Oladimeji George Opadijo

Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria

Background: Metabolic syndrome (MetS) is an important cause of morbidity and mortality. Nigeria is currently undergoing rapid epidemiological transition. The objective was to study whether urbanization is associated with increased prevalence of MetS between native rural Abuja settlers and genetically related urban dwellers. Materials and Methods: It was a cross-sectional study. Three hundred and forty-two urban native Abuja settlers and 325 rural dwellers were used for the study. Fasting blood lipid, glucose, waist circumference, blood pressure, and body mass index were determined. MetS was defined according to three standard criteria. SPSS 16.0 was used for statistical analysis. P<0.05 was used as statistically significant. Results: Obesity, hypertriglyceridemia, and hypertension were commoner among urban dwellers than rural dwellers. MetS was associated more with the female gender. Urbanization significantly increases the frequency of MetS using the three standard definitions. The prevalence of MetS using International Diabetes Federation, World Health Organization, and National Cholesterol Education Program Adult Treatment Panel III among rural versus urban dwellers were 7.7% vs. 14.9%, P<0.05; 0% vs. 0.9%, P>0.05; and 3.7% vs. 13.7%, P<0.05, respectively. Conclusion: This study shows that MetS is a major health condition among rural and urban Nigerians and that urbanization significantly increases the prevalence of MetS. This can be explained on the basis of higher prevalence of dyslipidemia, obesity, and hypertension in urban setting, possibly as a result of stress, diet, and reduction in physical activity. Effective preventive strategy is therefore required to stem the increased risk associated with urbanization to reduce the cardiovascular risk associated with MetS among Nigerians.

Prevalence of traditional cardiovascular risk factors among staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria

AIM The aim was to describe the frequency of occurrence of traditional cardiovascular (CV) risk factors among selected university workers in Ladoke Akintola University of Technology (LAUTECH) Nigeria. MATERIALS AND METHODS A cross-sectional study of 206 staff of LAUTECH, Ogbomoso, Nigeria had an assessment for nine traditional CV risk factors. Demographic and clinical parameters were taken. Blood sample was taken to determine the random blood sugar and lipid profile. 12-lead resting electrocardiography (ECG) was done for all participants. Statistical analysis was performed with the aid of Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago Ill., USA) Results: The study population included 96 males (46.6%) and 110 females. The mean age was 45.3 ± 7.9 years (range 27-73 years). The prevalence of CV risk factors were as follows: Hypertension 84 (40.8%), visceral obesity 92 (44.7%), generalized obesity 79 (38.3%), low high density lipoprotein 113 (54.9%), impaired blood glucose 16 (7.8%), diabetes mellitus 3 (1.5%), hypercholesterolemia 102 (49.5%), left ventricular hypertrophy-ECG 24 (11.7%), elevated low density lipoprotein-cholesterol 99 (48.1%). About - (72.3%) had two or more CV risk factors clustered together. Females had a higher prevalence of CV risk factors and its clusters than their male counterparts. Of those diagnosed with hypertension in this study, more than half had never been told they were hypertensive 48 (57.1%). CONCLUSION This study suggests a very high prevalence of CV risk factors among University Staff in LAUTECH, Ogbomoso, Nigeria. Clustering of CV risk factors is more prevalent among women. Appropriate preventive strategy in terms of education and modification of risk factors are important to reduce the burden of CV diseases among this population.

QT Interval prolongation and dispersion: Epidemiology and clinical correlates in subjects with newly diagnosed systemic hypertension in Nigeria

Background: The use of easily obtainable clinical and laboratory parameters to identify hypertensive patients with increased cardiovascular risk in resource limited settings cannot be overemphasized. Prolongation of QT intervals and increased dispersion has been associated with increased risk of cardiovascular death. The study aimed at describing the epidemiology of QT interval abnormalities among newly diagnosed hypertensive subjects and associated clinical correlates. Materials and Methods: One hundred and forty newly diagnosed hypertensive subjects and 70 controls were used for this study. Clinical and sociodemographic characteristics were obtained. Twelve lead resting electrocardiography, QT dispersion, heart rate corrected minimum and maximum QT intervals were determined manually. Increased QTcmax was defined at QTcmax >440msec. QT parameters were compared between various groups. SPSS 16.0 was used for data analysis. Results: The hypertensive subjects were well matched in age and gender distribution with controls. QTmax and QTcmax were significantly higher among hypertensive subjects than controls (379.7±45.1 vs. 356.7±35.6, 447.5± 49.0 vs. 414.5 ±34.7 ms, respectively, P<0.05). QTd and QTcd were also significantly higher among hypertensive subjects than controls (62.64±25.65 vs. 46.1±17.2, 73.8 ±30.0 vs. 52.5±18.8, respectively, P<0.05). Seventy three (52.14%) of the hypertensive subjects had QTcmax >440ms compared to 21.43% of controls, P=0.01. Increased QTc dispersion was present in 36.4% of hypertensive subjects. Hypertensive subjects with QT abnormalities had significantly higher mean waist hip ratio, mean body mass index and a higher proportion of smoking than controls. Conclusion: QT prolongation and increased QTc dispersion are common among newly diagnosed hypertensive Nigerians and seem to be significantly associated with obesity. Effective antihypertensive therapy and control of obesity are important management modality for newly diagnosed hypertensive patients.

