Spectrum of hypertensive heart disease in Nigerians: cross-sectional study of echocardiographic indices and their correlation with treadmill exercise capacity.
OBJECTIVE
The aims of this study were to provide cross-sectional data on echocardiography in Nigerians with normotension, essential hypertension and hypertensive heart failure, and to correlate the echocardiographic indices with treadmill functional capacity.


METHODS
M-mode and two-dimensional echocardiography and a Bruce protocol treadmill test were undertaken in Nigerians with essential hypertension (n = 22) and hypertensive heart failure (n = 12), and in matched healthy volunteers (n = 15).


RESULTS
A striking echocardiographic feature was the tendency to eccentric or asymmetric left ventricular hypertrophy in Nigerians. The septum to posterior wall ratios were 1.4 +/- 0.1 in the normotensives, 1.6 +/- 0.1 in the hypertensives and 1.5 +/- 0.1 in the heart failure group. There was a progressive increase in left ventricular mass index and a reduction in fractional fibre shortening in the hypertensive spectrum. Treadmill exercise capacity also showed a progressive fall from normotensives through hypertensives to the heart failure group. A significant positive correlation was found between fractional fibre shortening and treadmill time in the heart failure group.


CONCLUSIONS
In Nigerians with hypertensive heart disease, there was a striking tendency for eccentric (asymmetric) rather than concentric left ventricular hypertrophy. Systolic left ventricular contractility may be predictive of treadmill exercise capacity in hypertensives.
Department of Medicine, Faculty of Health Sciences, Awolowo University, Ile-Ife, Nigeria.
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Ajayi
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Akinwusi
D002303:Cardiac Output, Low / Q000209:etiology; D006332:Cardiomegaly / Q000150:complications / Q000000981:diagnostic imaging; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000502:physiology