In African patients, AHF has a predominantly nonischemic cause, most commonly hypertension. The condition occurs in middle-aged adults, equally in men and women, and is associated with high mortality. The outcome is similar to that observed in non-African AHF registries, suggesting that AHF has a dire prognosis globally, regardless of the cause.

To review studies on hypertension in Nigeria over the past five decades in terms of prevalence, awareness and treatment and complications. Following our search on Pubmed, African Journals Online and the World Health Organization Global cardiovascular infobase, 1060 related references were identified out of which 43 were found to be relevant for this review. The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population, type of measurement and cut-off value used for defining hypertension. The prevalence is similar in men and women (7.9%-50.2% vs 3.5%-68.8%, respectively) and in the urban (8.1%-42.0%) and rural setting (13.5%-46.4%). The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5% (2000-2011). Awareness, treatment and control of hypertension were generally low with attendant high burden of hypertension related complications. In order to improve outcomes of cardiovascular disease in Africans, public health education to improve awareness of hypertension is required. Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.

BackgroundObesity is a major health problem, and there is an increasing trend of overweight and obese individuals in developing countries. Being overweight or obese is known to contribute significantly to morbidity and mortality rates in various countries around the world. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in Nigeria.MethodA systematic review of papers published on the prevalence of obesity among adults in the country was carried out. We covered work published in MEDLINE, PubMed, Google, and African Journals Online using the terms “prevalence of overweight and obesity in Nigeria” or “overweight and obesity in Nigeria.” In addition, personal inquiries were made. The search limits were articles published from January 2001 to September 2012. Only studies that used the body mass index to assess for overweight and obesity were included.ResultsFour studies met the inclusion criteria out of the 75 studies reviewed. In Nigeria, the prevalence of overweight individuals ranged from 20.3%–35.1%, while the prevalence of obesity ranged from 8.1%–22.2%.ConclusionThe prevalence of overweight and obese individuals in Nigeria is of epidemic proportions. There is a need to pay closer attention to combating these health disorders.

This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.

Proactive public health interventions at a population level need to be introduced to control the growing hypertension epidemic, and there needs to be a major improvement in access to hypertensive care for the individual. There is an important need for better epidemiological data and hypertension related outcome trials in SSA.

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BackgroundDeveloping countries of sub-Saharan Africa (SSA) face a double burden of non-communicable diseases (NCDs) and communicable diseases. As high blood pressure (BP) is a common global cardiovascular (CV) disorder associated with high morbidity and mortality, the relationship between gradients of BP and other CV risk factors was assessed in Abia State, Nigeria.MethodsUsing the WHO STEPwise approach to surveillance of chronic disease risk factors, we conducted a population-based cross-sectional survey in Abia state, Nigeria from August 2011 to March 2012. Data collected at various steps included: demographic and behavioral risk factors (Step 1); BP and anthropometric measurements (Step 2), and fasting blood cholesterol and glucose (Step 3).ResultsOf the 2983 subjects with complete data for analysis, 52.1% were females and 53.2% were rural dwellers. Overall, the distribution of selected CV disease risk factors was diabetes (3.6%), hypertension (31.4%), cigarette smoking (13.3%), use of smokeless tobacco (4.8%), physical inactivity (64.2%) and being overweight or obese (33.7%). Presence of hypertension, excessive intake of alcohol, smoking (cigarette and smokeless tobacco) and physical inactivity occurred more frequently in males than in females (p<0.05); while low income, lack of any formal education and use of smokeless tobacco were seen more frequently in rural dwellers than in those living in urban areas (p<0.05). The frequency of selected CV risk factors increased as BP was graded from optimal, normal to hypertension; and high BP correlated with age, gender, smokeless tobacco, overweight or obesity, annual income and level of education.ConclusionGiven the high prevalence of hypertension in this part of Nigeria, there is an urgent need to focus on the reduction of preventable CV risk factors we have observed to be associated with hypertension, in order to effectively reduce the burden of NCDs in Africa.

Abstract-Black Africans have a higher incidence of cardiovascular disease than white Europeans. We explored potential mechanisms of this excess risk by assessing endothelium function, inflammatory status (C-reactive protein), oxidative stress (isoprostane-F2␣), and plasma asymmetrical dimethyl arginine (ADMA; an endogenous competitive inhibitor of NO synthase) in each ethnic group. 1 This in part may be explained by an increased prevalence and severity in blacks of some risk factors for atherosclerosis. In particular, in black subjects, essential hypertension has a higher prevalence, earlier onset, and is associated with more severe end-organ damage, including left ventricular hypertrophy, renal failure, and stroke. 1 However, conventional risk factors for cardiovascular disease do not account for all of this increased risk. A recent study demonstrated that black ethnicity is a strong and independent risk factor for the development of peripheral arterial disease, which was not explained by higher levels of diabetes, hypertension, or body mass index. 2 The mechanisms underlying this ethnic predisposition to cardiovascular dysregulation remain unresolved.A number of studies have demonstrated that black subjects have endothelial dysfunction, 3-5 a key step in the initiation/ progression of atherosclerotic vascular disease. A hallmark of endothelial cell dysfunction is a reduction in the bioavailability of the antiatherosclerotic signaling molecule NO. 6 Longitudinal studies have demonstrated that a reduction in NO bioavailability is a predictor of accelerated atherosclerosis. 7,8 NO is generated by a family of NO synthases from L-arginine in a reaction that requires oxygen, reduced nicotinamideadenine dinucleotide phosphate, and essential cofactors, including tetrahydrobiopterin. NO bioavailability is principally determined by a reduction in its biosynthesis and/or inactivation by reactive oxygen species. Asymmetric dimethylargi-