PubMed Health⌕ Search

Biomedical subjects

C O Ajuyah

Publications and source records attributed to C O Ajuyah.

3 recordsLinked to original sources

How common is heart failure due to systemic hypertension alone in hospitalised Nigerians?

Hypertension is regarded as the most common cause of heart failure in Nigeria and other Black African countries. A few reports suggest that heart failure due to hypertension hardly occurs without the presence of an extra burden on the heart from the presence of other cardiac risk factors. This study assesses the occurrence of other potential causes of heart failure in 55 consecutive admitted cases of hypertensive heart failure. All but six cases (88%) were associated with the presence of one or other significant cardiac risk factors while 56.2% were associated with multiple heart failure risk factors. Five of the six were poor drug compliers. Of the six, only one was completely free of cardiac risk factors and he was unaware of his hypertension and so had never had therapy. The others either consumed alcohol moderately, had mild renal impairment or were grossly obese. The factors found were anaemia, renal dysfunction, abnormal glucose tolerance, alcoholic ingestion and co-existing valvular heart disease. The finding shows that among Nigerian patients hospitalised for hypertensive heart failure, heart failure was rare in those hypertensive patients who had no extra cardiac burden, and therefore control of these factors will help prevent the development of heart failure in hypertension with its dismal prognosis.

Heart Failure↗

Heart failure in Nigerian hypertensive patients: the role of renal dysfunction.

Heart failure in hypertensive patients is known to be dependent not only on the absolute value of blood pressure but also on other factors, hence the prognosis varies. In this study, the effect of renal dysfunction on the development of heart failure in hypertensive patients was assessed. Fifty-five patients who were admitted in hypertensive heart failure (HHF) were compared with 55 hypertensive patients who had never been in heart failure (HT), in their renal function, assessed by serum creatinine and urea levels. The haemoglobin (Hb) and serum albumin (Alb) levels were also measured. The two groups were matched for age, sex, level of blood pressure and body mass index. The duration of hypertension was similar in both groups. Mean serum creatinine was higher in the HHF group: 4.50 +/- 0.90 vs. 0.97 +/- 0.06 mg/100ml (P < 0.001). Also the Hb and Alb levels were lower in the HHF than the HT group: 11.63 +/- 0.40 vs. 13.2 +/- 0.21 g/100 ml (P < 0.001) and 3.7 +/- 0.1 vs. 4.40 +/- 0.09 g/100 ml (P < 0.001), respectively. The proportion with abnormal renal function (creatinine > 1.5 mg%) was also significantly higher in HHF: 28/55 vs. 8/54, chi 2 = 16.3 (P < 0.001). When adjustment was made for low serum albumin, Hb and fundal changes by multivariate analysis, serum creatinine was significantly higher in the HHF group: F = 4.294 (P < 0.05). Low serum albumin was also independent of haemoglobin and creatinine: F = 19.52 (P < 0.001), but Hb was not significantly different after adjustment for Alb and creatinine. This study suggests that renal dysfunction is independently associated with the development of heart failure in HT patients.

Analysis of Variance↗

Prosthetic valve dysfunction in a Nigerian.

A case is presented of a mechanical cardiac valve dysfunction occurring in a 19-year-old Nigerian 7 years after valve surgery and presenting with cardiac failure, supraventricular tachycardia and later, cardiogenic shock but initially masquerading as generalised bleeding probably from Warfarin-drug interaction. The problem of management of an artificial heart valve in our setting is discussed.

Adult↗