Risk factors for heart failure in adult Nigerians

Heart failure (HF) is a lethal disorder most common in blacks. Available treatment options have little impact on prognosis, making primary prevention a priority. We aimed to describe the spectrum of established HF risk factors and clinical features in Nigerian adults.

We recruited consecutive adults with HF diagnosed using the Framingham criteria in a Teaching Hospital, and recorded clinical findings with a structured form. Blood was drawn for haematocrit, erythrocyte sedimentation rate (ESR) and serum cholesterol.

102 subjects were studied. Common HF risk factors were hypertension 45 (44%), obesity 26 (25%), alcohol intake 25 (24%) and hypercholesterolaemia 22 (21%). Both tachycardia (OR 5.5, 95%CI 1.7-14.9) and S3 gallop (OR 4.05, 95%CI 1.53-10.76) were significantly related with NYHA class IV HF. BMI was strongly related with total serum cholesterol (r = 0.70, P < 0.001). Low ESR (< 5 mm/h) was protective of NYHA class IV HF (OR 0.40, 95%CI 0.16-0.88).

Hypertension, obesity, alcohol intake and hypercholesterolaemia were common in blacks with HF. Both S3 gallop and high ESR indicated more severe HF.