Journal Article

Left Ventricular Systolic Dysfunction in Asymptomatic Black Hypertensive Subjects

Dike Ojji, John Atherton, Karen Sliwa, Jacob Alfa, Murtala Ngabea and Lionel Opie

in American Journal of Hypertension

Volume 28, issue 7, pages 924-929
Published in print July 2015 | ISSN: 0895-7061
Published online January 2015 | e-ISSN: 1941-7225 | DOI: http://dx.doi.org/10.1093/ajh/hpu247
Left Ventricular Systolic Dysfunction in Asymptomatic Black Hypertensive Subjects

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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.

Keywords: blood pressure; hypertension; left ventricular; systolic dysfunction.

Journal Article.  3958 words. 

Subjects: Cardiovascular Medicine ; Biological Sciences

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