Association between White Coat Hypertension and Left Ventricular Hypertrophy among Adult Nigerians.

There has been an age-long controversy on whether white coat hypertension (WCH) is associated with end organ damage or not. Hence, the presence of left ventricular hypertrophy was assessed in individuals with WCH. This study determined the association between WCH and left ventricular hypertrophy among adult Nigerians. A total of 88 participants consisting of 44 patients with WCH and 44 age and sex-matched normotensive controls were studied. They all underwent 24-hour ambulatory blood pressure measurement and echocardiography. Thirty-one (70.5%) females were in each group. The mean body mass index of patients (26.4 ± 4.5kg/m2) was significantly higher than that of the controls (23.8 ± 4.3kg/m2). Twenty-four of 44 patients and 19 of 44 controls had left ventricular hypertrophy; (chi square=1.137, p-value=0.286). There is high but similar prevalence of LVH among participants with WCH and normotension among adult Nigerians. Hence, there is need to assess every patient with WCH for the presence of LVH and to be followed up for the development of other cardiovascular risk factors

Acute Rapid QTc Changes Following Chloroquine Overdose With No Suicidal Intent

We report a 39 year-old male with unintentional chloroquine overdose without any suicidal intention. Marked QTc prolongation of 0.508sec was observed acutely though patient’s total ingested dose was lower than most fatal doses reported in literature. This range of QTc carries a predisposition to potentially fatal ventricular arrhythmias. Serial electrocardiograms (ECGs) demonstrated gradual return of QTc towards normal while patient was on observation without any indication for active intervention. We recommend that in the event of chloroquine overdose, close monitoring of the cardiovascular system should be done even in apparently stable individuals

Association between blood pressure dipping patterns and hypertension-mediated organ damage among Nigerians with newlydiagnosed hypertension

Introduction: Abnormal blood pressure (BP) dipping patterns are associated with increased cardiovascular risk among Africans. This study determined the association between BP dipping patterns and hypertension-mediated organ damage among patients with newly-diagnosed hypertension.Methods: Ambulatory BP monitoring and echocardiography were carried out on 120 participants. Participants were categorized based on the ratio of night-time to day-time systolic BP into 4 patterns: Normal dipper (≥ 10% but < 20%), non-dippers (≥ 0% but < 10%), reverse  dippers (<0%) and extreme dippers (≥ 20%).Result: Fifty-one (42.5%) were males, the mean age and body mass index were 44.2±9.8years and 27.1±4.4kg/m2 respectively. The non-dipping pattern was the most prevalent while the reverse dipping had the lowest mitral E/A ratio. Office systolic blood pressure was the only predictor of left ventricular hypertrophy (OR=1.050, 95% CI=1.004-1.098; p-value = 0.034).Conclusions: The non-dipping pattern was the most prevalent abnormal dipping pattern while the reverse dippers had the highest risk of hypertension-mediated organ damage. Office blood pressure was the only predictor of left ventricular hypertrophy. Hence, office BP measurement as well as ambulatory blood pressure measurements are potentially important tools in risk stratification in resource-poor settings of sub-Saharan Africa

Characteristics of patients with acute heart failure in North Central Nigeria

Objectives: Heart failure (HF) is an important cause of hospital admission in Nigeria. HF is increasingly prevalent because the population is aging and HF epidemiology is changing. We aimed at profiling the socio-demographic, clinical and echocardiographic (Echo)  characteristics of patients admitted for acute HF. This is one of the largest cohorts of HF patients profiled in Nigeria so far. Methods: Cross sectional design. Socio-demographic, clinical and Echo data were collected from 455 patients admitted for AHF at University of Ilorin Teaching Hospital, North central, Nigeria. Results: Mean age of patients was 58.9± 15.7years, (men were older than women, P= 0.006). 265(58.2%) were males, most patients were aged >60 years, 4.8% had pre-existing Type2 Diabetes mellitus. 53.2% of patients presented in New York Heart Association Stages III and IV. Median duration of admission was 11days (IQR, 6-17), intrahospital mortality- 11.6%. Hypertension was the commonest aetiological factor (62.4%), followed by dilated cardiomyopathy 17.6%, rheumatic heart disease (6.6%), Peripartum cardiomyopathy (5.3%), and others. Conclusion: AHF patients in our study are older than those in previous studies in Nigeria and sub-Saharan Africa. Hypertension is main driver of AHF, and patients largely present with clinically advanced disease necessitating stronger public health education about risk factors and early presentation. &nbsp

