool, with some suggestions for clarification. Patients and healthcare professionals found the screening tool favourable for dietary counselling in hypertension care. The tailored dietary screening tool (FFQ) demonstrated promising feasibility for integration into clinical care as assessed by patients and healthcare professionals. Successful implementation may benefit from proactive time management and addressing training needs. This user-centred approach provided key insights to refine FFQ and set the foundation for ongoing validity testing and evaluation in clinical practice.</div

Sociodemographic characteristics of patients (<i>n</i> = 58).

Sociodemographic characteristics of patients (n = 58).</p

Inclusion and exclusion criteria.

Dietary risks significantly contribute to hypertension in West Africa. Food frequency questionnaires (FFQs) can provide valuable dietary assessment but require rigorous validation and careful design to facilitate usability. This study assessed the feasibility and interest of a dietary screening tool for identifying adults at high risk of hypertension in Nigeria. Fifty-eight (58) consenting adult patients with hypertension and their caregivers and 35 healthcare professionals from a single-centre Nigerian hospital were recruited to complete a 27-item FFQ at two-time points and three 24-hour recalls for comparison in a mixed method study employing both quantitative questionnaires and qualitative techniques to elicit free form text. Data analyses were conducted using R software version 4.3.1 and NVivo version 14. The trial was registered with ClinicalTrials.gov: NCT05973760. The mean age of patients was 42.6 ± 11.9 years, with an average SBP of 140.3 ± 29.8 mmHg and a BMI of 29.5 ± 7.1 Kg/m2. The adherence rate was 87.9%, and the mean completion time was 7:37 minutes. 96.6% of patients found the FFQ easy to complete, comprehensive, and valuable. A minority reported difficulty (3.4%), discomfort (10.3%), and proposed additional foods (6.9%). Healthcare professionals considered the dietary screening tool very important (82.9%) and expressed a willingness to adopt the tool, with some suggestions for clarification. Patients and healthcare professionals found the screening tool favourable for dietary counselling in hypertension care. The tailored dietary screening tool (FFQ) demonstrated promising feasibility for integration into clinical care as assessed by patients and healthcare professionals. Successful implementation may benefit from proactive time management and addressing training needs. This user-centred approach provided key insights to refine FFQ and set the foundation for ongoing validity testing and evaluation in clinical practice.</div

Benefits and challenges of implementing the screening tool.

Benefits and challenges of implementing the screening tool.</p