Martin U. Nwankwo

Factors associated with hypertension in Nigerian civil servants

BACKGROUND Study of hypertension in segments of West African populations in transition toward Westernization may lead to better understanding of the high risk for hypertension among Westernized blacks. METHODS Five hundred fifty-nine urban civil servants, ages 25-54, were recruited from six ministries of Bendel State, Nigeria. Blood pressure, physical measurements, urinary protein and glucose, fasting blood glucose, and demographic data were collected at the workplace. Subjects were classified as senior staff (professionals or administrators) or junior staff (non-administrators). RESULTS Among 172 male senior staff, the age-adjusted rate of hypertension (diastolic blood pressure > or = 90 mm Hg, systolic blood pressure > or = 140 mm Hg, or on an antihypertensive medication) was 43% and occurrence rose dramatically from 21 to 63% across age groups 25-34 to 45-54, respectively. Among 266 male junior staff, the age-adjusted rate of hypertension was 23%, and occurrence did not rise with age. Logistic regression showed that body mass index (kg/m2), age, alcohol drinking, and being senior staff were all independently related to hypertension in men. On the other hand, the age-adjusted rate of hypertension in 121 women was 20% and was significantly related only to body mass index. CONCLUSION Male urban civil servants appeared to have a risk for hypertension similar to that of U.S. black males. Age, body mass index, alcohol drinking, and other unidentified factors related to higher socioeconomic status were strong determinants of hypertension in this population.

Respiratory syncytial virus infections in malnourished children

The prevalence of respiratory syncytial virus (RSV) infection among severely malnourished children was studied at the University of Benin Teaching Hospital, Benin City, Nigeria at a time when the infection was known to be prevalent in the community. Nasopharyngeal washings were obtained from subjects on admission and thereafter every 4 days until discharge. RSV was detected by ELISA technique. Of 20 well nourished children who served as controls, 11 were ELISA-positive for RSV (55%). Eight (16%) of the 51 patients who were malnourished were ELISA-positive, four of whom (8%) had nosocomial infection. Fever and rhinitis were the most common presenting features in the RSV-infected malnourished children. None of the children showed any clinical or radiological signs of lower respiratory tract infection. Malnourished children appear not to be at increased risk of RSV infection, and those who contract the infection usually do not manifest severe disease.

Assessment of cardiovascular risk factors in Nigerian students.

The present study assessed the prevalence of cardiovascular risk factors in 65 Nigerian medical students attending the University of Benin, Benin City, Nigeria. Their ages ranged from 17 to 28 years with a mean age for men of 20.9 years and for women of 18.8 years. Approximately 8% of the men and 0% of the women were current cigarette smokers, whereas alcohol use was observed in 14.6% of the men and in 0% of the women. The Nigerian men had significantly higher diastolic blood pressures than did American black and white men. Compared to American black men, the Nigerian men had considerably lower total cholesterol and triglyceride concentrations. The Nigerian women did not differ from American black women with respect to total cholesterol, but had significantly lower triglyceride concentrations.

Breast milk composition and bile salt-stimulated lipase in well-nourished and under-nourished Nigerian mothers.

Breast milk was analysed in 9 under-nourished Nigerian mothers and 23 well-nourished mothers who served as controls. Milk from the under-nourished mothers contained adequate amounts of lactose and total triglycerides, but had significantly lower bile salt-stimulated lipase activity (BSSL); their mean BSSL activity was only about 50% of the activity in milk from the control group. Total milk protein was also significantly lower than for the controls (1.45 vs. 1.09 g/dl, respectively;P<0.01). Our findings may have nutritional implications for breast-fed infants of under-nourished nursing mothers.

Serum retinol, carotenoids, vitamin E, and cholesterol in Nigerian women

An epidemiologic study was conducted to assess serum levels of retinol, carotenoids, vitamin E, and their associations with cholesterol in an indigenous African population. The study population consisted of 116 black Nigerian women representing a response rate of 74%. The ages ranged from 17–32 years with a mean age of 22.6 years. The beta-carotene, total carotenoids, alpha-tocopherol, and cholesterol levels for the Nigerian women were 3.93 μmol/L, 7.03 μmol/L, 18.78 μmol/L, and 4.01 mmol/L, respectively. The beta-carotene levels of the Nigerian women ranged from 1.2–13 times greater than the United States population, and the total carotenoid levels were 2.5 times greater in the Nigerians compared with the United States population. On the contrary, the cholesterol levels of the Nigerians ranged from 5%–24% lower than similarly aged United States populations. Significant positive associations were observed between cholesterol and the following: 1) beta-carotene (r = 0.31, P < 0.001): 2) total carotenoids (r = 0.43, P < 0.001); and alpha-tocopherol (r = 0.72, P < 0.001). The findings suggest that dietary intake may not be the key factor in the vitamin A-cholesterol relationship, because this relationship has been observed in populations with significantly lower vitamin A and higher saturated fat intake.

An epidemiological assessment of blood pressure determinants in an adolescent population of Nigerians

An epidemiological assessment of blood pressure determinants in a random sample of 254 Nigerian adolescents aged 6-17 years in Benin City, Nigeria, was conducted. None of the adolescents reported cigarette smoking. Only 2.6% of the males and 0% of the females were alcohol users. Socio-economic status of the children according to parental education revealed that approximately 23% of the mothers and 9.8% of the fathers received less than a secondary (high school) education. At the other end of the education spectrum, a college education was received by 64.1% and 30.8% of the fathers and mothers, respectively. Two percent of the females and 1.3% of the males either had systolic blood pressures of greater than or equal to 140 mmHg or diastolic blood pressures of greater than or equal to 90 mmHg. No significant blood pressure differences existed between the two sexes. Among the males, it was demonstrated that age, body mass index, and heart rate were significant independent predictors of systolic blood pressure, explaining 49% of the variance. Forty-seven per cent of systolic blood pressure variance was explained by age and heart rate, for females. It was interesting to note that age was the only independent predictor of diastolic blood pressure for both males and females after control for heart rate and body mass index.

The quality of milk in a 65 year-old nigerian woman

Abstract Breast milk quality in a 65 year-old postmenopausal Nigerian woman is compared to a control group of well-nourished Nigerian mothers. Successful relactation ensued 19 years after her last confinement. Three grand-children have been nursed successively over a 4-year period of continuous lactation. The lactose and triglyceride concentration; and the Bile salt-stimulated lipase (BSSL) activity in her breast milk were not significantly different from the control group. However, the total protein content was only 40% of the control group.