Microalbuminuria and hypertensive retinopathy among newly diagnosed nondiabetic hypertensive adult Nigerians

Objective: Microalbuminuria (MA) is a marker of vascular damage and has prognostic implications in hypertension. The objective of this study was to determine if the presence of MA increases the risk of hypertensive retinal damage in nondiabetic adult Nigerians with hypertension.Materials and Methods: A total of 96 consecutive newly diagnosed hypertensive patients attending the outpatient clinic and who consented and met the criteria for the study were recruited. There was also the same number of age- and sex-matched normotensive controls.Results: MA was present in 31 (32.3%) of the patients and 6 (6.3%) of the controls. The mean (±SD) ages of patients with and without MA were 52.5 ± 11.9 years and 48.3 ± 13.0 years, respectively. The diastolic blood pressure (P = 0.03) and mean arterial pressure (P = 0.01) were statistically higher in hypertensive patients with MA than in their counterparts without it. Patients with MA were more likely to have hypertensive retinopathy (HRP) than patients without it (71% vs 37%, P = 0.001). Advanced HRP, i.e., Grades III - IV, was more common in patients with MA than in those without it (22.6% vs 1.5%).Conclusion: This study shows a high prevalence of HRP in Nigerian hypertensives with MA

Prevalence of traditional cardiovascular risk factors among staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria

Aim: The aim was to describe the frequency of occurrence of traditional cardiovascular (CV) risk factors among selected university workers in Ladoke Akintola University of Technology (LAUTECH) Nigeria.Materials and Methods: A cross‑sectional study of 206 staff of LAUTECH, Ogbomoso, Nigeria had an assessment for nine traditional CV risk factors. Demographic and clinical parameters were taken. Blood sample was taken to determine the random blood sugar and lipid profile. 12‑lead resting electrocardiography (ECG) was done for all participants. Statistical analysis was performed with the aid of Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago Ill., USA)Results: The study population included 96 males (46.6%) and 110 females. The mean age was 45.3 ± 7.9 years (range 27-73 years). The prevalence of CV risk factors were as follows: Hypertension 84 (40.8%), visceral obesity 92 (44.7%), generalized obesity 79 (38.3%), low high density lipoprotein 113 (54.9%), impaired blood glucose 16 (7.8%), diabetes mellitus 3 (1.5%), hypercholesterolemia 102 (49.5%), left ventricular hypertrophy‑ECG 24 (11.7%), elevated low density lipoprotein‑cholesterol 99 (48.1%). About – (72.3%) had two or more CV risk factors clustered together. Females had a higher prevalence of CV risk factors and its clusters than their male counterparts. Of those diagnosed with hypertension in this study, more than half had never been told they were hypertensive 48 (57.1%).Conclusion: This study suggests a very high prevalence of CV risk factors among University Staff in LAUTECH, Ogbomoso, Nigeria. Clustering of CV risk factors is more prevalent among women. Appropriate preventive strategy in terms of education and modification of risk factors are important to reduce the burden of CV diseases among this population.Key words: Cardiovascular risk factors, dyslipidemia, hypertension, obesity, prevalence, universit

Burden of obesity in essential hypertension: Pattern and prevalence

Obesity continues to be an epidemic worldwide. There also continues to be a relationship between obesity and hypertension both causal and consequentially. The study aims at determining the prevalence and pattern of overweight and obesity among our patients being managed for essential hypertension. The study was a cross sectional study. Consecutive patients diagnosed with essential hypertension were recruited from two university teaching hospitals in the SouthWest of Nigeria. Demographicdata such as age, gender, weight and height were obtained from patients at recruitment. Patients with congestive heart failure, secondary hypertension, chronic kidney disease, and other chronic diseases wereexcluded. Pregnant women were also excluded. Obesity was defined according toWHOclassification. Statistical analysis was done by the Statistical Package for Social Sciences version 11.0. One thousand one hundred and two (1102) consecutive hypertensive patients were recruited. Two hundred and eighty six (286) were dropped due to evidence of overt heart failure (98) and chronic kidney disease and others (188).There were (420) males (51.5%) and 396 females (48.5%), mean age 54.97 (±13.14) years. (Range 10-91). 7.6% (62) were underweight (36 males, 26 Females): 260 (31.9%) were overweight, consisting of 148 males and 112 females: 135 (16.5%) had mild obesity consisting of 48 males and 87 females: 43(5.3%) had moderate obesity with 15 males and 28 females while 30 (3.7%) had severe obesity (consisting of 22 females).About two thirds of the hypertensive patients seen in two teaching hospitals in the SouthWest of Nigeria in this study were either overweight or obese. Therefore lifestyle modification geared toward weightreduction should be emphasized in these patients

Prognostic Significance Of QT Interval Prolongation In Adult Nigerians With Chronic Heart Failure.

Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six consecutive patientswith heart failurewere recruitedwith 90 age and sexmatched controls.All the subjects had a 12-lead electrocardiogramat a paper speed of 25mm/sec and a rhythm strip (lead II) at 50mm/sec.The latterwas used to calculate theQTc using the Bazett\'s formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively.Theywere followed-up for sixmonths. Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9±16 years) of the patientswas similar to that of the controls (50.3±15) (P= 0.475).Twenty-eight (30.8%) patients died after 6months of follow-up against none of the controls.The mean QTc was significantly longer in the non-survivors (0.494±0.027) than in the survivors (0.462±0.035) (P = 0.0001). The percentage mortality in patients with prolonged QTc against those with normal QTc was 41% and 14% respectively (P = 0.001). In the stepwise regression analysis, QTc was an independent predictor of mortality (R = 0.412, R = 0.17, P= 0.001). QTc prolongation is a predictor of mortality in CHF and may be an important adjunct in risk stratification of patientswith heart failure. Keywords: Chronic Heart Failure, QTc Prolongation, Mortality Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 336-34

Cardio-metabolic risk factors and metabolic syndrome: A study of the prevalence and level of awareness of related risk factors among school teachers in Ogbomoso, South West Nigeria

Background: The overall health of school teachers is closely related to the performance of children in school and life generally. Objectives: This study aimed to describe the prevalence of cardiovascular risk factors and metabolic syndrome among school teachers in Ogbomoso, Nigeria. Methods: Two hundred secondary school teachers were randomly selected from all the secondary schools in the two local Governments in Ogbomoso, Nigeria. Relevant laboratory investigations and electrocardiography were performed. Metabolic syndrome was defined using the Joint Scientific Statement on Harmonising the Metabolic Syndrome Criteria. Results: Metabolic syndrome (MS) was identified among 44(22.0%) of study participants. It was more common among females 33(28.2%) compared to males 11(13.3%) [p = 0.002]. The prevalence of some cardiovascular risk factors were as follows: visceral obesity 108(54.0%), low HDL 105(52.5%), hypertension 58 (29.0%), BP > 130/85 mmHg, 76(38.0%), impaired fasting blood glucose 49(24.5%) and hypertriglyceridaemia 14(7.0%). Only a small fraction (39; 19.5%) demonstrated good level of knowledge about the cardiovascular risk factors. Conclusion: Cardiovascular risk factors were common among school teachers in Ogbomoso, south-west Nigeria in addition to a low level of awareness and poor control of the risk factors

Intracardiac tumor: A risk factor for stroke in the young –A case report

Stroke occurs commonly in individuals above 65years, especially in the background of atherosclerosis and other risk factors. In young persons below 45 years it is a rare disorder with devastating sequelae on the affected individual. Presently there are few reports on the aetiology/risk factors for stroke in young adults in Nigeria. This is due to limited facility for thorough investigation; therefore management of such cases poses a diagnostic challenge. In this report we present a case of embolic stroke in a male undergraduate that began with two brief episodes of transient left sided weakness before a completed stroke four hours later. 2-D echocardiography showed that the likely source of emboli to be a non-pedunculated left atria tumour attached to the root of posteriormitral valve leaflet. Intracardiac mass should be considered a possible risk factor for ischemic stroke in young adult, especially in the absence of other risk factors such as connective tissue disorders, HIV/AIDS, hemoglobinopathy or use of recreational drugs. High index of suspicion is required in order not to overlook such source of emboli. Early diagnosis offers the best panacea for a definitive therapy and prevention of stroke recurrence with its devastating sequelae.Intracardic tumour, risk factor, stroke . Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp. 82-8

Microalbuminuria and its relations with serum lipid abnormalities in adult Nigerians with newly diagnosed hypertension

No Abstract

Case report of a 26 year old primigravida with Patent Ductus Arteriosus (PDA) in heart failure

Congenital heart disease is an important cause of maternal morbidity and mortality during pregnancy. Pregnancy alters the circulatory and respiratory physiology with attendant deleterious effect on the mother with congenital heart disease and the foetus. Additional insult to the circulatory physiology by other factors coexisting together with congenital heart disease can further reduce the cardiac reserve in pregnancy and precipitate heart failure. These factors include anaemia, thromboembolism, hypertension, multiple pregnancy, strenuous physical activity, extremes of temperature and the normal physiological edema of pregnancy

Plasma lipids pattern in hypertensives on treatment in Illorin, Nigeria

Hypertension, a major cause of CVD, is frequently associated with dyslipidaemia and overweight. These risk factors have sex differences that need local study. This work aims to evaluate the pattern of plasma lipids and BMI in male and female hypertensives. Fifty hypertensives attending the Cardiology Clinic of University of Ilorin Teaching Hospital, and fifty sex matched controls, were involved in the study. Conditions that can cause dyslipidaemia were ruled out in the subjects. Plasma TC, TG, HDL-C, LDL-C and BMI were determined. Plasma TC (4.80mmol/L ± 2.27 vs. 3.20mmol/L), HDL-C (1.16mmol/L ± 0.37 vs. 0.93mmol/L ± 0.41), LDL-C (3.62mmol/L ± 1.30 vs. 2.28mmol/L ± 1.01) and BMI (27.20kg/m2 ± 6.57 vs. 23.37kg/m2 ± 4.75) were higher in hypertensives. Plasma TG (1.14mmol/L ± 0.71 vs. 0.83mmol/L ± 0.29) and HDL-C (1.22mmol/L ± 0.42 vs. 1.05mmol/L ± 0.25) were higher in female hypertensives than in male hypertensives. Management of hypertension in our environment should involve the screening and control of dyslipidaemia and overweight. It should recognize possible differences in the pattern of dyslipidaemia. The finding of higher LDL-C and lower HDL-C in male hypertensives, suggest that they are more likely to have poorer lipid pattern than females. Nigerian Medical Practitioner Vol. 49(1&2) 2006: 3-