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Factors influencing the development of malignant hypertension in Nigeria
S Kadiri1, B O Olutade, O Osobamiro
1Department of Medicine, University College Hospital, Ibadan, Nigeria.
Abstract:
Hypertension prevalence rates remain comparatively low in Nigeria, although the associated morbidity and mortality including that due to malignant hypertension (MHT) is considerable. To determine the factors that may be associated with the development of MHT we compared 74 patients with essential MHT (age 48 +/- 9 years, 59 male, blood pressure (BP) 234 +/- 31/140 +/- 17 mm Hg) with 74, age, gender and BP-matched patients with essential benign hypertension (BHT) (49 +/- 8 years, 60 male, 227 +/- 26/136 +/- 15 mm Hg). Body mass index was higher in the BHT [corrected] group by 1.3 (95% Cl: 0.5 to 2.1, P < 0.01). In the subset (25 MHT, 43 BHT) in whom hypertension had been diagnosed before presentation, duration of hypertension was shorter (P < 0.05) in the MHT group. Patients with MHT, were more likely to have been receiving inadequate therapy in the months before (OR 2.7, 95% Cl: 1.4 to 5.4), showed a decreasing proportion with increasing socio-economic class (chi2 = 5.79, P < 0.02) and had been exposed to a greater degree of stress (OR 3.5, 95% Cl: 1.7 to 7. 1). Smoking (OR 1.1, 0.6 to 2.3), alcohol use (OR 0.9, 0.5 to 1.8) and contraceptive pill use (OR 0.9, 0.1 to 8.6) did not impart excess risk. MHT is associated with the underprivileged and measures aimed at raising the general awareness and the socio-economic level of the people are expected to produce a decline in the incidence of MHT. Journal of Human Hypertension (2000) 14, 171-174.
Insights
Malignant hypertension (MHT) in Nigeria is linked to lower socioeconomic status and higher stress levels, despite lower overall hypertension prevalence. Addressing these factors may reduce MHT incidence.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension prevalence is low in Nigeria, but malignant hypertension (MHT) contributes significantly to morbidity and mortality.
- Understanding factors associated with MHT is crucial for targeted interventions.
Purpose of the Study:
- To identify factors associated with the development of malignant hypertension (MHT) in Nigeria.
- To compare patients with essential MHT to those with essential benign hypertension (BHT).
Main Methods:
- A case-control study comparing 74 MHT patients with 74 age, gender, and BP-matched BHT patients.
- Analysis included body mass index, duration of hypertension, therapy adequacy, socioeconomic status, stress, smoking, alcohol, and contraceptive pill use.
Main Results:
- MHT patients were more likely to have received inadequate therapy and reported higher stress levels.
- MHT was associated with lower socioeconomic status.
- Body mass index was higher in the BHT group; hypertension duration was shorter in the MHT group.
Conclusions:
- Malignant hypertension in Nigeria is disproportionately associated with underprivileged populations and higher stress.
- Improving general awareness and socioeconomic conditions may decrease MHT incidence.