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Electrocardiographic hypertrophic patterns in hypertensive Nigerians
J O Olubodun1, T O Cole, A O Falase
1Department of Medicine, University College Hospital, Ibadan, Nigeria.
Insights
Electrocardiogram (ECG) findings reveal significant left ventricular and left atrial hypertrophy in Nigerian hypertensives, particularly those with heart failure. These hypertrophic patterns are more pronounced than in other populations, indicating late presentation of hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Medical Imaging
Background:
- Hypertension is a significant global health issue, often leading to cardiac complications.
- Electrocardiographic (ECG) patterns of cardiac hypertrophy are key indicators of hypertensive heart disease.
- Understanding these patterns in diverse populations is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence and patterns of cardiac hypertrophy using ECG in Nigerian hypertensive patients.
- To compare hypertrophic findings between hypertensive patients with and without heart failure.
- To assess the relationship between blood pressure severity and hypertrophic changes.
Main Methods:
- Retrospective analysis of ECGs from 60 Nigerian hypertensive patients.
- Patients were divided into two groups: 30 with heart failure and 30 without (matched for age and sex).
- Analysis focused on identifying patterns of left ventricular hypertrophy (LVH), left atrial hypertrophy (LAH), and right atrial hypertrophy (RAH).
Main Results:
- Combined LVH and LAH was the most common finding (58.3%), followed by LVH alone (30%).
- Prevalence of combined LVH and LAH was significantly higher in the heart failure group (76.7%) compared to the non-heart failure group (40%) (P < 0.02).
- All patients with Class IV heart failure exhibited combined LVH and LAH; 3 of these also had RAH, with 2 deaths during follow-up.
Conclusions:
- Nigerian hypertensives exhibit marked cardiac hypertrophy, especially combined LVH and LAH, often presenting late with severe disease.
- These ECG-derived hypertrophic changes are more pronounced than reported in Caucasian and previous African cohorts.
- The findings underscore the severity of long-standing hypertension and late presentation in this population, necessitating earlier detection and intervention.
Abstract:
We studied hypertrophic patterns in the electrocardiograms of 60 Nigerian hypertensives. Thirty were in heart failure and 30 without failure (matched for age and sex). Combined left ventricular and left atrial hypertrophy was the commonest finding occurring in 58.3%, followed by left ventricular hypertrophy alone in 30%. 76.7% and 40% had combined left ventricular and left atrial hypertrophy in the heart failure and the non-heart failure groups, respectively (P less than 0.02). Though these changes increased with increased blood pressure, the latter is similarly severe in both groups. 100% of patients in Class IV failure had combined left ventricular and left atrial hypertrophy. The 3 patients who had additional right atrial hypertrophy were in Class IV failure, 2 of whom died during follow-up. These changes are much more marked at presentation than reprots in caucasians and even in previous reports in Africans. The changes reflect the long-standing nature and severity of the hypertensive process, and point to the fact that the majority of hypertensives in this environment present rather late.