title: Left Ventricular Systolic Dysfunction in Asymptomatic Black Hypertensive Subjects.
abstract: BACKGROUND
  Hypertension has been established as one of the commonest causes of heart failure especially in sub-Saharan Africa. We have previously observed a high prevalence of left ventricular (LV) systolic dysfunction in hypertensive heart failure patients in Nigeria despite a low prevalence of ischemic heart disease. The present study was, therefore, undertaken to assess the prevalence of asymptomatic LV systolic dysfunction in hypertensive black African subjects with no history of heart failure.
  
  
  METHODS
  One thousand nine hundred forty-seven hypertensive subjects without heart failure presenting to the Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Nigeria, from April 2006 to August 2013 had clinical and echocardiographic evaluation.
  
  
  RESULTS
  Nine hundred fifty-three (48.9%) were males and 994 (51.1%) were females. One thousand eight hundred seventeen (93.3%) had normal LV systolic function (LV ejection fraction (LVEF) ≥ 54%), 68 (3.5%) had mild LV systolic dysfunction (LVEF 45-54%), 43 (2.3%) had moderate LV systolic dysfunction (LVEF 30-44%), and 16 (0.9%) had severe LV systolic dysfunction (LVEF < 30%). Male subjects had worse LV systolic function compared to women (mean LVEF 73.2% vs. 75.6%, P value < 0.0001) and diabetic subjects had worse LV systolic function compared to nondiabetic subjects (LVEF 72.3% vs. 75.7%, P = 0.02). In multivariate regression analysis, lower LVEF as a continuous variable was associated with older age, male sex, diabetes mellitus, LV mass indexed for body surface area, diastolic blood pressure, posterior wall thickness in diastole, left atrial diameter, and LV internal diameter in diastole.
  
  
  CONCLUSIONS
  In a cohort of asymptomatic Black hypertensive subjects, 6.7% had LV systolic dysfunction, which was associated with male gender, diabetes mellitus, and larger LV mass.
authors.affiliation: Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria; dikeojjki@yahoo.co.uk.
authors.forename: Dike
authors.initials: D
authors.lastname: Ojji
authors.affiliation: Department of Cardiology, Royal Brisbane and Women Hospital, University of Queensland School of Medicine, Brisbane, Queensland, Australia;
authors.forename: John
authors.initials: J
authors.lastname: Atherton
authors.affiliation: Faculty of Medicine, Hatter Institute of Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa
authors.affiliation: Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria;
authors.forename: Jacob
authors.initials: J
authors.lastname: Alfa
authors.affiliation: Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria;
authors.forename: Murtala
authors.initials: M
authors.lastname: Ngabea
authors.affiliation: Faculty of Medicine, Hatter Institute of Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
authors.forename: Lionel
authors.initials: L
authors.lastname: Opie
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D044383:Black People; D001794:Blood Pressure; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: blood pressure; hypertension; left ventricular; systolic dysfunction.