Abiodun Olugbenga O, Anya Tina, Salau Ibrahim, Ogunsakin Olalekan, Adekanmbi Victor
Internal Medicine/Cardiology, Federal Medical Centre, Abuja, NGA.
Basic Biomedical Sciences (Pathology), Touro University College of Osteopathic Medicine (TouroCOM), New York, USA.
Cureus. 2025 Apr 11;17(4):e82060. doi: 10.7759/cureus.82060. eCollection 2025 Apr.
Objective There is a lack of studies on the phenotyping of hypertensive heart disease (HHD) that examine both left ventricular (LV) structure and function in patients with essential hypertension (HTN) in sub-Saharan Africa. In this study, we investigated the prevalence of HHD, its phenotypic characteristics, and associated cardiovascular (CV) comorbidities by analyzing both LV structure and function. This can significantly enhance the understanding of HHD in the Nigerian population. Methods This cross-sectional study involved 1,799 patients diagnosed with essential HTN, who were recruited from the Federal Medical Centre Abuja Hypertension Registry between 2016 and 2021. HHD was defined as the presence of abnormal LV geometry and/or LV diastolic dysfunction (LVDD), as assessed by echocardiography in accordance with the guidelines set by the American Society of Echocardiography and the European Association of CV Imaging. Abnormal LV geometry was characterized by either concentric remodeling, which is defined as a normal left ventricular mass index (LVMI) with a relative wall thickness (RWT) > 0.42, or left ventricular hypertrophy (LVH), which is indicated by an increased LVMI (> 95 g/m² in women and > 115 g/m² in men) with an RWT > 0.42. Patients with secondary HTN and those with HTN during pregnancy were excluded from the study. Results The mean age of the study participants was 55.3±13.0 years and the majority were female patients (55.9%). The prevalence of HHD, concentric LV remodeling, LVH, and LVDD was 90.8%, 38.2%, 47.4%, and 61.6%, respectively. After multivariate analysis, heart failure (adjusted odds ratio (OR): 9.71, confidence interval (CI) 6.20-15.23, p<0.001), stroke (OR: 1.59, CI 1.01-2.52, p=0.045), LVDD (OR: 2.01, CI 1.61-2.50, p<0.001), and female sex (OR: 1.47, CI 1.20-1.80, p<0.001) were independently and positively associated with LVH. Similarly, LVH (OR: 3.51, CI 2.53-4.87, p<0.001), diabetes mellitus (OR: 1.83, CI 1.37-2.44, p<0.001), concentric LV remodeling (OR: 2.18, CI 1.58-3.01, p<0.001), stroke (OR: 1.87, CI 1.06-3.32, p=0.032), and age ≥60 years (OR: 3.92, CI 3.09-4.96, p<0.001) were independently and positively associated with LVDD. Conclusion Our study showed a high prevalence of HHD with LVH and LVDD as common phenotypes in our hypertensive cohort. These findings suggest that the widespread use of echocardiography should be promoted to aid the early diagnosis of HHD.
在撒哈拉以南非洲地区，缺乏对原发性高血压（HTN）患者同时检查左心室（LV）结构和功能的高血压性心脏病（HHD）表型研究。在本研究中，我们通过分析LV结构和功能来调查HHD的患病率、其表型特征以及相关的心血管（CV）合并症。这可以显著增强对尼日利亚人群中HHD的理解。方法：这项横断面研究纳入了1799例诊断为原发性HTN的患者，这些患者于2016年至2021年从阿布贾联邦医疗中心高血压登记处招募。根据美国超声心动图学会和欧洲心血管成像协会制定的指南，通过超声心动图评估，将HHD定义为存在异常LV几何形状和/或LV舒张功能障碍（LVDD）。异常LV几何形状的特征为向心性重塑，定义为左心室质量指数（LVMI）正常但相对壁厚度（RWT）>0.42，或左心室肥厚（LVH），表现为LVMI增加（女性>95 g/m²，男性>115 g/m²）且RWT>0.42。继发性HTN患者和孕期HTN患者被排除在研究之外。结果：研究参与者的平均年龄为55.3±13.0岁，大多数为女性患者（55.9%）。HHD、向心性LV重塑、LVH和LVDD的患病率分别为90.8%、38.2%、47.4%和61.6%。多变量分析后，心力衰竭（调整优势比（OR）：9.71，置信区间（CI）6.20 - 15.23，p<0.001）、中风（OR：1.59，CI 1.01 - 2.52，p = 0.045）、LVDD（OR：2.01，CI 1.61 - 2.50，p<0.001）和女性性别（OR：1.47，CI 1.20 - 1.80，p<0.001）与LVH独立且呈正相关。同样，LVH（OR：3.51，CI 2.53 - 4.87，p<0.001）、糖尿病（OR：1.83，CI 1.37 - 2.44，p<0.001）、向心性LV重塑（OR：2.18，CI 1.58 - 3.01，p<0.001）、中风（OR：1.87，CI 1.06 - 3.32，p = 0.032）和年龄≥60岁（OR：3.92，CI 3.09 - 4.96，p<0.001）与LVDD独立且呈正相关。结论：我们的研究表明，在我们的高血压队列中，HHD患病率很高，LVH和LVDD是常见表型。这些发现表明应推广广泛使用超声心动图以辅助HHD的早期诊断。
