Clustering of cardiovascular disease risk factors in a rural adult population in Nigeria

Background: Cardiovascular disease (CVD) is responsible for one third of global deaths and is the leading contributor to global disease burden. A non-communicable disease survey done in Nigeria helped determine the prevalence of major CVD risk factors in the country and showed a rising trend in the prevalence. This study aims to determine the proportion of adults in a rural farming community in the Niger Delta region of Nigeria with clustering of the following CVD risk factors: hypertension, diabetes, obesity, dyslipidaemia, hyperuricaemia, ECG-LVH, smoking, heavy alcohol consumption and physical inactivity.Methods: Descriptive cross-sectional survey carried out in a rural farming community in the Niger Delta region of Nigeria. Stratified sampling method was used to recruit study subjects aged 18 years and above and a total of 500 subjects completed the survey. Socio-demographic information, anthropometric, blood pressure and ECG measurements were obtained. Venous samples were collected and analyzed.Results: Five hundred subjects participated. There were 156 males and 344 females with male to female ratio of 1:2.3. The overall mean age was 41.32±17.0 with range of 18 years to 95 years. The mean age for males was 42.84±17.8 and females 40.62±16.6. Overall, 38.2%, of subjects had 2 or more risk factors. Additionally, 42.1% of males and 31.4% of females had ≥2 of these risk factors. Multivariate logistic regression showed higher clustering of risk factors with increasing age, male gender, Government staff and higher educational attainment.Conclusions: Clustering of CVD risk factors is high in this rural community of Nigeria and requires integrated approach to its prevention, detection and treatment

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

Clustering of cardiovascular disease risk factors in a rural adult population in Nigeria

Background: Cardiovascular disease (CVD) is responsible for one third of global deaths and is the leading contributor to global disease burden. A non-communicable disease survey done in Nigeria helped determine the prevalence of major CVD risk factors in the country and showed a rising trend in the prevalence. This study aims to determine the proportion of adults in a rural farming community in the Niger Delta region of Nigeria with clustering of the following CVD risk factors: hypertension, diabetes, obesity, dyslipidaemia, hyperuricaemia, ECG-LVH, smoking, heavy alcohol consumption and physical inactivity.Methods: Descriptive cross-sectional survey carried out in a rural farming community in the Niger Delta region of Nigeria. Stratified sampling method was used to recruit study subjects aged 18 years and above and a total of 500 subjects completed the survey. Socio-demographic information, anthropometric, blood pressure and ECG measurements were obtained. Venous samples were collected and analyzed.Results: Five hundred subjects participated. There were 156 males and 344 females with male to female ratio of 1:2.3. The overall mean age was 41.32±17.0 with range of 18 years to 95 years. The mean age for males was 42.84±17.8 and females 40.62±16.6. Overall, 38.2%, of subjects had 2 or more risk factors. Additionally, 42.1% of males and 31.4% of females had ≥2 of these risk factors. Multivariate logistic regression showed higher clustering of risk factors with increasing age, male gender, Government staff and higher educational attainment.Conclusions: Clustering of CVD risk factors is high in this rural community of Nigeria and requires integrated approach to its prevention, detection and treatment

Prevalence and Spectrum of Albuminuria among Type 2 Diabetic Patients in a Tertiary Health-care Facility in Southern Nigeria

Background: Diabetic nephropathy (DN) is a life-threatening microvascular complication often leading to progressive renal failure and death. Microalbuminuria is an early marker of DN and a major risk factor for endothelial dysfunction. Routine screening for albuminuria will improve health outcomes in these patients. Materials and Methods: A cross-sectional study comprising 150 consecutive adults with type 2 diabetes mellitus (DM) (WHO criteria) attending the medical outpatient clinic of our hospital from December 2017 to December 2018. The study was done in accordance with the Declaration of Helsinki. Ethical approval was sought and obtained from the Ethical and Research Committee of the hospital before the commencement of the study. Written informed consent was obtained from individual participants after a careful explanation of the study. Samples for spot urine albumin-to-creatinine ratio were collected for analysis. Results were analysed with the Statistical Package for the Social Sciences (SPSS)-23 software. Results: The study involved 94 (62.7%) females and 56 (37.3%) males with a mean age of 55.87 ± 10.96 years. The mean duration of diabetes was 9.45 ± 6.94 years and 56 (37.3%) have had diabetes for 6–10 years. The mean urine albumin-to-creatinine ratio (uACR) was 153.54 ± 146.28 mg/g, with 66.7% having values between 30 and 299 mg/g while 15.3% had values ≥ 300 mg/g. The prevalence of albuminuria was 82% among participants. The relationship between the duration of Type 2 DM and UACR categories was not statistically significant, with P = 0.473. Conclusion: Routine screening for albuminuria in type 2 DM patients will improve health outcomes