Unexpectedly high prevalence of target-organ damage in newly diagnosed Nigerians with hypertension.
BACKGROUND
Hypertension remains a formidable cardiovascular problem in the entire world. Untreated or poorly controlled hypertension predisposes to target-organ damage and is often followed by serious cardiovascular events. Knowledge of the type and distribution of endorgan damage in newly diagnosed hypertensive patients would help to determine the interventions or preventative measures needed in such patients.


OBJECTIVE
To assess target-organ involvement in newly diagnosed, untreated hypertensive patients presenting at the University College Hospital, Ibadan, Nigeria.


METHODS
Newly diagnosed hypertensive men and women were recruited consecutively into the study. Target-organ damage was assessed using electroctrocardiography, echocardiography, renal function assessment (including tests for albuminuria) and fundoscopy.


RESULTS
A total of 68 subjects were recruited, but only 54 (79.4%), with a mean age of 59.1 ( +/- 12.4) years, completed the study. There were 29 ( +/- 53.7%) men, mean age 63.5 ( +/- 12.6) years, and 25 (46.3%) women, mean age 54.1 ( +/- 10.4) years. Fifty per cent of the subjects had no symptoms. Some form of albuminuria was found in about 40.7%. Seventy-one per cent (71%) had between grade 1 and 2 hypertensive retinopathy. Only six (11.1%) had glomerular filtration rate greater than 90 ml/min. Systolic function was impaired in three (5.6%) of the subjects. Diastolic dysfunction was present in 36 (66.7%) subjects.


CONCLUSIONS
Target-organ damage already exists in newly diagnosed hypertensive subjects before presentation. We suggest early screening for cardiovascular risk factors and possibly a reduction in the criteria for the definition of hypertension in black Africans.
Salako
B L
BL
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Ogah
O S
OS
Adebiyi
A A
AA
Adedapo
K S
KS
Bekibele
C O
CO
Oluleye
T S
TS
Okpechi
Ikechi
I
D000368:Aged; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012044:Regression Analysis; D018754:Ventricular Dysfunction / Q000209:etiology