Male erectile dysfunction and microalbuminuria in adult nigerians with essential hypertension

Background: Microalbuminuria has been described as a marker of generalized vascular damage. Aims: The aim of the present study was to determine the prevalence of erectile dysfunction (ED) and microalbuminuria in adult male Nigerians with newly diagnosed hypertension. We also evaluated the relations between ED and microalbuminuria, electrocardiographic left ventricular hypertrophy, serum lipids, and cigarette smoking. Materials and Methods: A total of 81 male adult Nigerians with newly diagnosed hypertension were recruited into the study. There were also 75 age- and sex-matched healthy normotensive controls. ED was evaluated using a standardized questionnaire of the International Index of Erectile Function and microalbuminuria was determined using the Micra Test strips (Boehringer Manneheim GMBh, Mannheim, Germany). Results: Eighty-one hypertensive patients and 75 normotensive controls were studied. Mean age of the patients and the controls was 53.8 ± 5.6 and 51.2 ± 7.1 respectively. ED was found in 32.1% of the hypertensive patients and 16% of normotensive controls (P < 0.001). The prevalence of microalbuminuria was significantly higher in patients with ED than in those without it (65.4% vs. 23.6%, P < 0.0001). Conclusion: The study shows that ED and microalbuminuria are common in male adult Nigerians with hypertension. It also demonstrates that male ED is associated with an increased risk of cardiovascular disease.

Knowledge of heart disease risk factors among workers in a Nigerian University: A call for concern

Introduction: Cardiovascular disease is the commonest cause of mortality worldwide. Many risk factors predate the development of cardiovascular diseases. Adequate knowledge of risk factors for cardiovascular diseases is the first step towards effective preventive strategies to combat the cardiovascular diseases burden in any population. This study aims to determine the knowledge of workers in a Nigerian University on risk factors for cardiovascular diseases. Materials and Methods: A cross-sectional survey of 206 academic and non-academic staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria using the Heart Disease Fact Questionnaire (HDFQ). Demographic data were taken. The lipid profile and random blood sugar were taken. Statistical analysis was done using SPSS 17.0. Results: The mean age of the study participants was 45.3 ΁ 7.9 years. There were 96 males (46.6%). The mean HDFQ score was 48.6%. Only 41 (19.9%) of participants were assessed to have good knowledge of heart disease risk factors. Majority, 101 (49.0%) had poor knowledge while 64 (31.2%) had fair knowledge of heart disease risk factors. There was no significant difference between prevalence of CV risk factors between those with good or fair or low level of knowledge. Most participants did not have a good level of knowledge about risk factors, prevention, treatment and association with diabetes as it relates to heart diseases. Conclusion: Knowledge of heart disease risk factors is low among University workers in Nigeria. Effective education on heart disease risk factors and appropriate preventive strategies are indeed important to reduce cardiovascular disease burden in Nigerian University communities.

Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors.

Background: Snoring remains under diagnosed in general population. It however has significant morbidity and mortality risk factors with multiple effects on the cardiovascular system. The Berlin questionnaire is a worldwide validated instrument to identify those at increased risk for obstructive sleep apnoea (OSA). Materials and Methods: In all, 206 workers of LAUTECH were invited to participate in the study. The Berlin questionnaire was used for this study. It was a cross-sectional study. Socio-demographic and clinical data were taken with a data form. Statistical Package for the Social Sciences software (SPSS 17.0) was used for statistical analysis. P < 0.05 was taken as statistically significant value. Results: The study participants consisted of 96 males (46.6%) and 110 (53.4%) females. The mean age was 45.3 ± 7.9 years. The mean body mass index was 28.5 ± 6.0 kg/m². The frequency of occurrence of snoring was 91 (44.2%) including 50 males (54.9% and 41 females (37.3 %, P <0.05). Using the Berlin score, 63 (30.6%) including 34 females (30.9%) were assessed to be at high risk for OSA. Snorers were more likely to be at higher risk of OSA compared to non snorers: odd risk was 113.8, relative risk was 3.3. Snoring was most likely to be associated with obesity, elevated blood pressure and male gender in this study. Conclusion: We concluded that snoring and high risk for sleep apnoea is common among this unselected University population and they are closely related to many conventional cardiovascular risk factors. Appropriate interventional strategies are indicated to reduce the burden of the increased morbidity and mortality associated with sleep apnoea in our population.

Clustering of Metabolic Syndrome and Obstructive Sleep Apnoea - Syndrome Z among Adult Nigerians with Systemic Hypertension: Prevalence and Clinical Correlates

Clustering of Metabolic Syndrome and Obstructive Sleep Apnoea - Syndrome Z among Adult Nigerians with Systemic Hypertension: Prevalence and Clinical Correlates Obstructive sleep apnoea (OSA) syndrome and metabolic syndrome are independent cardiovascular risk factors. Syndrome Z is the clustering of metabolic syndrome and obstructive sleep apnoea. Syndrome Z is associated with a higher cardiovascular risk profile compared to those without it.

