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Blood pressure control and left ventricular hypertrophy in hypertensive Nigerians

Babatunde L Salako1, Okechukwu S Ogah, Adewole A Adebiyi

  • 1Department of Medicine, Federal Medical Centre, PMB 3031 Sapon, Abeokuta, Ogun State, Nigeria.

Annals of African Medicine
|November 4, 2009
PubMed

Insights

Left ventricular hypertrophy (LVH) persists in treated hypertensive patients, even with controlled office blood pressure. This indicates ongoing cardiovascular risk despite therapy, highlighting the need for better monitoring beyond clinic readings.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Hypertension is a major cause of morbidity and mortality, often leading to end-organ damage.
  • Left ventricular hypertrophy (LVH) is a significant risk factor for adverse outcomes in hypertensive and general populations.
  • Investigating LVH prevalence in treated hypertensive patients in Nigeria.

Purpose of the Study:

  • To determine the prevalence and pattern of left ventricular hypertrophy (LVH) in treated hypertensive patients.
  • To compare LVH in controlled and uncontrolled hypertensive groups against normotensive controls.
  • To assess the effectiveness of clinic blood pressure measurements in reflecting cardiac structural changes.

Main Methods:

  • Prospective observational study at University College Hospital, Ibadan, Nigeria.
  • Collected blood pressure measurements over 6 visits for systolic (SBP) and diastolic (DBP) values.
  • Utilized echocardiograms to measure left ventricular mass (LVM) indexed to body surface area (BSA) and height.

Main Results:

  • LVH prevalence varied based on indexing method: 18.2% (normotensive), 20.8% (uncontrolled), 24.1% (controlled) when indexed to BSA.
  • When indexed to height, LVH was found in 0% (normotensive), 22.4% (uncontrolled), and 24.1% (controlled) of subjects.
  • A significant difference in LVH prevalence was observed only when left ventricular mass was indexed to height.

Conclusions:

  • Clinic blood pressure measurements are insufficient for accurately assessing blood pressure control.
  • Cardiac structural changes like LVH can persist in hypertensive patients despite apparent control via office readings.
  • Patients with seemingly controlled hypertension remain at risk for cardiovascular events.
Abstract

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