Left ventricular geometric patterns in newly presenting nigerian hypertensives: An echocardiographic study

Abstract

BackgroundHypertension is a global problem and it is prevalent in Nigeria. Left ventricular hypertrophy is a major complication of hypertension with risk of sudden death and arrhythmias among others. Abnormal left ventricular geometric patterns also increase the burden of morbidity and mortality. It is therefore important to know the different left ventricular geometric patterns in Nigerian hypertensives because of their prognostic significance.MethodsOne hundred (100) newly presenting hypertensives (53 males and 47 females) and 100 controls (53 males and 47 females) were recruited for the study. All were subjected to clinical evaluation and full echocardiographic examination was performed according to the ASE recommendation. The relative wall thickness and the presence or absence of echocardiographic left ventricular hypertrophy were used to determine the various geometric patternsResultsThe mean age of the hypertensive subjects was 56.06 (± 7.68) years while that of the control subjects was 56.10 (± 7.68) years. There was no significant difference in the mean ages of the two groups. In the hypertensive subjects 28% had normal geometry, 26% had concentric remodeling, 28% had concentric hypertrophy and 18% had eccentric hypertrophy. In the control group, 86% had normal geometry, 11% had concentric remodeling, 3% had eccentric hypertrophy and none had concentric hypertrophy. There was statistical significance when the geometric patterns of the hypertensive and controls were compared (χ2 = 74.30, p value < 0.0001).ConclusionThe study showed that only 28% of the hypertensive subjects had normal LV geometric pattern while 86% of the normal subjects had normal geometry. There is need for longitudinal studies in order to prognosticate the various geometric patterns.

Assessment of left ventricular geometrical patterns and function among hypertensive patients at a tertiary hospital, Northern Tanzania

“…In this study abnormal LV geometry was detected in 70% of patients while Aje [11] found 72% of newly diagnosed hypertensive patients to have abnormal LV geometry. Akintunde [12] found abnormal LV geometry in 72% of treated hypertensive patients.…”

“…In this study, the distribution of different abnormal LV geometrical patterns was 19.8%, 28.2%, 22% for concentric remodeling, concentric hypertrophy and eccentric hypertrophy respectively. Aje [11] found the distribution of abnormal LV geometry to be 26%, 28% and 18% for concentric remodeling, concentric hypertrophy and eccentric hypertrophy respectively, while Akintunde [12] found the distribution to be 60.1%, 5.3% and 6.9% for concentric remodeling, eccentric hypertrophy and concentric hypertrophy respectively. The variation can partly be explained by difference in echocardiographic cut-off values for defining LVH and intrinsic population characteristics of a given geographical location.…”

Hypertensive heart disease in Africa

“…In Africa, a study of 100 newly diagnosed hypertensives by Aje, et al (20) showed that 72% of the patients had abnormal geometric patterns (concentric hypertrophy-28%, concentric remodelling-26%, eccentric hypertrophy-18%). Ogah, et al (21) in another study in Ibadan, Nigeria found that eccentric hypertrophy was the commonest geometric pattern in hypertensives with ECG LVH with strain.…”

Aortic elasticity, left ventricular geometry and diastolic dysfunction in hypertension

“…Left ventricular (LV) hypertrophy or an increase in the LV mass is a well recognised major complication of systemic hypertension and another important predictor of cardiovascular morbidity and mortality (5,6). In addition, a reduction in the LV mass by antihypertensive treatment reduces the risk for subsequent cardiovascular events.…”