Carotid atherosclerosis and right ventricular diastolic dysfunction in a sample of hypertensive Nigerian patients

Aim To determine the association of carotid atherosclerosis and right ventricular diastolic dysfunction (DD) among treated hypertensive Nigerian patients. Methods This was a single center cross-sectional study performed at the Cardiology Clinic of LAUTECH Teaching Hospital, Ogbomoso, Nigeria between January and December 2012. The study included 122 hypertensive Nigerians (mean age, 57.3 ± 14.7 years, 36.9% women). Patients’ clinical, demographic, and echocardiographic parameters were obtained. Diastolic dysfunction was assessed with the trans-tricuspid Doppler flow. Results Patients with DD were significantly older than those with normal diastolic function. Mean and maximum carotid intima media thickness measurements were significantly higher among patients with right ventricular DD than in those with normal diastolic function. Mean systolic blood pressure (148.3 ± 31.9 vs 128.0 ± 2.8 mm Hg, P = 0.049) and interventricular septal thickness in diastole (12.8 ± 2.3 vs 11.6 ± 2.8mm, P = 0.048) were significantly higher and tricuspid annular pulmonary systolic excursion (33.6 ± 4.9 vs 23.0 ± 4.2 mm, P = 0.035) was significantly lower in patients with right ventricular DD than in those with normal diastolic function. Carotid intima media thickness measurements were correlated with early trans-tricuspid Doppler flow and early transtricuspid diastolic flow/late right atrial transtricupsid diastolic flow ratio. Conclusion Right ventricular DD in hypertensive patients was significantly correlated with increased carotid atherosclerosis. Carotid intima media thickness measurements may therefore be a surrogate marker for DD in hypertensive subjects.

Profile and Determinants of Neurocognitive Dysfunction in a Sample of Adult Nigerians With Heart Failure.

Background:Heart failure (HF) in Africans is peculiar because subjects are younger than whites and have lower socioeconomic and educational level in addition to the high prevalence of hypertension-related etiology and increased mortality. Whereas cognitive dysfunction have been demonstrated among whites with HF, the prevalence and pattern of cognitive dysfunction among sub-Saharan African patients with HF have not been evaluated against this background. Objectives:The aim of this study is to determine the 1-year prevalence and the factors contributing to cognitive dysfunction in a cohort of Nigerian patients with HF. Materials and Methods:In this cross-sectional case-control study, cognitive performance was evaluated in 111 consecutive individuals (60 HF patients and 51 controls matched for age, gender, and level of education) using the Community Screening Interview for Dementia, Word List Learning Delayed Recall, Boston Naming Test, and Modified Token Test. Other clinical and disease-specific variables were collated and correlated with cognitive performance. Results:The mean total Community Screening Interview for Dementia, Word List Learning Delayed Recall, Boston Naming Test, and Modified Token Test scores were significantly lower among HF patients (P = < .001). The prevalence of global cognitive dysfunction was 90.0% in HF and 5.9% among controls (odds ratio, 15.3; 95% confidence interval, 5.08–46.01). Elevated systolic blood pressure, increased comorbidity index, and wide pulse pressure were significantly associated with poorer performance on at least 1 neuropsychological test. Using a multivariate linear regression analysis, pulse pressure retained its significance (P = .029; 95% confidence interval, −0.117 to −0.007) as the most important predictor of cognitive dysfunction in the cohort of HF patients. Conclusion:Cognitive dysfunction is prevalent among this sample of Nigerians with HF. Regular cognitive screening is therefore advocated among this high-risk group. Controlling comorbidities as well as blood pressure may improve cognitive performance among patients with HF.

Prevalence and determinants of electrocardiographic abnormalities among staff of a tertiary institution in Southwest, Nigeria

Background: Electrocardiogram (ECG) is a simple bedside investigation that can identify cardiovascular abnormalities among apparently normal individuals. Objectives: To assess the prevalence and determinants of ECG abnormalities among staff of a tertiary institution (Ladoke Akintola University of Technology [LAUTECH]) in Southwest, Nigeria. Materials and Methods: A total of 202 participants (47% men, 53% female) randomly selected staff of LAUTECH university was subjected to comprehensive medical examination, including body mass index, fasting lipid profile, ECG among others. ECG abnormalities were identified and related to potential determinants. Results: The main ECG aberrations (prevalence %) are: left ventricular hypertrophy (LVH) (39.6%), QTc prolongation (20.3%), sinus tachycardia (7.9%), right ventricular hypertrophy (4.7%), conduction defects (6.4%), ectopic beats (3.9%). T-wave abnormalities (2.1%), arrhythmia (1.0%), ischemic heart disease (1.5%), Wolf-Parkinson-White pattern (1.0%) and 82.3% had normal axis while the remaining had some form of abnormal axis. Blood pressure variables were consistently associated with all ECG abnormalities. Conclusion: ECG aberrations in this apparently normal population were dominated by conduction defects and LVH. This study emphasizes the necessity of regular cardiovascular assessment in apparently normal population in order to identify cardiovascular disease in its early stage and implement appropriate therapeutic and preventive strategies.