Assessment of probability of pulmonary arterial hypertension among HIV-1 infected patients on haart and its relationship with Cd4 cells Count and viral load

HIV patients are more likely to develop cardiovascular disease than the general population and have a 2500-fold increased risk of developing pulmonary artery hypertension (PAH). HIV associated pulmonary hypertension was said to be more severe and is associated with higher mortality. Methodology: Across-sectional conducted among consecutive HIV patients age greater than 18 years receiving treatment at the antiretroviral therapy (ART) clinic of the Federal Medical Centre Nguru Yobe State Northeastern Nigeria. Results: One hundred and twenty (120) subjects were recruited into the study, thirteen had incomplete data and were excluded from the analysis. There was a significant negative correlation between CD4 cells count with tricuspid regurgitant flow velocity (TRv), pulmonary regurgitant flow velocity (PRv), pulmonary artery trunk diameter (PATd), right ventricular to left ventricular internal diameter (RV/LV) ratio, left ventricular eccentricity index (LVEI), and right atrial area (RAA), while the correlation between CD4 cells count and right ventricular acceleration time (RVAT) was positive and significant. On the other hand, the correlations between viral load and TRv, PRv, PATd, RV/LV ratio, and RAA were positive and significant while that between viral load and RVAT was negative and significant. Conclusions: This study revealed that HIV patients with low CD4 cell count and high viral load had a high probability of developing PAH (significant negative relationship between variables associated with the probability of PAH with CD4 cell count and significant positive relationship with viral load), In HIV patients the probability of developing PAH decreases with adequate treatment (that suppress viral replication and increases CD4 count). We, therefore, recommend routine assessment of the probability of PAH in patients with HIV infection particularly those with low CD4 cell count and high viral load and encourage early commencement of HAART to prevent the development of pulmonary arterial hypertension

Digoxin and symptomatic Bradyarrhythmia: The 'demon' or a 'red herring'

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Factors associated with hypertension among adults in high burden kidney disease areas of Jigawa State, Nigeria: A cross-sectional survey

Background: Hypertension is the leading risk factor for preventable cardiovascular-related complications and mortalities worldwide. Materials and Methods: A cross-sectional survey was conducted to assess the prevalence and factors associated with hypertension among 361 adults from four local government areas (LGAs) of Jigawa state identified to have high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed and data were analysed using IBM SPSS version 22.0 Results: The age of the respondents ranged from 18 to 102 years with a median of 45 (interquartile range = 30–80) years. More than a quarter (34.9%) of the respondents were unemployed. Few reported history of alcohol ingestion (0.8%) and cigarette smoking (1.1%). The prevalence of systolic hypertension was 116 (32.1%), while that of diastolic hypertension was 133 (36.8%). Jahun LGA had higher cases (36.7%) of systolic hypertension, whereas Dutse LGA had higher cases (47.8%) of diastolic hypertension. Systolic hypertension was significantly higher (P 35 years of age. The odds of developing systolic hypertension were significantly lower among those between the ages of 18 and 35 years, and those between the ages of 18 and 35 years were less likely to have systolic hypertension than those above the age of 35 years (adjusted odds ratio = 9.0; 95% confidence interval = 4.6–17.6). Similarly, those who reported family history of diabetes and hypertension (P < 0.001) had a significantly higher proportion of systolic hypertension. Conclusions: The prevalence of hypertension was alarming in the high burden kidney disease areas. The government should develop a sustainable model for the mass community screening of risk factors and community-based health insurance for the effective management of all identified cases