Prevalence of peripheral artery disease in adult hypertensive patients in Nnewi, Nigeria

Background: Peripheral artery disease (PAD) is usually due to artherosclerosis obliterans of the arteries of the lower limbs. Patients with PAD are at increased risk of mortality from major cardiovascular events, such as myocardial infarction and stroke. This study aims to find the prevalence of peripheral artery disease in adult hypertensive subjects in Nnewi. Materials and Methods : The study was carried out among adult hypertensive subjects in the medical outpatient clinics and the medical wards of the NnamdiAzikiwe University Teaching Hospital, Nnewi.Two-hundred and fifty subjects were recruited between August 2004 and December 2004 for this study. The Rose Intermittent Claudication Questionnaire was administered and the Ankle-Brachial Index (ABI) was assessed with a hand-held Doppler device. PAD was defined as ABI > 0.9.TheEpi info (2002 version) statistical software was used for statistical analysis. Results: The mean age of the study subjects was 58.9±8.9 years. They comprises106 (42.5%) males and 144 (57.6%) females. The overall prevalence of PAD was 24.8% in the total study group. The ratio of asymptomatic to symptomatic subjects was 3.4:1. Hypertensive subjects with diabetes mellitus had a slightly higher prevalence rate (26%), compared to those with hypertension only (24%). The prevalence of PAD was much higher in patients above 55 years (30.7%) than in those below 55 yearsof age (15.5%). Conclusion : Peripheral artery disease is common, though largely asymptomatic in Nigerian hypertensive subjects. More efforts at screening and unmasking subjects are required

Nonalcoholic Fatty Liver Disease Among Adults Attending Medical Outpatient Clinic Using Ultrasound

Background: Nonalcoholic fatty liver disease (NAFLD) is a common metabolic disorder characterized by accumulation of excess fat in the liver in the absence of significant alcohol consumption. This condition has been linked to certain risk factors such as obesity, Type 2 diabetes, and dyslipidaemia. Data in the developing economies are very scanty, hence the need for this study.Objectives: To ascertain the frequency and correlates of NAFLD among adult Nigerians and staging this condition using ultrasound. It also aimed at evaluating correlations between NAFLD and possible associated factors such as obesity, type 2 diabetes and dyslipidaemia.Methodology: Consenting adult patients attending Out Patient Clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH) who do not have significant alcohol consumption and were serologically negative for Hepatitis B or C infections were recruited for the study. Biodata and other relevant clinical histories were taken and clinical anthropometric measurements obtained. Blood samples were taken from the patients to assess their fasting blood glucose, liver function tests and fasting lipid profiles. An experienced ultra-sonographer performed abdominal ultrasound scan looking for presence of NAFLD and staged it. Data were analysed with statistical package for social sciences software(SPSS), version 17Results: A total of 102 individuals participated in the study, 46(45.1%) females and 56(54.9%) males. The mean age of the study participants was 53.1±16.4 years (range 22-88 years). Female male ratio was 1:1.2. About thirty-one percent of the patients studied had NAFLD. Both the mean BMI and mean Waist Circumference were higher among subjects with NAFLD compared to those without ultrasonographic evidence of NAFLD, with p-values of ˂0.001 and 0.008 respectively. Diabetes mellitus was significantly present among the participants with NAFLD compared to those participants without evidence of NAFLD (53.1% vs 27.1%, p=0.011). Hypertension had a similar relationship, but not significant (p = 0.121).Conclusion: The prevalence of NAFLD seems to be high in this hospital based study and important correlates are obesity and Diabetes mellitus. Key Words: Fatty liver disease, Obesity, Type 2 diabetes, Hyperlipidemia, Metabolic syndrome, Insulin resistanc