Pattern of left ventricular geometry in Nigerians with prehypertension

Abstract

Background: The previous studies in Western countries have suggested that subjects with prehypertension have a higher risk of developing cardiovascular disease and mortality, increased left ventricular mass (LVM), and abnormal LV geometry, than those with normal blood pressure (BP). The aim of this study was to determine the pattern of LV geometry in Nigerian prehypertensives and compared with those of hypertensives and normotensives. Methods: This was a cross-sectional comparative study conducted at Aminu Kano Teaching Hospital, Kano, Nigeria. Clinical evaluation and full echocardiographic examination were performed among selected patients with normal BP (group 1), prehypertension (group 2), and hypertension (group 3). Results: A total of 300 subjects were studied, 100 in each group. The mean age of subjects in group 1 was 27.86 ± 8.60 years, and 60% were female, while that of group 2 was 34.04 ± 6.25 years, and 53% were female, and that for group 3 was 52.62 ± 11.8 years, and 56% were female. About 86% of group 1 had normal geometry (NG) while 12% had concentric LV remodeling concentric remodeling (CR) and 2% had eccentric hypertrophy (EH). Among subjects in group 2, NG was found in 72%, CR in 14%, EH in 12% and concentric hypertrophy (CH), in 2%. In group 3, NG was found in only 21% while 13% of them had CR, 28% CH, and 38% had EH. There was a progressive increase in LVM index from normal BP (30.13 ± 8.53 g/Ht2.7) to prehypertension (33.26 ± 8.95 g/Ht2.7) and to hypertension (48.41 ± 12.4 g/Ht2.7) (P = 0.001). Conclusion: This study has shown a higher prevalence of abnormal LV geometric patterns and higher LVM among subjects with prehypertension compared with normotensives. Such findings could carry prognostic implication and require further population survey involving a larger group.