Factors affecting medication adherence in patients with hypertension attending a tertiary hospital in southern Nigeria

Introduction: Hypertension is one of the leading causes of morbidity and mortality globally. Blood pressure control is poor among patients with hypertension due to poor health-seeking behaviour, poor medication adherence, financial burden etc. This study aimed to determine the factors affecting medication adherence in patients with hypertension attending Irrua Specialist Teaching Hospital, Irrua, Nigeria. Its findings will improve blood pressure control among hypertensives and reduce the attendant overall morbidity and mortality.Methods: This was a descriptive cross-sectional, hospital-based study that was conducted in the Family Medicine clinic of Irrua Specialist Teaching Hospital, Irrua, Nigeria. A total of 192 adult patients with hypertension were consecutively recruited. Data was collected using the open data kit with a semi-structured, interviewer-based questionnaire. Analysis was done using the Statistical Package for Social Sciences version 21.Results: In this study, out of 192 respondents, 105 (54.7%) were males, 151 (78.7%) were married, 117 (60.9%) had secondary school education, 122 (63.5%) were non-NHIS (National Health Insurance Scheme) enrolees and 93 (48.4%) had uncontrolled blood pressure at presentation. The mean age of the respondents was 51±12 years. There was an association between medication adherence and female sex, being married, high monthly income, NHIS enrolees, and clinic appointment keeping. There was also association between blood pressure control and reduction in salt intake. Conclusion: Ensuring good financial status, with enrolment in health insurance scheme as well as advocating for regular clinic appointment will go a long way in achieving good blood pressure control and reducing related morbidity and mortality

Benefits, disadvantages and challenges of virtual conferencing in the COVID-19 era: Adjusting to the new normal

Objective: The COVID-19 pandemic has had tremendous effect on the medical and scientific community. Measures instituted to curb the spread of the disease such as physical distancing and ban on large gatherings have significantly altered conferencing activities of medical professional associations. With no end in sight to the pandemic, it is certain that medical professional associations may have to make do with purely virtual or hybrid conferencing for some time to come. The objective of this paper is to highlight the benefits, disadvantages and challenges of virtual conferencingMethods: We searched Pubmed, Embase, Scopus, and AJOL databases from January 1, 2021 to December 31, 2021 for publications describing the benefits, disadvantages and challenges of virtual conferencing during the pandemic. This, together with authors' experience formed the resource base for this work.Conclusion: We propose ways the scientific community in Nigeria can maximize the virtual conferencing while the pandemic lasts. We also advocate increased discussion about how to improve the virtual conferencing culture and the development of guidelines for purely virtual or hybrid scientific conferences

Rehospitalization rate and predictors of rehospitalization in heart failure patients in North Central Nigeria

Abstract Heart failure (HF) is a major cause of morbidity and mortality worldwide. Despite the advancement in its treatment the rate of rehospitalization of patients after treatment for HF is still high around the world. Studies assessing rehospitalization rates of HF patients are few in Nigeria. The objective of the study was to determine the 180-day rehospitalization rate and predictors of rehospitalization in acute HF patients managed in our Centre. The study was a retrospective cohort study of 148 patients with acute HF. The 180-day rehospitalization rate in our patients was 16.2%. The median time to rehospitalization was 61days. Serum urea (p=0.016), serum creatinine (p=0.033), admission eGFR < 60mls/min/1.73m2 (p=0.007), LVEF (p=0.045) were associated with rehospitalization. eGFR < 60mls/min/1.73m2 was an independent predictor of 180-day rehospitalization OR 5.4, (CI 1.701-7.690), p=0.014 suggesting 5 times greater likelihood of rehospitalization than patients with higher eGFR. The Kaplan-Meier survival curve for 180-day rehospitalization was plotted. In conclusion, the 180-day rehospitalization rate among our patients varies from other reported rates in our environment. Acute HF patients with renal dysfunction have a high likelihood of medium term rehospitalization and hence constitute an at-risk group for targeted intervention during admission