Departments of Medicine, Bowen University, Iwo, Osun State.
Department of Medicine, Osun State University, Osogbo, State.
West Afr J Med. 2021 Mar 22;38(3):223-240.
Hypertension is the commonest cardiovascular risk factor globally and is a cause of untold morbidity and mortality. However, its clinical correlates at the community level have not been well elucidated.
History taking, anthropometric measurements, electrocardiograms and laboratory investigations were done for all the study subjects. Ethical approval was obtained from the institution's ethical body. Analysis was done using SPSS version 20. Two hundred people were recruited for the study. The prevalence of hypertension in the community was 58.5% with 31(15.5%) being newly diagnosed. The Body Mass Index [BMI] (28.2±6vs 25.6±5.3; P=0.003),Waist-Hip ratio (0.9±0.08 vs 0.86±0.06; p= 0.001), total cholesterol (5.675±1.8 vs 4.6±1.7, P=0.000), triglycerides (1.19±0.85 vs 0.91±0.59; p=0.019), LDL cholesterol (3.38±1.6 vs 2.66±1.5; p=0.002), heart rate (82.4±15.8 vs 76.8±11.2; p=0.018) QRS duration (84.8±13.4 vs 80.5±11.2; p=0.040), and QTc (0.423±0.041 vs 0.402±0.035; p=0.001) were higher in those with hypertension. NYHA functional class was worse in hypertensives (p=0.041). Prevalence of left ventricular hypertrophy (LVH) in hypertensives ranged from 2.6 to 48.2%, depending on the criteria used. Systolic blood pressure, pulse pressures, HDL levels and hip circumferences were higher in those with electrocardiographic LVH. Systolic blood pressure (OR:1.045, P=0.006; CI: 1.013-1.079) and a normal BMI (OR: 0.159, p= 0.004; CI: 0.045-0.559) were the independent predictors of LVH in this study.
The prevalence of hypertension is rising, even in rural populations, with accompanying LVH, higher QTc and florid cardiovascular risk factors. It is therefore imperative to tighten the reins of control of blood pressure and other cardiovascular risk factors before the cardiovascular morbidity and mortality explode in the rural communities.
高血压是全球最常见的心血管危险因素，也是造成大量发病率和死亡率的原因。然而，其在社区层面的临床相关性尚未得到充分阐明。
对所有研究对象进行病史询问、人体测量、心电图和实验室检查。本研究获得了机构伦理委员会的批准。使用 SPSS 版本 20 进行分析。这项研究共招募了 200 人。社区高血压患病率为 58.5%，其中 31 人（15.5%）为新诊断病例。身体质量指数（BMI）[28.2±6 比 25.6±5.3；P=0.003]、腰围-臀围比（0.9±0.08 比 0.86±0.06；p=0.001）、总胆固醇（5.675±1.8 比 4.6±1.7，P=0.000）、甘油三酯（1.19±0.85 比 0.91±0.59；p=0.019）、低密度脂蛋白胆固醇（3.38±1.6 比 2.66±1.5；p=0.002）、心率（82.4±15.8 比 76.8±11.2；p=0.018）、QRS 持续时间（84.8±13.4 比 80.5±11.2；p=0.040）和 QTc（0.423±0.041 比 0.402±0.035；p=0.001）在高血压患者中更高。高血压患者的纽约心脏协会（NYHA）功能分级更差（p=0.041）。高血压患者左心室肥厚（LVH）的患病率为 2.6%至 48.2%，具体取决于所使用的标准。心电图 LVH 的高血压患者的收缩压、脉压、高密度脂蛋白水平和臀围较高。收缩压（OR：1.045，P=0.006；CI：1.013-1.079）和正常 BMI（OR：0.159，p=0.004；CI：0.045-0.559）是本研究中 LVH 的独立预测因子。
即使在农村人群中，高血压的患病率也在上升，同时伴有 LVH、更高的 QTc 和明显的心血管危险因素。因此，在农村社区心血管发病率和死亡率飙升之前，必须加强血压和其他心血管危险因素的控制。
