Left ventricular geometry in untreated hypertensive patients presenting to a tertiary hospital in North Eastern Nigeria

Abstract

Background: With the increasing prevalence of hypertension, an increase in burden of diseases due to hypertensive changes in left ventricular (LV) geometry is eminent. Assessment of LV geometric pattern identifies hypertensive patients with increased risk of cardiovascular mortality and morbidity.

Methods: This was a cross-sectional study in which LV geometric patterns were evaluated in treatment naïve adult hypertensive patients. Blood pressure (BP) and anthropometric parameters were determined using standard protocols. Echocardiographic LV indices were obtained using American Society of Echocardiography (ASE) guidelines. Spot urine sample was collected for determination of urine albumin-creatinine ratio (ACR). Data was analyzed using SPSS Version 16 for windows and a p value of =0.05 considered significant.

Results: One hundred and thirty six patients (made of 66 males and 70 females) with a mean of 44.82 (10.51) years were studied. Abnormal LV geometry was observed in 80.88%. Concentric remodeling was seen in 44.12%. Concentric left ventricular hypertrophy (LVH) was present in 24.26% while 12.50% had eccentric LVH, giving an overall prevalence of 36.77% for LVH. LVH is commoner among the obese and those with stage II hypertension. Ejection fraction (EF) and fractional shortening (FS) were significantly lower in eccentric hypertrophy but did not differ in other geometric patterns. Systolic blood pressure, pulse rate and ACR independently predicts LVH.

Conclusions: There is a high prevalence of abnormal LV geometry and LVH in newly presenting untreated hypertensive patients. Eccentric hypertrophy is associated with lower systolic function compared to other geometric patterns.