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Biomedical subjects

A C Ikeme

Publications and source records attributed to A C Ikeme.

15 recordsLinked to original sources

Hypertension studies in developing countries.

Developing countries vary considerably with respect to the behaviour of the blood pressure among its populations. In many countries hypertension is the commonest cardiovascular disorder; but communities also exist within many of these countries that do not manifest hypertension. Some of the characteristics of such communities include primitive social structures and low dietary salt intake. Some special features of hypertension among African populations and persons of African descent may be related to fundamental differences in cellular handling of cations. Difficulties with hypertension control in developing countries are largely economic. The next decade should attempt to ascertain whether observed variations in hypertension prevalence might provide the key to the pathogenesis of high blood pressure and whether primary prevention might resolve the difficulties the developing world encounters in instituting hypertension control.

Cross-Sectional Studies

The Mamprobi Survey--a screening survey for cardiovascular disease and risk factors in Africa: methodology and validity.

The Mamprobi Survey is a cardiovascular disease prevalence sample survey in an African community in Ghana. This preliminary paper describes its methodology and validity. Response rate corrected for migration from the area was 73%. Subsequent sampling of non-respondents revealed only trivial reasons for non-attendance and only minor differences in health status, suggesting that estimates of disease prevalence by the survey were likely to be accurate.

Adolescent

Cardiovascular status and blood pressure in a population sample in Ghana--the Mamprobi survey.

In a medical survey of an urban population in Ghana, abnormal cardiovascular findings were present in 25% of the population aged from 15 to 64 years. This was largely due to hypertension and to cardiomegaly of obscure origin. The prevalence of valvular heart disease was comparatively low. Abnormal cardiovascular findings were commonest in the lowest third of the socio-economic stratum and next most frequent in the highest third. Abnormal findings were not related to smoking or drinking habits; these seem to be only marginally important in the population at present.

Adolescent

Socioeconomic scoring in an urban area of a developing country.

A group of variables that might define "life-style" was selected and a questionnaire based on these was distributed to the families of 2350 schoolchildren in Accra, Ghana to determine the presence or absence of these variables. Analysis of the replies revealed a set of answers that formed a related group. A scoring system was developed in which rarer attributes were weighted, and the community was thus graded by socioeconomic status on a ten-point scale. Principles for developing questionnaires applicable to other types of community were defined.

Child

Idiopathic cardiomegaly in Africa.

Idiopathic cardiomegaly is probably the commonest single diagnosis other than hypertension made in tropical and subtropical African cardiovascular practice. Understanding of the nature of this disease has been hampered by failure to recognize the possibility that the term "idiopathic cardiomegaly" may embrace several disease entities. Evidence suggests that many factors, sometimes acting singly, but often acting in combination, may be responsible for the genesis of so-called idiopathic myocardial failure. The future attitude to research should not be one of excluding well-defined forms from the concept of idiopathic cardiomegaly, but one of clinicopathological classification, which should be a prelude to the search, within each moiety of this group of disorders, for a specific or dominant etiological factor.

Adult

The significance of the enlargement of the aortic shadow in adult Nigerians.

A study of the width of the aortic shadow and of the cardiothoracic ratios in 183 chest radiographs, of persons over the age of 35 years, shows that hypertension produces a constant enlargment of the aortic shadow. The study suggests that gross enlargement, in the absence of disease of the aorta or of the aortic valves, is a result of hypertension. The authors suggest that this enlargement is valuable in delineating a sub-group of cases of myocardial failure in which the primary cause of failure may be hypertension. Cases with gross aortic arch dilation and no detectable cardiovascular disease often have cardiomegaly. The question of the possibility of remission of untreated hypertension is raised.

Adult

The sick-sinus syndrome in Africans.

Fifteen cases of the sick-sinus syndrome in young Negroes are presented. The etiology was unknown in all cases; organic heart disease was absent. The very high default rate suggests that the prognosis may be grave. This disorder is by no means uncommon in young persons in tropical countries and the dangers of a mistaken diagnosis of epilepsy or a psychiatric illness have been emphasized. In the absence of an artificial pacemaker, it is suggested that sympathomimetic drugs, while not affecting the heart rate, may be useful in reducing the frequency of syncopal attacks.

Adolescent

A survey for cardiovascular disease in middle-aged Ugandans.

A study of 412 persons aged at least 45 years showed that cardiovascular disease, especially hypertension, was common. Cardiac enlargement was the most frequent complication of hypertension; cerebrovascular accidents were rare. Cardiomegaly without hypertension or valvular disease was found in 29 persons. Valvular disease was present in 17 persons, but was symptomless in all but 3 cases.

Aged